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Nammas W, Paunonen C, Teuho J, Luoto P, Kakela M, Hietanen A, Viljanen T, Li XG, Roivainen A, Knuuti J, Saraste A. Molecular imaging of alphaVbeta3 integrin for evaluation of myocardial injury after acute myocardial infarction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
68Ga-NODAGA-RGD is a positron emission tomography (PET) tracer targeting αvβ3 integrin that is upregulated during angiogenesis. αvβ3 integrin expression increases early after acute myocardial infarction (AMI), and has been proposed as a marker of myocardial repair.
Purpose
We prospectively evaluated the uptake of 68Ga-NODAGA-RGD and its association to left ventricular function after human AMI.
Methods
Thirty patients underwent PET at 7.7±3.8 days after primary percutaneous coronary intervention for ST-elevation AMI. Resting myocardial perfusion was evaluated using 15O-water PET followed by evaluation of 68Ga-NODAGA-RGD uptake 60–75 minutes after injection of 179 MBq of tracer. Left ventricular function was evaluated by transthoracic echocardiography on the day of PET, and at 6-month follow-up. The definition of the ischemic area at risk and remote myocardial segments was based on the culprit coronary arterial segments in invasive angiography. 68Ga-NODAGA-RGD images were co-registered with perfusion images and uptake was measured as the standardized uptake value in the segment with the highest uptake (SUVmax) in ischemic area at risk, and the mean standardized uptake value (SUVmean) in remote segments. In addition, we calculated 68Ga-NODAGA-RGD uptake corrected to the mean myocardial blood flow (MBF) in the area at risk (SUVmax/MBFmean) to account for reduced distribution of tracer in non-viable tissue.
Results
Mean age of patients was 64±9 years, and 90% were males. Uptake of 68Ga-NODAGA-RGD was low in the remote myocardium, but focally increased in the ischemic area at risk (Figure 1). SUVmax in the ischemic area at risk was higher than SUVmean of the remote myocardium (0.73±0.16 vs. 0.51±0.11, p<0.001). 68Ga-NODAGA-RGD SUVmax did not correlate with MBF in the area at risk. Univariable predictors of 68Ga-NODAGA-RGD SUVmax in the area at risk included peak Troponin T (p<0.001), peak pro-BNP (p<0.001), low global longitudinal strain (p=0.01), and low regional longitudinal strain in the area at risk (p=0.02). In multivariable analysis, peak pro-BNP independently predicted SUVmax in the area at risk (p<0.001). At follow-up, left ventricular ejection fraction increased by 1.6±6.9% and global longitudinal strain by 0.5±3.2%. In univariable analysis, SUVmax and SUVmax/MBFmean in the area at risk predicted improvement of global longitudinal strain at 6 months after AMI (p=0.04 and p<0.001, respectively).
Conclusion
68Ga-NODAGA-RGD uptake shows increased αvβ3 integrin expression in the ischemic area at risk early after reperfused AMI that is associated with the extent of myocardial injury, both regional and global systolic dysfunction, and increased left ventricular filling pressure. Increased 68Ga-NODAGA-RGD uptake in ischemic myocardium at risk predicts left ventricular function improvement at 6 months after AMI.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Academy of Finland, Finnish Foundation for Cardiovascular Research
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Affiliation(s)
- W Nammas
- Turku PET Centre , Turku , Finland
| | | | - J Teuho
- Turku PET Centre , Turku , Finland
| | - P Luoto
- Turku PET Centre , Turku , Finland
| | - M Kakela
- Turku PET Centre , Turku , Finland
| | | | | | - X G Li
- Turku PET Centre , Turku , Finland
| | | | - J Knuuti
- Turku PET Centre , Turku , Finland
| | - A Saraste
- Turku University Hospital, Heart Center , Turku , Finland
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Motiani P, Teuho J, Saari T, Virtanen KA, Honkala SM, Middelbeek RJ, Goodyear LJ, Eskola O, Andersson J, Löyttyniemi E, Hannukainen JC, Nuutila P. Exercise training alters lipoprotein particles independent of brown adipose tissue metabolic activity. Obes Sci Pract 2019; 5:258-272. [PMID: 31275600 PMCID: PMC6587322 DOI: 10.1002/osp4.330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction New strategies for weight loss and weight maintenance in humans are needed. Human brown adipose tissue (BAT) can stimulate energy expenditure and may be a potential therapeutic target for obesity and type 2 diabetes. However, whether exercise training is an efficient stimulus to activate and recruit BAT remains to be explored. This study aimed to evaluate whether regular exercise training affects cold‐stimulated BAT metabolism and, if so, whether this was associated with changes in plasma metabolites. Methods Healthy sedentary men (n = 11; aged 31 [SD 7] years; body mass index 23 [0.9] kg