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Chaptal MC, Maraninchi M, Musto G, Mancini J, Chtioui H, Dupont-Roussel J, Marlinge M, Fromonot J, Lalevee N, Mourre F, Beliard S, Guieu R, Valero R, Mottola G. Low Density Lipoprotein Cholesterol Decreases the Expression of Adenosine A 2A Receptor and Lipid Rafts-Protein Flotillin-1: Insights on Cardiovascular Risk of Hypercholesterolemia. Cells 2024; 13:488. [PMID: 38534331 DOI: 10.3390/cells13060488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/26/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
High blood levels of low-density lipoprotein (LDL)-cholesterol (LDL-C) are associated with atherosclerosis, mainly by promoting foam cell accumulation in vessels. As cholesterol is an essential component of cell plasma membranes and a regulator of several signaling pathways, LDL-C excess may have wider cardiovascular toxicity. We examined, in untreated hypercholesterolemia (HC) patients, selected regardless of the cause of LDL-C accumulation, and in healthy participants (HP), the expression of the adenosine A2A receptor (A2AR), an anti-inflammatory and vasodilatory protein with cholesterol-dependent modulation, and Flotillin-1, protein marker of cholesterol-enriched plasma membrane domains. Blood cardiovascular risk and inflammatory biomarkers were measured. A2AR and Flotillin-1 expression in peripheral blood mononuclear cells (PBMC) was lower in patients compared to HP and negatively correlated to LDL-C blood levels. No other differences were observed between the two groups apart from transferrin and ferritin concentrations. A2AR and Flotillin-1 proteins levels were positively correlated in the whole study population. Incubation of HP PBMCs with LDL-C caused a similar reduction in A2AR and Flotillin-1 expression. We suggest that LDL-C affects A2AR expression by impacting cholesterol-enriched membrane microdomains. Our results provide new insights into the molecular mechanisms underlying cholesterol toxicity, and may have important clinical implication for assessment and treatment of cardiovascular risk in HC.
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Affiliation(s)
- Marie-Charlotte Chaptal
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
| | - Marie Maraninchi
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
| | - Giorgia Musto
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
| | - Julien Mancini
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
| | - Hedi Chtioui
- Department of Nutrition, Metabolic Diseases and Endocrinology, Hospital La Conception, APHM, 13005 Marseille, France
| | - Janine Dupont-Roussel
- Department of Nutrition, Metabolic Diseases and Endocrinology, Hospital La Conception, APHM, 13005 Marseille, France
| | - Marion Marlinge
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Secteur de Biochimie, Biogenopôle, Hôpital de la Timone, APHM, 13005 Marseille, France
| | - Julien Fromonot
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Secteur de Biochimie, Biogenopôle, Hôpital de la Timone, APHM, 13005 Marseille, France
| | - Nathalie Lalevee
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
| | - Florian Mourre
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Department of Nutrition, Metabolic Diseases and Endocrinology, Hospital La Conception, APHM, 13005 Marseille, France
| | - Sophie Beliard
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Department of Nutrition, Metabolic Diseases and Endocrinology, Hospital La Conception, APHM, 13005 Marseille, France
| | - Régis Guieu
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Secteur de Biochimie, Biogenopôle, Hôpital de la Timone, APHM, 13005 Marseille, France
| | - René Valero
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Department of Nutrition, Metabolic Diseases and Endocrinology, Hospital La Conception, APHM, 13005 Marseille, France
| | - Giovanna Mottola
- Centre de Recherche en Cardiovasculaire et Nutrition (C2VN), Aix-Marseille Université, INSERM 1263, INRAE 1260, 13005 Marseille, France
