Skip to main content
Erschienen in: Sleep and Breathing 4/2018

05.03.2018 | Sleep Breathing Physiology and Disorders • Original Article

Assessment of atherosclerotic plaque activity in patients with sleep apnea using hybrid positron emission tomography/magnetic resonance imaging (PET/MRI): a feasibility study

verfasst von: Vaishnavi Kundel, Maria Giovanna Trivieri, Nicolas A. Karakatsanis, Phillip M. Robson, Venkatesh Mani, Jorge R. Kizer, Robert Kaplan, Zahi Fayad, Neomi Shah

Erschienen in: Sleep and Breathing | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Evidence suggests that the inflammatory state of an atherosclerotic plaque is important in predicting future risk of plaque rupture. This study aims to investigate the feasibility of measuring plaque inflammation in patients with obstructive sleep apnea (OSA) utilizing advanced vascular imaging — hybrid positron-emission tomography/magnetic resonance imaging (PET/MRI) with fluorodeoxyglucose (FDG) tracer—before and after continuous positive airway pressure (CPAP).

Methods

Patients with newly diagnosed moderate to severe OSA underwent baseline PET/MRI for assessment of vascular inflammation of the carotid arteries and thoracic aorta prior to initiation of CPAP. Those adherent to CPAP returned for repeat imaging after 3–6 months of CPAP use. Atherosclerotic plaque activity, as measured by arterial wall FDG uptake, was calculated using target-to-background ratios (TBR) before and after CPAP.

Results

Five patients were recruited as part of a focused project. Mean age was 52 years (80% male), and mean apnea-hypopnea index (AHI) was 33. Three patients were objectively adherent with CPAP. In the pre-CPAP phase, all patients had focal FDG uptake in the carotid arteries and aorta. After CPAP, there was an average reduction in TBR of 5.5% (TBRmean) and 6.2% (TBRmax) in carotid and aortic plaque inflammation, similar in magnitude to the reduction observed with statin therapy alone in non-OSA patients (previously reported by others).

