tetano
Editor, Senior Moderator
J Nucl Cardiol
. 2022 May 2.
doi: 10.1007/s12350-022-02962-1. Online ahead of print.
Time-related aortic inflammatory response, as assessed with [SUP]18[/SUP] F-FDG PET/CT, in patients hospitalized with severely or critical COVID-19: the COVAIR study
Charalambos Vlachopoulos[SUP] 1 [/SUP], Dimitrios Terentes-Printzios[SUP] 2 [/SUP], Paraskevi Katsaounou[SUP] 3 [/SUP], Eirini Solomou[SUP] 2 [/SUP], Vasiliki Gardikioti[SUP] 2 [/SUP], Dimitrios Exarchos[SUP] 3 [/SUP], Dimitrios Economou[SUP] 3 [/SUP], Georgia Christopoulou[SUP] 2 [/SUP], Antonios-Dimosthenis Kalkinis[SUP] 4 [/SUP], Pavlos Kafouris[SUP] 5 [/SUP], Alexios Antonopoulos[SUP] 2 [/SUP], Georgios Lazaros[SUP] 2 [/SUP], Anastasia Kotanidou[SUP] 3 [/SUP], Ioannis Datseris[SUP] 3 [/SUP], Konstantinos Tsioufis[SUP] 2 [/SUP], Constantinos Anagnostopoulos[SUP] 6 4 [/SUP]
Affiliations
Abstract
Aim: Arterial involvement has been implicated in the coronavirus disease of 2019 (COVID-19). Fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) imaging is a valuable tool for the assessment of aortic inflammation and is a predictor of outcome. We sought to prospectively assess the presence of aortic inflammation and its time-dependent trend in patients with COVID-19.
Methods: Between November 2020 and May 2021, in this pilot, case-control study, we recruited 20 patients with severe or critical COVID-19 (mean age of 59 ± 12 years), while 10 age and sex-matched individuals served as the control group. Aortic inflammation was assessed by measuring [SUP]18[/SUP]F-FDG uptake in PET/CT performed 20-120 days post-admission. Global aortic target to background ratio (GLA-TBR) was calculated as the sum of TBRs of ascending and descending aorta, aortic arch, and abdominal aorta divided by 4. Index aortic segment TBR (IAS-TBR) was designated as the aortic segment with the highest TBR.
Results: There was no significant difference in aortic [SUP]18[/SUP]F-FDG PET/CT uptake between patients and controls (GLA-TBR: 1.46 [1.40-1.57] vs. 1.43 [1.32-1.70], respectively, P = 0.422 and IAS-TBR: 1.60 [1.50-1.67] vs. 1.50 [1.42-1.61], respectively, P = 0.155). There was a moderate correlation between aortic TBR values (both GLA and IAS) and time distance from admission to [SUP]18[/SUP]F-FDG PET-CT scan (Spearman's rho = - 0.528, P = 0.017 and Spearman's rho = - 0.480, p = 0.032, respectively). Patients who were scanned less than or equal to 60 days from admission (n = 11) had significantly higher GLA-TBR values compared to patients that were examined more than 60 days post-admission (GLA-TBR: 1.53 [1.42-1.60] vs. 1.40 [1.33-1.45], respectively, P = 0.016 and IAS-TBR: 1.64 [1.51-1.74] vs. 1.52 [1.46-1.60], respectively, P = 0.038). There was a significant difference in IAS- TBR between patients scanned ≤ 60 days and controls (1.64 [1.51-1.74] vs. 1.50 [1.41-1.61], P = 0.036).
Conclusion: This is the first study suggesting that aortic inflammation, as assessed by [SUP]18[/SUP]F-FDG PET/CT imaging, is increased in the early post COVID phase in patients with severe or critical COVID-19 and largely resolves over time. Our findings may have important implications for the understanding of the course of the disease and for improving our preventive and therapeutic strategies.
Keywords: 18F-FDG PET/CT; Aortic inflammation; COVID 19; CRP; Cardiovascular risk; Endothelial dysfunction; Long COVID.