m−2; VO2 max 39 [7.6] mL min−1 kg−1) participated in a 6‐week exercise training intervention. Fasting BAT and neck muscle glucose uptake (GU) were measured using quantitative [18F]fluorodeoxyglucose positron emission tomography–magnetic resonance imaging three times: (1) before training at room temperature and (2) before and (3) after the training period during cold stimulation. Cervico‐thoracic BAT mass was measured using MRI signal fat fraction maps. Plasma metabolites were analysed using nuclear magnetic resonance spectroscopy. Results Cold exposure increased supraclavicular BAT GU by threefold (p < 0.001), energy expenditure by 59% (p < 0.001) and plasma fatty acids (p < 0.01). Exercise training had no effect on cold‐induced GU in BAT or neck muscles. Training increased aerobic capacity (p = 0.01) and decreased visceral fat (p = 0.02) and cervico‐thoracic BAT mass (p = 0.003). Additionally, training decreased very low‐density lipoprotein particle size (p = 0.04), triglycerides within chylomicrons (p = 0.04) and small high‐density lipoprotein (p = 0.04). Conclusions Although exercise training plays an important role for metabolic health, its beneficial effects on whole body metabolism through physiological adaptations seem to be independent of BAT activation in young, sedentary men.
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Affiliation(s)
- P Motiani
- Turku PET Centre University of Turku Turku Finland
| | - J Teuho
- Turku PET Centre University of Turku Turku Finland.,Department of Medical Physics Turku University Hospital Turku Finland
| | - T Saari
- Turku PET Centre University of Turku Turku Finland
| | - K A Virtanen
- Turku PET Centre University of Turku Turku Finland.,Institute of Public Health and Clinical Nutrition University of Eastern Finland (UEF) Kuopio Finland
| | - S M Honkala
- Turku PET Centre University of Turku Turku Finland
| | - R J Middelbeek
- Section on Integrative Physiology and Metabolism Joslin Diabetes Center, Harvard Medical School Boston MA USA.,Division of Endocrinology Diabetes and Metabolism, Beth Israel Deaconess Medical Center Boston MA USA
| | - L J Goodyear
- Section on Integrative Physiology and Metabolism Joslin Diabetes Center, Harvard Medical School Boston MA USA
| | - O Eskola
- Turku PET Centre University of Turku Turku Finland
| | - J Andersson
- Section of Radiology, Department of Surgical Sciences Uppsala University Uppsala Sweden
| | - E Löyttyniemi
- Department of Biostatistics University of Turku Turku Finland
| | | | - P Nuutila
- Turku PET Centre University of Turku Turku Finland.,Department of Endocrinology, Turku PET Centre Turku University Hospital Turku Finland
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Martikainen IK, Kemppainen N, Johansson J, Teuho J, Helin S, Liu Y, Helisalmi S, Soininen H, Parkkola R, Ngandu T, Kivipelto M, Rinne JO. Brain β-Amyloid and Atrophy in Individuals at Increased Risk of Cognitive Decline. AJNR Am J Neuroradiol 2018; 40:80-85. [PMID: 30545837 DOI: 10.3174/ajnr.a5891] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 10/12/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND PURPOSE The relationship between brain β-amyloid and regional atrophy is still incompletely understood in elderly individuals at risk of dementia. Here, we studied the associations between brain β-amyloid load and regional GM and WM volumes in older adults who were clinically evaluated as being at increased risk of cognitive decline based on cardiovascular risk factors. MATERIALS AND METHODS Forty subjects (63-81 years of age) were recruited as part of a larger study, the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability. Neuroimaging consisted of PET using 11C Pittsburgh compound-B and T1-weighted 3D MR imaging for the measurement of brain β-amyloid and GM and WM volumes, respectively. All subjects underwent clinical, genetic, and neuropsychological evaluations for the assessment of cognitive function and the identification of cardiovascular risk factors. RESULTS Sixteen subjects were visually evaluated as showing cortical β-amyloid (positive for β-amyloid). In the voxel-by-voxel analyses, no significant differences were found in GM and WM volumes between the samples positive and negative for β-amyloid. However, in the sample positive for β-amyloid, increases in 11C Pittsburgh compound-B uptake were associated with reductions in GM volume in the left prefrontal (P = .02) and right temporal lobes (P = .04). CONCLUSIONS Our results show a significant association between increases in brain β-amyloid and reductions in regional GM volume in individuals at increased risk of cognitive decline. This evidence is consistent with a model in which increases in β-amyloid incite neurodegeneration in memory systems before cognitive impairment manifests.