Conclusions

We demonstrate the feasibility of using hybrid PET/MRI to assess atherosclerotic plaque inflammation in patients with OSA before and after CPAP. Use of the vascular PET/MRI platform in patients with OSA may provide better insight into the role of OSA and its treatment in reducing atherosclerotic inflammation.
Literatur
8.
Zurück zum Zitat Little WCCM, Applegate RJ, Kutcher MA, Burrows MT, Kahl FR, Santamore WP (1988) Can coronary angiography predict the site of a subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease? Circulation 78(5):1157–1166CrossRefPubMed Little WCCM, Applegate RJ, Kutcher MA, Burrows MT, Kahl FR, Santamore WP (1988) Can coronary angiography predict the site of a subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease? Circulation 78(5):1157–1166CrossRefPubMed
11.
Zurück zum Zitat Moreno PR, Falk E, Palacios IF, Newell JB, Fuster V, Fallon JT (1994) Macrophage infiltration in acute coronary syndromes. Implications for plaque rupture. Circulation 90(2):775–778CrossRefPubMed Moreno PR, Falk E, Palacios IF, Newell JB, Fuster V, Fallon JT (1994) Macrophage infiltration in acute coronary syndromes. Implications for plaque rupture. Circulation 90(2):775–778CrossRefPubMed
12.
Zurück zum Zitat Tawakol A, Migrino RQ, Bashian GG, Bedri S, Vermylen D, Cury RC, Yates D, LaMuraglia GM, Furie K, Houser S, Gewirtz H, Muller JE, Brady TJ, Fischman AJ (2006) In vivo 18F-fluorodeoxyglucose positron emission tomography imaging provides a noninvasive measure of carotid plaque inflammation in patients. J Am Coll Cardiol 48(9):1818–1824. https://doi.org/10.1016/j.jacc.2006.05.076 CrossRefPubMed Tawakol A, Migrino RQ, Bashian GG, Bedri S, Vermylen D, Cury RC, Yates D, LaMuraglia GM, Furie K, Houser S, Gewirtz H, Muller JE, Brady TJ, Fischman AJ (2006) In vivo 18F-fluorodeoxyglucose positron emission tomography imaging provides a noninvasive measure of carotid plaque inflammation in patients. J Am Coll Cardiol 48(9):1818–1824. https://​doi.​org/​10.​1016/​j.​jacc.​2006.​05.​076 CrossRefPubMed
14.
Zurück zum Zitat Kubota R, Kubota K, Yamada S, Tada M, Ido T, Tamahashi N (1994) Microautoradiographic study for the differentiation of intratumoral macrophages, granulation tissues and cancer cells by the dynamics of fluorine-18-fluorodeoxyglucose uptake. J Nucl Med 35(1):104–112PubMed Kubota R, Kubota K, Yamada S, Tada M, Ido T, Tamahashi N (1994) Microautoradiographic study for the differentiation of intratumoral macrophages, granulation tissues and cancer cells by the dynamics of fluorine-18-fluorodeoxyglucose uptake. J Nucl Med 35(1):104–112PubMed
17.
Zurück zum Zitat Marnane M, Merwick A, Sheehan OC, Hannon N, Foran P, Grant T, Dolan E, Moroney J, Murphy S, O'Rourke K, O'Malley K, O'Donohoe M, McDonnell C, Noone I, Barry M, Crowe M, Kavanagh E, O'Connell M, Kelly PJ (2012) Carotid plaque inflammation on 18F-fluorodeoxyglucose positron emission tomography predicts early stroke recurrence. Ann Neurol 71(5):709–718. https://doi.org/10.1002/ana.23553 CrossRefPubMed Marnane M, Merwick A, Sheehan OC, Hannon N, Foran P, Grant T, Dolan E, Moroney J, Murphy S, O'Rourke K, O'Malley K, O'Donohoe M, McDonnell C, Noone I, Barry M, Crowe M, Kavanagh E, O'Connell M, Kelly PJ (2012) Carotid plaque inflammation on 18F-fluorodeoxyglucose positron emission tomography predicts early stroke recurrence. Ann Neurol 71(5):709–718. https://​doi.​org/​10.​1002/​ana.​23553 CrossRefPubMed
23.
Zurück zum Zitat Tawakol A, Fayad ZA, Mogg R, Alon A, Klimas MT, Dansky H, Subramanian SS, Abdelbaky A, Rudd JH, Farkouh ME, Nunes IO, Beals CR, Shankar SS (2013) Intensification of statin therapy results in a rapid reduction in atherosclerotic inflammation. results of a multicenter fluorodeoxyglucose-positron emission tomography/computed tomography feasibility study J Am Coll Cardiol 62(10):909–917. https://doi.org/10.1016/j.jacc.2013.04.066 CrossRefPubMed Tawakol A, Fayad ZA, Mogg R, Alon A, Klimas MT, Dansky H, Subramanian SS, Abdelbaky A, Rudd JH, Farkouh ME, Nunes IO, Beals CR, Shankar SS (2013) Intensification of statin therapy results in a rapid reduction in atherosclerotic inflammation. results of a multicenter fluorodeoxyglucose-positron emission tomography/computed tomography feasibility study J Am Coll Cardiol 62(10):909–917. https://​doi.​org/​10.​1016/​j.​jacc.​2013.​04.​066 CrossRefPubMed
