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CARDIAC MICROCALCIFICATION BURDEN: GLOBAL ASSESSEMENT IN HIGH CARDIOVASCULAR RISK PATIENTS
Session:
Sessão de Comunicações Orais - Imagem
Speaker:
João Borges Rosa
Congress:
CPC 2020
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.5 Hybrid and Fusion Imaging
Session Type:
Comunicações Orais
FP Number:
---
Authors:
João Borges Rosa; Manuel Oliveira Santos; Rodolfo Silva; Antero J Abrunhosa; Miguel Castelo Branco; Lino Gonçalves; Maria João Ferreira
Abstract
<p>Background: Sodium fluoride (<sup>18</sup>F-NaF) atherosclerotic plaque uptake in positron emission tomography with computed tomography (PET-CT) potentially identifies active microcalcification. We aimed to evaluate global cardiac microcalcification activity with <sup>18</sup>F-NaF, as a measure of unstable microcalcification burden, in high cardiovascular (CV) risk patients, to explore its association to CV risk factors and other calcification assessment methods. There is no data on this cardiac molecular “instability” marker in patients with high CV risk. </p> <p>Methods: Twenty five high CV risk individuals without previous CV events from a single centre were prospectively scanned with <sup>18</sup>F-NaF PET-CT. Total cardiac <sup>18</sup>F-NaF uptake was measured as global molecular calcium score (GMCS), which was retrospectively calculated by summing the product of mean standardized uptake value (SUV) and volume of the region of interest (ROI) on every slice within the borders of the heart. The result was then divided by the number of slices to adjust for the volume.</p> <p>Results: Mean age was 64 years, 56% male and 96% Caucasian. Median GMCS was 342.58, IQR 174.02-609.52. Individuals with more than five CV risk factors (45.8%) had increased overall GMCS (365.08, IQR 240.79-565.83 vs. 291.57, IQR 174.022-609.52, p=0.04), which was positively correlated with predicted fatal CV risk by SCORE (r = 0.49, p=0.02). There was a moderate correlation between GMCS and weight (r = 0.77, p<0.01), body mass index (r = 0.79, p<0.01), abdominal perimeter (r = 0.76, p<0.01) and thoracic fat volume (r = 0.60, p=0.02). There was no correlation between GMCS and coronary calcium score (r = 0.09, p=0.75) nor coronary artery wall <sup>18</sup>F-NaF uptake. As an exploratory endpoint, individuals with heart failure with preserved ejection fraction (HFpEF) (n=4) had higher GMCS (488.58, IQR 402.84-609.52 vs. 316.66 IQR 174.92-565.83, p=0,01).</p> <p>Conclusions: In a high CV risk group, the global cardiac microcalcification burden was related to CV risk factors, weight, BMI, abdominal perimeter and thoracic fat volume. For the first time, we report an association between GMCS and HFpEF, putatively due to cardiac fibrosis, which require further validation in larger studies. </p>
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