- Secteur de Biochimie, Biogenopôle, Hôpital de la Timone, APHM, 13005 Marseille, France
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Vairo D, Giacobbe C, Guiol C, Chaptal MC, Di Taranto MD, Bruzzese L, Ruf J, Guieu R, Fortunato G, Fenouillet E, Mottola G. Correlation between low adenosine A 2A receptor expression and hypercholesterolemia: A new component of the cardiovascular risk? Biochim Biophys Acta Mol Cell Biol Lipids 2020; 1866:158850. [PMID: 33161070 DOI: 10.1016/j.bbalip.2020.158850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/25/2020] [Accepted: 10/26/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Donato Vairo
- Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France
| | - Carola Giacobbe
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Naples, Italy; CEINGE S.C.a r.l, Biotecnologie Avanzate, Naples, Italy
| | - Claire Guiol
- Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France
| | | | - Maria Donata Di Taranto
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Naples, Italy; CEINGE S.C.a r.l, Biotecnologie Avanzate, Naples, Italy
| | - Laurie Bruzzese
- Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France
| | - Jean Ruf
- Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France
| | - Régis Guieu
- Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France; Laboratory of Biochemistry, Hôpital de La Timone, Marseille, France
| | - Giuliana Fortunato
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Naples, Italy; CEINGE S.C.a r.l, Biotecnologie Avanzate, Naples, Italy
| | - Emmanuel Fenouillet
- Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France; INSB, CNRS, Paris, France
| | - Giovanna Mottola
- Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France; Laboratory of Biochemistry, Hôpital de La Timone, Marseille, France.
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3
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Kim SC, Di Carli MF, Garg RK, Vanni K, Wang P, Wohlfahrt A, Yu Z, Lu F, Campos A, Bibbo CF, Smith S, Solomon DH. Asymptomatic hyperuricemia and coronary flow reserve in patients with metabolic syndrome. BMC Rheumatol 2018; 2:17. [PMID: 30886968 PMCID: PMC6390615 DOI: 10.1186/s41927-018-0027-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 06/11/2018] [Indexed: 12/22/2022] Open
Abstract
Background Patients with metabolic syndrome (MetS) are at increased risk of asymptomatic hyperuricemia (i.e., elevated serum uric acid (SUA) level without gout) and cardiovascular disease. We conducted a cross-sectional study to examine associations between SUA levels and coronary flow reserve and urate deposits in carotid arteries in patients with asymptomatic hyperuricemia and MetS. Methods Adults aged ≥40 years with MetS and SUA levels ≥6.5 mg/dl, but no gout, were eligible. Using a stress myocardial perfusion positron emission tomography (PET), we assessed myocardial blood flow (MBF) at rest and stress and calculated coronary flow reserve (CFR). CFR < 2.0 is considered abnormal and associated with increased cardiovascular risk. We also measured insulin resistance by homeostatic model assessment (HOMA-IR) method and urate deposits using dual-energy CT (DECT) of the neck for the carotid arteries. Results Forty-four patients with the median age of 63.5 years underwent a blood test, cardiac PET and neck DECT scans. Median (IQR) SUA was 7.8 (7.1-8.4) mg/dL. The median (IQR) CFR was abnormally low at 1.9 (1.7-2.4) and the median (IQR) stress MBF was 1.7 (1.3-2.2) ml/min/g. None had urate deposits in the carotid arteries detected by DECT. In multivariable linear regression analyses, SUA had no association with CFR (β = - 0.12, p = 0.78) or stress MBF (β = - 0.52, p = 0.28). Among non-diabetic patients (n = 25), SUA was not associated with HOMA-IR (β = 2.08, p = 0.10). Conclusions Among MetS patients with asymptomatic hyperuricemia, we found no relationship between SUA and CFR, stress MBF, and insulin resistance. No patients had any DECT detectable subclinical urate deposition in the carotid arteries.
