Format

Send to

Choose Destination
Sleep Breath. 2018 Dec;22(4):1125-1135. doi: 10.1007/s11325-018-1646-2. Epub 2018 Mar 5.

Assessment of atherosclerotic plaque activity in patients with sleep apnea using hybrid positron emission tomography/magnetic resonance imaging (PET/MRI): a feasibility study.

Author information

1
Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1232, New York, NY, 10029, USA.
2
Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
3
Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
4
Division of Radiopharmaceutical Sciences, Department of Radiology, Weill Cornell Medical College, New York, NY, USA.
5
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
6
Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
7
Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1232, New York, NY, 10029, USA. Neomi.shah@mssm.edu.
8
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA. Neomi.shah@mssm.edu.

Abstract

PURPOSE:

Evidence suggests that the inflammatory state of an atherosclerotic plaque is important in predicting future risk of plaque rupture. This study aims to investigate the feasibility of measuring plaque inflammation in patients with obstructive sleep apnea (OSA) utilizing advanced vascular imaging - hybrid positron-emission tomography/magnetic resonance imaging (PET/MRI) with fluorodeoxyglucose (FDG) tracer-before and after continuous positive airway pressure (CPAP).

METHODS:

Patients with newly diagnosed moderate to severe OSA underwent baseline PET/MRI for assessment of vascular inflammation of the carotid arteries and thoracic aorta prior to initiation of CPAP. Those adherent to CPAP returned for repeat imaging after 3-6 months of CPAP use. Atherosclerotic plaque activity, as measured by arterial wall FDG uptake, was calculated using target-to-background ratios (TBR) before and after CPAP.

RESULTS:

Five patients were recruited as part of a focused project. Mean age was 52 years (80% male), and mean apnea-hypopnea index (AHI) was 33. Three patients were objectively adherent with CPAP. In the pre-CPAP phase, all patients had focal FDG uptake in the carotid arteries and aorta. After CPAP, there was an average reduction in TBR of 5.5% (TBRmean) and 6.2% (TBRmax) in carotid and aortic plaque inflammation, similar in magnitude to the reduction observed with statin therapy alone in non-OSA patients (previously reported by others).

CONCLUSIONS:

We demonstrate the feasibility of using hybrid PET/MRI to assess atherosclerotic plaque inflammation in patients with OSA before and after CPAP. Use of the vascular PET/MRI platform in patients with OSA may provide better insight into the role of OSA and its treatment in reducing atherosclerotic inflammation.

KEYWORDS:

Atherosclerosis; CPAP; Inflammation; Obstructive sleep apnea; PET/MRI; Plaque

PMID:
29508121
PMCID:
PMC6425735
DOI:
10.1007/s11325-018-1646-2
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center