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Affiliation(s)
- I K Martikainen
- From the Department of Radiology (I.K.M.), Medical Imaging Center, Tampere University Hospital, Tampere, Finland
| | - N Kemppainen
- Division of Clinical Neurosciences (N.K., J.O.R.), Turku University Hospital, Turku, Finland.,Turku PET Centre (N.K., J.J., J.T., S. Helin, J.O.R.), University of Turku, Turku, Finland
| | - J Johansson
- Turku PET Centre (N.K., J.J., J.T., S. Helin, J.O.R.), University of Turku, Turku, Finland
| | - J Teuho
- Turku PET Centre (N.K., J.J., J.T., S. Helin, J.O.R.), University of Turku, Turku, Finland
| | - S Helin
- Turku PET Centre (N.K., J.J., J.T., S. Helin, J.O.R.), University of Turku, Turku, Finland
| | - Y Liu
- Department of Neurology (Y.L., S. Helisalmi, H.S., M.K.), University of Eastern Finland, Kuopio, Finland.,Neurocenter (Y.L., H.S., M.K.), Neurology, Kuopio University Hospital, Kuopio, Finland
| | - S Helisalmi
- Department of Neurology (Y.L., S. Helisalmi, H.S., M.K.), University of Eastern Finland, Kuopio, Finland
| | - H Soininen
- Department of Neurology (Y.L., S. Helisalmi, H.S., M.K.), University of Eastern Finland, Kuopio, Finland.,Neurocenter (Y.L., H.S., M.K.), Neurology, Kuopio University Hospital, Kuopio, Finland
| | - R Parkkola
- Department of Radiology (R.P.), University of Turku and Turku University Hospital, Turku, Finland
| | - T Ngandu
- Department of Public Health Solutions (T.N., M.K.), Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics (T.N., M.K.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - M Kivipelto
- Department of Neurology (Y.L., S. Helisalmi, H.S., M.K.), University of Eastern Finland, Kuopio, Finland.,Neurocenter (Y.L., H.S., M.K.), Neurology, Kuopio University Hospital, Kuopio, Finland.,Department of Public Health Solutions (T.N., M.K.), Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics (T.N., M.K.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - J O Rinne
- Division of Clinical Neurosciences (N.K., J.O.R.), Turku University Hospital, Turku, Finland.,Turku PET Centre (N.K., J.J., J.T., S. Helin, J.O.R.), University of Turku, Turku, Finland
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Uotila S, Hoppela E, Teuho J, Pietila M, Airaksinen J, Teras M, Knuuti J, Saraste A. 3401Detection of inflammatory activity of coronary plaques in patients with acute coronary syndrome and stable angina. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Uotila
- Turku PET Centre, Turku, Finland
| | - E Hoppela
- Turku PET Centre, University of Turku & Turku University Hospital, Turku, Finland
| | - J Teuho
- Turku PET Centre, Turku, Finland
| | - M Pietila
- Turku University Hospital, Turku, Finland
| | | | - M Teras
- Turku PET Centre, Turku, Finland
| | - J Knuuti
- Turku PET Centre, University of Turku & Turku University Hospital, Turku, Finland
| | - A Saraste
- Turku PET Centre, University of Turku & Turku University Hospital, Turku, Finland
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