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Affiliation(s)
- Seoyoung C Kim
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, Suite 3030, Boston, MA 02120 USA.,Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
| | - Marcelo F Di Carli
- Division of Nuclear Medicine, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA.,Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
| | - Rajesh K Garg
- Division of Endocrinology, Diabetes & Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
| | - Kathleen Vanni
- Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
| | - Penny Wang
- Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
| | - Alyssa Wohlfahrt
- Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
| | - Zhi Yu
- Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
| | - Fengxin Lu
- Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
| | - Anarosa Campos
- Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
| | - Courtney F Bibbo
- Division of Nuclear Medicine, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
| | - Stacy Smith
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
| | - Daniel H Solomon
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, Suite 3030, Boston, MA 02120 USA.,Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA
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Leiva A, Guzmán-Gutiérrez E, Contreras-Duarte S, Fuenzalida B, Cantin C, Carvajal L, Salsoso R, Gutiérrez J, Pardo F, Sobrevia L. Adenosine receptors: Modulators of lipid availability that are controlled by lipid levels. Mol Aspects Med 2017; 55:26-44. [DOI: 10.1016/j.mam.2017.01.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 01/25/2017] [Accepted: 01/25/2017] [Indexed: 12/20/2022]
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5
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Rosas EA, Castro JB, Anaya DAV, del Moral Díez JJ, Bueso JSM, Niño AJ, Germán AGA, Rodríguez EDM, Sánchez CAG, González AM. Metabolic Syndrome and Diabetes Mellitus in Mexico: the Role of PET/CT in Endothelial Dysfunction and Cardiovascular Disease Detection. CURRENT CARDIOVASCULAR IMAGING REPORTS 2017. [DOI: 10.1007/s12410-017-9404-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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6
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An Increasing Mexican Population with Metabolic Syndrome-Emerging Role of Hybrid SPECT/CT and PET/CT in Cardiovascular Disease Detection. CURRENT CARDIOVASCULAR IMAGING REPORTS 2015. [DOI: 10.1007/s12410-015-9348-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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7
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Alexanderson-Rosas E, Berríos-Bárcenas E, Meave A, de la Fuente-Mancera JC, Oropeza-Aguilar M, Barrero-Mier A, Monroy-González ADG, Cruz-Mendoza R, Guinto-Nishimura GY. Novel contributions of multimodality imaging in hypertension: A narrative review. World J Hypertens 2015; 5:28-40. [DOI: 10.5494/wjh.v5.i2.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 12/05/2014] [Accepted: 03/05/2015] [Indexed: 02/06/2023] Open
Abstract
Hypertension is currently one of the most prevalent illnesses worldwide, and is the second most common cause of heart failure, only behind ischemic cardiomyopathy. The development of novel multimodality imaging techniques in recent years has broadened the diagnostic methods, risk stratification and monitoring of treatment of cardiovascular diseases available for clinicians. Cardiovascular magnetic resonance (CMR) has a great capacity to evaluate cardiac dimensions and ventricular function, is extremely useful in ruling-out ischemic cardiomyopathy, the evaluation of the vascular system, in making the differential diagnosis for resistant hypertension and risk stratification for hypertensive cardiomyopathy and constitutes today, the method of choice to evaluate left ventricular systolic function. Computed tomography (CT) is the method of choice for the evaluation of vascular anatomy, including coronary arteries, and is also able to provide both functional and structural information. Finally, nuclear cardiology studies have been traditionally used to evaluate myocardial ischemia, along with offering the capacity to evaluate ventricular, endothelial and cardiac innervation function; information that is key in directing the treatment of the patient. In this narrative review, the most recent contributions of multimodality imaging to the patient with hypertension (CMR, CT and nuclear cardiology) will be reviewed.