. 2022 May 2.
doi: 10.1007/s12350-022-02962-1. Online ahead of print.
Time-related aortic inflammatory response, as assessed with [SUP]18[/SUP] F-FDG PET/CT, in patients hospitalized with severely or critical COVID-19: the COVAIR study
Charalambos Vlachopoulos[SUP] 1 [/SUP], Dimitrios Terentes-Printzios[SUP] 2 [/SUP], Paraskevi Katsaounou[SUP] 3 [/SUP], Eirini Solomou[SUP] 2 [/SUP], Vasiliki Gardikioti[SUP] 2 [/SUP], Dimitrios Exarchos[SUP] 3 [/SUP], Dimitrios Economou[SUP] 3 [/SUP], Georgia Christopoulou[SUP] 2 [/SUP], Antonios-Dimosthenis Kalkinis[SUP] 4 [/SUP], Pavlos Kafouris[SUP] 5 [/SUP], Alexios Antonopoulos[SUP] 2 [/SUP], Georgios Lazaros[SUP] 2 [/SUP], Anastasia Kotanidou[SUP] 3 [/SUP], Ioannis Datseris[SUP] 3 [/SUP], Konstantinos Tsioufis[SUP] 2 [/SUP], Constantinos Anagnostopoulos[SUP] 6 4 [/SUP]
Affiliations
- PMID: 35501458
- DOI: 10.1007/s12350-022-02962-1
Abstract
Aim: Arterial involvement has been implicated in the coronavirus disease of 2019 (COVID-19). Fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) imaging is a valuable tool for the assessment of aortic inflammation and is a predictor of outcome. We sought to prospectively assess the presence of aortic inflammation and its time-dependent trend in patients with COVID-19.
Methods: Between November 2020 and May 2021, in this pilot, case-control study, we recruited 20 patients with severe or critical COVID-19 (mean age of 59 ± 12 years), while 10 age and sex-matched individuals served as the control group. Aortic inflammation was assessed by measuring [SUP]18[/SUP]F-FDG uptake in PET/CT performed 20-120 days post-admission. Global aortic target to background ratio (GLA-TBR) was calculated as the sum of TBRs of ascending and descending aorta, aortic arch, and abdominal aorta divided by 4. Index aortic segment TBR (IAS-TBR) was designated as the aortic segment with the highest TBR.
Results: There was no significant difference in aortic [SUP]18[/SUP]F-FDG PET/CT uptake between patients and controls (GLA-TBR: 1.46 [1.40-1.57] vs. 1.43 [1.32-1.70], respectively, P = 0.422 and IAS-TBR: 1.60 [1.50-1.67] vs. 1.50 [1.42-1.61], respectively, P = 0.155). There was a moderate correlation between aortic TBR values (both GLA and IAS) and time distance from admission to [SUP]18[/SUP]F-FDG PET-CT scan (Spearman's rho = - 0.528, P = 0.017 and Spearman's rho = - 0.480, p = 0.032, respectively). Patients who were scanned less than or equal to 60 days from admission (n = 11) had significantly higher GLA-TBR values compared to patients that were examined more than 60 days post-admission (GLA-TBR: 1.53 [1.42-1.60] vs. 1.40 [1.33-1.45], respectively, P = 0.016 and IAS-TBR: 1.64 [1.51-1.74] vs. 1.52 [1.46-1.60], respectively, P = 0.038). There was a significant difference in IAS- TBR between patients scanned ≤ 60 days and controls (1.64 [1.51-1.74] vs. 1.50 [1.41-1.61], P = 0.036).
Conclusion: This is the first study suggesting that aortic inflammation, as assessed by [SUP]18[/SUP]F-FDG PET/CT imaging, is increased in the early post COVID phase in patients with severe or critical COVID-19 and largely resolves over time. Our findings may have important implications for the understanding of the course of the disease and for improving our preventive and therapeutic strategies.
Keywords: 18F-FDG PET/CT; Aortic inflammation; COVID 19; CRP; Cardiovascular risk; Endothelial dysfunction; Long COVID.