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Coronary artery calcium burden, carotid atherosclerotic plaque burden, and myocardial blood flow in patients with end-stage renal disease: A non-invasive imaging study combining PET/CT and 3D ultrasound

BACKGROUND: Imaging-based measures of atherosclerosis such as coronary artery calcium score (CACS) and coronary flow reserve (CFR) as well as carotid atherosclerotic plaque burden (cPB) are predictors of cardiovascular events in the general population. The objective of this study was to correlate CA...

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Autores principales: Wenning, Christian, Vrachimis, Alexis, Pavenstädt, Hermann-Joseph, Reuter, Stefan, Schäfers, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709813/
https://www.ncbi.nlm.nih.gov/pubmed/32140994
http://dx.doi.org/10.1007/s12350-020-02080-w
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author Wenning, Christian
Vrachimis, Alexis
Pavenstädt, Hermann-Joseph
Reuter, Stefan
Schäfers, Michael
author_facet Wenning, Christian
Vrachimis, Alexis
Pavenstädt, Hermann-Joseph
Reuter, Stefan
Schäfers, Michael
author_sort Wenning, Christian
collection PubMed
description BACKGROUND: Imaging-based measures of atherosclerosis such as coronary artery calcium score (CACS) and coronary flow reserve (CFR) as well as carotid atherosclerotic plaque burden (cPB) are predictors of cardiovascular events in the general population. The objective of this study was to correlate CACS, cPB, myocardial blood flow (MBF), and CFR in patients with end-stage renal disease (ESRD). METHODS AND RESULTS: 39 patients (mean age 53 ± 12 years) with ESRD prior to kidney transplantation were enrolled. MBF and CFR were quantified at baseline and under hyperemia by (13)N-NH(3)-PET/CT. CACS was calculated from low-dose CT scans acquired for PET attenuation correction. cPB was assessed by 3D ultrasound. Uni- and multivariate regression analyses between these and clinical parameters were performed. Median follow-up time for clinical events was 4.4 years. Kaplan–Meier survival estimates with log-rank test were performed with regards to cardiovascular (CV) events and death of any cause. CACS and cPB were associated in ESRD patients (r = 0.48; p ≤ 0.01). While cPB correlated with age (r = 0.43; p < 0.01), CACS did not. MBF(stress) was negatively associated with age (r = 0.44; p < 0.01) and time on dialysis (r = 0.42; p < 0.01). There were negative correlations between MBF(stress) and CACS (r = − 0.62; p < 0.001) and between MBF(stress) and cPB (r = − 0.43; p < 0.01). Age and CACS were the strongest predictors for MBF(stress). CFR was impaired (< 2.0) in eight patients who also presented with higher cPB and higher CACS compared to those with a CFR > 2.0 (p = 0.06 and p = 0.4). In contrast to MBF(stress), there was neither a significant correlation between CFR and CACS (r = − 0.2; p = 0.91) nor between CFR and cPB (r = − 0.1; p = 0.55). CV event-free survival was associated with reduced CFR and MBF(stress) (p = 0.001 and p < 0.001) but not with cPB or CACS. CONCLUSIONS: CACS, cPB, and MBF(stress) are associated in patients with ESRD. Atherosclerosis is earlier detected by MBF(stress) than by CFR. CV event-free survival is associated with impaired CFR and MBF(stress). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12350-020-02080-w) contains supplementary material, which is available to authorized users.