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Ohira H, Dowsley T, Dwivedi G, deKemp RA, Chow BJ, Ruddy TD, Davies RA, DaSilva J, Beanlands RSB, Hessian R. Quantification of myocardial blood flow using PET to improve the management of patients with stable ischemic coronary artery disease. Future Cardiol 2014; 10:611-31. [DOI: 10.2217/fca.14.44] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
ABSTRACT Cardiac PET has been evolving over the past 30 years. Today, it is accepted as a valuable imaging modality for the noninvasive assessment of coronary artery disease. PET has demonstrated superior diagnostic accuracy for the detection of coronary artery disease compared with single-photon emission computed tomography, and also has a well-established prognostic value. The routine addition of absolute quantification of myocardial blood flow increases the diagnostic accuracy for three-vessel disease and provides incremental functional and prognostic information. Moreover, the characterization of the vasodilator capacity of the coronary circulation may guide proper decision-making and monitor the effects of lifestyle changes, exercise training, risk factor modification or medical therapy for improving regional and global myocardial blood flow. This type of image-guided approach to individualized patient therapy is now attainable with the routine use of cardiac PET flow reserve imaging.
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Affiliation(s)
- Hiroshi Ohira
- MFI program, National Cardiac PET Center, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Taylor Dowsley
- MFI program, National Cardiac PET Center, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Girish Dwivedi
- MFI program, National Cardiac PET Center, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Robert A deKemp
- MFI program, National Cardiac PET Center, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Benjamin J Chow
- MFI program, National Cardiac PET Center, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Terrence D Ruddy
- MFI program, National Cardiac PET Center, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Ross A Davies
- MFI program, National Cardiac PET Center, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Jean DaSilva
- MFI program, National Cardiac PET Center, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Rob SB Beanlands
- MFI program, National Cardiac PET Center, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Renee Hessian
- MFI program, National Cardiac PET Center, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
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McArdle B, Dowsley TF, Cocker MS, Ohira H, deKemp RA, DaSilva J, Ruddy TD, Chow BJ, Beanlands RS. Cardiac PET: metabolic and functional imaging of the myocardium. Semin Nucl Med 2014; 43:434-48. [PMID: 24094711 DOI: 10.1053/j.semnuclmed.2013.06.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cardiac PET has evolved over the past 30 years to gain wider acceptance as a valuable modality for a variety of cardiac conditions. Wider availability of scanners as well as changes in reimbursement policies in more recent years has further increased its use. Moreover, with the emergence of novel radionuclides as well as further advances in scanner technology, the use of cardiac PET can be expected to increase further in both clinical practice and the research arena. PET has demonstrated superior diagnostic accuracy for the diagnosis of coronary artery disease in comparison with single-photon emission tomography while it provides robust prognostic value. The addition of absolute flow quantification increases sensitivity for 3-vessel disease as well as providing incremental functional and prognostic information. Metabolic imaging using (18)F-fluorodeoxyglucose can be used to guide revascularization in the setting of heart failure and also to detect active inflammation in conditions such as cardiac sarcoidosis and within atherosclerotic plaque, improving our understanding of the processes that underlie these conditions. However, although the pace of new developments is rapid, there remains a gap in evidence for many of these advances and further studies are required.
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Affiliation(s)
- Brian McArdle
- National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Taqueti VR, Ridker PM. Inflammation, coronary flow reserve, and microvascular dysfunction: moving beyond cardiac syndrome X. JACC Cardiovasc Imaging 2014; 6:668-71. [PMID: 23764095 DOI: 10.1016/j.jcmg.2013.02.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 02/21/2013] [Indexed: 10/26/2022]
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11
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Comley RA, Kallend D. Imaging in the cardiovascular and metabolic disease area. Drug Discov Today 2013; 18:185-92. [DOI: 10.1016/j.drudis.2012.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 09/14/2012] [Accepted: 09/24/2012] [Indexed: 01/09/2023]
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12
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Murthy VL, Di Carli MF. Non-invasive quantification of coronary vascular dysfunction for diagnosis and management of coronary artery disease. J Nucl Cardiol 2012; 19:1060-72; quiz 1075. [PMID: 22714648 PMCID: PMC6526508 DOI: 10.1007/s12350-012-9590-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Venkatesh L. Murthy
- Noninvasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women’s Hospital, Boston, MA
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Marcelo F. Di Carli
- Noninvasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women’s Hospital, Boston, MA
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women’s Hospital, Boston, MA
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13
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Mc Ardle B, Ziadi MC, Ruddy TD, Beanlands RS. Nuclear perfusion imaging for functional evaluation of patients with known or suspected coronary artery disease: the future is now. Future Cardiol 2012; 8:603-22. [DOI: 10.2217/fca.12.40] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Nuclear imaging, with both single-photon emission computed tomography and PET, has a well-established role in the assessment of patients with known or suspected coronary artery disease. There is a large body of evidence regarding the diagnostic accuracy and prognostic value of these modalities, however, they continue to evolve rapidly with advances in camera and tracer technology, as well as changes in imaging protocols to increase lab efficiency, improve image quality and to decrease radiation exposure to patients. Nuclear imaging also provides insights into atherogenesis at a molecular level and can be combined with other imaging modalities, providing both functional and structural data and complimentary information on the presence of coronary disease and its functional implications.
