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Int J Cardiovasc Imaging. 2015 Dec;31(8):1677-85. doi: 10.1007/s10554-015-0725-8. Epub 2015 Jul 29.

Prognostic value of (18)F-fluorodeoxyglucose PET-CT imaging in acute aortic syndromes: comparison with serological biomarkers of inflammation.

Author information

1
Department of Cardiology, West-German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany.
2
Cardiology Clinic, "Ospedale di Circolo" Varese, University of Insubria, Varese, Italy.
3
Department of Cardiology, West-German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany. raimund.erbel@uk-essen.de.
4
West-German Heart and Vascular Center Essen, University Clinic of Cardiology, Hufelandstrasse 55, 45147, Essen, Germany. raimund.erbel@uk-essen.de.
5
Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
6
Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany.
7
Department of Radiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
8
Cardioangiological Center Bethanien, Frankfurt am Main, Germany.
9
"Heart" Department, University Hospital, Salerno, Italy.

Abstract

Aim of this study was to investigate the relationship between (18)F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) findings and serological biomarkers of inflammation and the related discriminant value of unfavourable outcome during follow-up in patients with acute aortic syndromes (AAS). Sixty patients with AAS underwent PET-CT imaging during the hospitalization along with measurement of C-reactive protein (CRP) and D-dimer (D-d) serum levels. An aortic wall pathology was considered PET-positive by a maximum standardized uptake value (SUVmax) >2.5. A combined endpoint of major adverse events (MAE) including aorta-related mortality, disease progression and re-intervention was used to compare patient subgroups at 3-year follow-up. PET-CT detected an elevated FDG uptake within the aortic wall in 25 (41.7%) patients. PET-positive patients showed significantly increased CRP levels (10.0 ± 6.6 mg/dL) and tended to higher D-d levels (5.1 ± 3.9 mg/L), compared to PET-negative patients (5.8 ± 6.1 mg/dL and 3.1 ± 4.7 mg/L respectively; P = 0.048, P = 0.19). At 3-year follow-up, all-cause mortality and MAE were higher in the PET-positive (21.7 and 47.8% respectively) than PET-negative group (0.0 and 13.3% respectively; P = 0.012, P = 0.006). On Kaplan-Meier analysis, PET-positive patients were at higher risk of MAE (P = 0.031). This tendency was more evident by combining PET results with D-d levels at a cutoff value of 4.8 mg/L (P < 0.001). In patients with AAS, a pathological glucose uptake in aortic wall lesions by PET-CT was associated with high CRP levels and increased mortality and MAE at 3-year follow-up. The combination of PET results with D-d levels had the best discriminant value of MAE.

KEYWORDS:

Acute aortic syndromes; C-reactive protein; D-dimer; PET-CT

PMID:
26220267
DOI:
10.1007/s10554-015-0725-8
[Indexed for MEDLINE]

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