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spelling pubmed-87098132022-01-10 Coronary artery calcium burden, carotid atherosclerotic plaque burden, and myocardial blood flow in patients with end-stage renal disease: A non-invasive imaging study combining PET/CT and 3D ultrasound Wenning, Christian Vrachimis, Alexis Pavenstädt, Hermann-Joseph Reuter, Stefan Schäfers, Michael J Nucl Cardiol Original Article BACKGROUND: Imaging-based measures of atherosclerosis such as coronary artery calcium score (CACS) and coronary flow reserve (CFR) as well as carotid atherosclerotic plaque burden (cPB) are predictors of cardiovascular events in the general population. The objective of this study was to correlate CACS, cPB, myocardial blood flow (MBF), and CFR in patients with end-stage renal disease (ESRD). METHODS AND RESULTS: 39 patients (mean age 53 ± 12 years) with ESRD prior to kidney transplantation were enrolled. MBF and CFR were quantified at baseline and under hyperemia by (13)N-NH(3)-PET/CT. CACS was calculated from low-dose CT scans acquired for PET attenuation correction. cPB was assessed by 3D ultrasound. Uni- and multivariate regression analyses between these and clinical parameters were performed. Median follow-up time for clinical events was 4.4 years. Kaplan–Meier survival estimates with log-rank test were performed with regards to cardiovascular (CV) events and death of any cause. CACS and cPB were associated in ESRD patients (r = 0.48; p ≤ 0.01). While cPB correlated with age (r = 0.43; p < 0.01), CACS did not. MBF(stress) was negatively associated with age (r = 0.44; p < 0.01) and time on dialysis (r = 0.42; p < 0.01). There were negative correlations between MBF(stress) and CACS (r = − 0.62; p < 0.001) and between MBF(stress) and cPB (r = − 0.43; p < 0.01). Age and CACS were the strongest predictors for MBF(stress). CFR was impaired (< 2.0) in eight patients who also presented with higher cPB and higher CACS compared to those with a CFR > 2.0 (p = 0.06 and p = 0.4). In contrast to MBF(stress), there was neither a significant correlation between CFR and CACS (r = − 0.2; p = 0.91) nor between CFR and cPB (r = − 0.1; p = 0.55). CV event-free survival was associated with reduced CFR and MBF(stress) (p = 0.001 and p < 0.001) but not with cPB or CACS. CONCLUSIONS: CACS, cPB, and MBF(stress) are associated in patients with ESRD. Atherosclerosis is earlier detected by MBF(stress) than by CFR. CV event-free survival is associated with impaired CFR and MBF(stress). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12350-020-02080-w) contains supplementary material, which is available to authorized users. Springer International Publishing 2020-03-05 2021 /pmc/articles/PMC8709813/ /pubmed/32140994 http://dx.doi.org/10.1007/s12350-020-02080-w Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Wenning, Christian
Vrachimis, Alexis
Pavenstädt, Hermann-Joseph
Reuter, Stefan
Schäfers, Michael
Coronary artery calcium burden, carotid atherosclerotic plaque burden, and myocardial blood flow in patients with end-stage renal disease: A non-invasive imaging study combining PET/CT and 3D ultrasound
title Coronary artery calcium burden, carotid atherosclerotic plaque burden, and myocardial blood flow in patients with end-stage renal disease: A non-invasive imaging study combining PET/CT and 3D ultrasound
title_full Coronary artery calcium burden, carotid atherosclerotic plaque burden, and myocardial blood flow in patients with end-stage renal disease: A non-invasive imaging study combining PET/CT and 3D ultrasound
title_fullStr Coronary artery calcium burden, carotid atherosclerotic plaque burden, and myocardial blood flow in patients with end-stage renal disease: A non-invasive imaging study combining PET/CT and 3D ultrasound
title_full_unstemmed Coronary artery calcium burden, carotid atherosclerotic plaque burden, and myocardial blood flow in patients with end-stage renal disease: A non-invasive imaging study combining PET/CT and 3D ultrasound
title_short Coronary artery calcium burden, carotid atherosclerotic plaque burden, and myocardial blood flow in patients with end-stage renal disease: A non-invasive imaging study combining PET/CT and 3D ultrasound
title_sort coronary artery calcium burden, carotid atherosclerotic plaque burden, and myocardial blood flow in patients with end-stage renal disease: a non-invasive imaging study combining pet/ct and 3d ultrasound
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709813/
https://www.ncbi.nlm.nih.gov/pubmed/32140994
http://dx.doi.org/10.1007/s12350-020-02080-w
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