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Affiliation(s)
- Brian Mc Ardle
- The National Cardiac PET Centre, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Maria Cecilia Ziadi
- The National Cardiac PET Centre, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Terrence D Ruddy
- The National Cardiac PET Centre, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Rob S Beanlands
- The National Cardiac PET Centre, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
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14
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Traub-Weidinger T, Graf S, Beheshti M, Ofluoglu S, Zettinig G, Khorsand A, Nekolla SG, Kletter K, Dudczak R, Pirich C. Coronary vasoreactivity in subjects with thyroid autoimmunity and subclinical hypothyroidism before and after supplementation with thyroxine. Thyroid 2012; 22:245-51. [PMID: 22233129 DOI: 10.1089/thy.2011.0183] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The association of subclinical hypothyroidism (SCH) with increased risk for cardiovascular disease is still controversial. This study aimed to examine coronary vascular reactivity by positron emission tomography (PET) in asymptomatic patients with SCH before and after levothyroxine (LT4) supplementation. METHODS Ten patients (7 women and 3 men; mean age 43±15 years) with untreated autoimmune SCH, defined by elevated levels of thyroid-stimulating hormone (mean TSH: 16.9±11.3 μU/mL), normal levels of free thyroxine (0.9±0.1 μg/mL), free triiodothyronine (3.2±0.4 pg/mL), and positive thyroid peroxidase antibodies were studied. Eight euthyroid subjects with similar low-risk cardiovascular risk profile served as controls. Myocardial blood flow (MBF) and coronary flow reserve (CFR) were quantitatively assessed with rest/stress N-13 ammonia PET at baseline and after 6 months of LT4 replacement therapy (given only to patients). RESULTS At baseline, stress MBF and CFR corrected (c) for rate pressure product (RPP) and myocardial vascular resistance (MVR) during stress were significantly reduced in SCH compared with controls (stress MBF: 2.87±0.93 vs. 4.79±1.16 mL/g/min, p=0.003; CFR: 2.6±0.73 vs. 4.66±1.38, p=0.004; MVR: 40.14±18.76 vs. 20.47±6.24 mmHg/mL/min, p=0.02). Supplementation therapy with LT4 normalized TSH in all subjects and was associated with an increase in CFR (2.6±0.73 vs. 3.81±1.19, p=0.003) and with a tendency toward a decrease in MVR. Differences in CFR between SCH and controls were also seen after correction of resting MBF for RPP. CONCLUSIONS In asymptomatic subjects with SCH due to thyroid autoimmunity, coronary microvascular function is impaired and improves after supplementation with LT4. This may partially explain the increased cardiovascular risk attributed to SCH.
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15
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Schwartz RG. Early insights of cardiac risk and treatment response with quantitative PET monitoring of coronary-specific endothelial dysfunction and myocardial perfusion reserve. J Nucl Cardiol 2010; 17:985-9. [PMID: 20963538 DOI: 10.1007/s12350-010-9295-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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