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dc.contributor.authorJoshi, Nikhil V
dc.contributor.authorElkhawad, Maysoon
dc.contributor.authorForsythe, Rachael O
dc.contributor.authorMcBride, Olivia MB
dc.contributor.authorRajani, Nikil K
dc.contributor.authorTarkin, Jason
dc.contributor.authorChowdhury, Mohammed
dc.contributor.authorDonoghue, Emma
dc.contributor.authorRobson, Jennifer MJ
dc.contributor.authorBoyle, Jonathan R
dc.contributor.authorFryer, Timothy
dc.contributor.authorHuang, Yuan
dc.contributor.authorTeng, Zhongzhao
dc.contributor.authorDweck, Marc R
dc.contributor.authorTawakol, Ahmed A
dc.contributor.authorGillard, Jonathan H
dc.contributor.authorCoughlin, Patrick A
dc.contributor.authorWilkinson, Ian
dc.contributor.authorNewby, David E
dc.contributor.authorRudd, James
dc.date.accessioned2020-01-28T00:30:52Z
dc.date.available2020-01-28T00:30:52Z
dc.date.issued2020
dc.identifier.issn2053-3624
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/301295
dc.description.abstractObjective: Using combined positron emission tomography and CT (PET-CT), we measured aortic inflammation and calcification in patients with abdominal aortic aneurysms (AAA), and compared them with matched controls with atherosclerosis. Methods: We prospectively recruited 63 patients (mean age 76.1±6.8 years) with asymptomatic aneurysm disease (mean size 4.33±0.73 cm) and 19 age-and-sex-matched patients with confirmed atherosclerosis but no aneurysm. Inflammation and calcification were assessed using combined 18F-FDG PET-CT and quantified using tissue-to-background ratios (TBRs) and Agatston scores. Results: In patients with AAA, 18F-FDG uptake was higher within the aneurysm than in other regions of the aorta (mean TBRmax2.23±0.46 vs 2.12±0.46, p=0.02). Compared with atherosclerotic control subjects, both aneurysmal and non-aneurysmal aortae showed higher 18F-FDG accumulation (total aorta mean TBRmax2.16±0.51 vs 1.70±0.22, p=0.001; AAA mean TBRmax2.23±0.45 vs 1.68±0.21, p<0.0001). Aneurysms containing intraluminal thrombus demonstrated lower 18F-FDG uptake within their walls than those without (mean TBRmax2.14±0.43 vs 2.43±0.45, p=0.018), with thrombus itself showing low tracer uptake (mean TBRmax thrombus 1.30±0.48 vs aneurysm wall 2.23±0.46, p<0.0001). Calcification in the aneurysmal segment was higher than both non-aneurysmal segments in patients with aneurysm (Agatston 4918 (2901-8008) vs 1017 (139-2226), p<0.0001) and equivalent regions in control patients (442 (304-920) vs 166 (80-374) Agatston units per cm, p=0.0042). Conclusions: The entire aorta is more inflamed in patients with aneurysm than in those with atherosclerosis, perhaps suggesting a generalised inflammatory aortopathy in patients with aneurysm. Calcification was prominent within the aneurysmal sac, with the remainder of the aorta being relatively spared. The presence of intraluminal thrombus, itself metabolically relatively inert, was associated with lower levels of inflammation in the adjacent aneurysmal wall.
dc.description.sponsorshipFunding was provided by the British Heart Foundation, The Evelyn Trust and the Academy of Medical Sciences. JHFR is supported by the NIHR Cambridge Biomedical Research Centre, HRFCE, the British Heart Foundation, the Wellcome Trust and the EPSRC.
dc.format.mediumElectronic-eCollection
dc.languageeng
dc.publisherBMJ
dc.rightsAll rights reserved
dc.subjectAorta, Abdominal
dc.subjectHumans
dc.subjectAortic Aneurysm, Abdominal
dc.subjectAortitis
dc.subjectAortography
dc.subjectSeverity of Illness Index
dc.subjectCase-Control Studies
dc.subjectProspective Studies
dc.subjectPredictive Value of Tests
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectEngland
dc.subjectScotland
dc.subjectFemale
dc.subjectMale
dc.subjectAtherosclerosis
dc.subjectPlaque, Atherosclerotic
dc.subjectVascular Calcification
dc.subjectPositron Emission Tomography Computed Tomography
dc.titleGreater aortic inflammation and calcification in abdominal aortic aneurysmal disease than atherosclerosis: a prospective matched cohort study.
dc.typeArticle
prism.issueIdentifier1
prism.publicationDate2020
prism.publicationNameOpen Heart
prism.startingPagee001141
prism.volume7
dc.identifier.doi10.17863/CAM.48376
dcterms.dateAccepted2020-01-21
rioxxterms.versionofrecord10.1136/openhrt-2019-001141
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2020-01
dc.contributor.orcidJoshi, Nikhil V [0000-0003-4592-1025]
dc.contributor.orcidTarkin, Jason [0000-0002-9132-120X]
dc.contributor.orcidTeng, Zhongzhao [0000-0003-3973-6157]
dc.contributor.orcidWilkinson, Ian [0000-0001-6598-9399]
dc.contributor.orcidRudd, James [0000-0003-2243-3117]
dc.identifier.eissn2053-3624
rioxxterms.typeJournal Article/Review
pubs.funder-project-idBritish Heart Foundation (None)
pubs.funder-project-idAcademy of Medical Sciences (unknown)
pubs.funder-project-idBritish Heart Foundation (None)
pubs.funder-project-idEvelyn Trust (unknown)
pubs.funder-project-idWellcome Trust (104492/Z/14/Z)
pubs.funder-project-idEngineering and Physical Sciences Research Council (EP/N014588/1)
pubs.funder-project-idMedical Research Council (MR/N028015/1)
pubs.funder-project-idWellcome Trust (211100/Z/18/Z)
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (unknown)
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (146281)
cam.issuedOnline2020-03-11
cam.orpheus.counter2
rioxxterms.freetoread.startdate2023-01-27


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