24.
Zurück zum Zitat Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545CrossRefPubMed Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545CrossRefPubMed
25.
Zurück zum Zitat Berry RB BR, Gamaldo CE, Harding SM, Lloyd RM, Marcus CL, Vaughn BV (2015) The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specifications. Am Acad Sleep Med Version 2.2 Berry RB BR, Gamaldo CE, Harding SM, Lloyd RM, Marcus CL, Vaughn BV (2015) The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specifications. Am Acad Sleep Med Version 2.2
30.
Zurück zum Zitat Bucerius J, Hyafil F, Verberne HJ, Slart RH, Lindner O, Sciagra R, Agostini D, Ubleis C, Gimelli A, Hacker M, Cardiovascular Committee of the European Association of Nuclear M (2016) Position paper of the cardiovascular Committee of the European Association of nuclear medicine (EANM) on PET imaging of atherosclerosis. Eur J Nucl Med Mol Imaging 43(4):780–792. https://doi.org/10.1007/s00259-015-3259-3 CrossRefPubMed Bucerius J, Hyafil F, Verberne HJ, Slart RH, Lindner O, Sciagra R, Agostini D, Ubleis C, Gimelli A, Hacker M, Cardiovascular Committee of the European Association of Nuclear M (2016) Position paper of the cardiovascular Committee of the European Association of nuclear medicine (EANM) on PET imaging of atherosclerosis. Eur J Nucl Med Mol Imaging 43(4):780–792. https://​doi.​org/​10.​1007/​s00259-015-3259-3 CrossRefPubMed
31.
Zurück zum Zitat Rudd JH, Myers KS, Bansilal S, Machac J, Pinto CA, Tong C, Rafique A, Hargeaves R, Farkouh M, Fuster V, Fayad ZA (2008) Atherosclerosis inflammation imaging with 18F-FDG PET: carotid, iliac, and femoral uptake reproducibility, quantification methods, and recommendations. J Nucl Med 49(6):871–878. https://doi.org/10.2967/jnumed.107.050294 CrossRefPubMed Rudd JH, Myers KS, Bansilal S, Machac J, Pinto CA, Tong C, Rafique A, Hargeaves R, Farkouh M, Fuster V, Fayad ZA (2008) Atherosclerosis inflammation imaging with 18F-FDG PET: carotid, iliac, and femoral uptake reproducibility, quantification methods, and recommendations. J Nucl Med 49(6):871–878. https://​doi.​org/​10.​2967/​jnumed.​107.​050294 CrossRefPubMed
32.
Zurück zum Zitat CMS (2016) Positive Airway Pressure (PAP) Devices: complying with documentation & coverage requirements. US Department of Health and Human Services; Center for Medicare and Medicaid Services (CMS) https://www.cms.gov/ CMS (2016) Positive Airway Pressure (PAP) Devices: complying with documentation & coverage requirements. US Department of Health and Human Services; Center for Medicare and Medicaid Services (CMS) https://​www.​cms.​gov/
33.
Zurück zum Zitat Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB (1998) Prediction of coronary heart disease using risk factor categories. Circulation 97(18):1837–1847CrossRefPubMed Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB (1998) Prediction of coronary heart disease using risk factor categories. Circulation 97(18):1837–1847CrossRefPubMed
34.
35.
Zurück zum Zitat Kim J, Mohler ER 3rd, Keenan BT, Maislin D, Arnardottir ES, Gislason T, Benediktsdottir B, Gudmundsdottir S, Sifferman A, Staley B, Pack FM, Maislin G, Chirinos JA, Townsend RR, Pack AI, Kuna ST (2017) Carotid Artery Wall thickness in obese and nonobese adults with obstructive sleep apnea before and following positive airway pressure treatment. Sleep 40(9). https://doi.org/10.1093/sleep/zsx126 Kim J, Mohler ER 3rd, Keenan BT, Maislin D, Arnardottir ES, Gislason T, Benediktsdottir B, Gudmundsdottir S, Sifferman A, Staley B, Pack FM, Maislin G, Chirinos JA, Townsend RR, Pack AI, Kuna ST (2017) Carotid Artery Wall thickness in obese and nonobese adults with obstructive sleep apnea before and following positive airway pressure treatment. Sleep 40(9). https://​doi.​org/​10.​1093/​sleep/​zsx126
41.
Zurück zum Zitat Sluimer JC, Gasc JM, van Wanroij JL, Kisters N, Groeneweg M, Sollewijn Gelpke MD, Cleutjens JP, van den Akker LH, Corvol P, Wouters BG, Daemen MJ, Bijnens AP (2008) Hypoxia, hypoxia-inducible transcription factor, and macrophages in human atherosclerotic plaques are correlated with intraplaque angiogenesis. J Am Coll Cardiol 51(13):1258–1265. https://doi.org/10.1016/j.jacc.2007.12.025 CrossRefPubMed Sluimer JC, Gasc JM, van Wanroij JL, Kisters N, Groeneweg M, Sollewijn Gelpke MD, Cleutjens JP, van den Akker LH, Corvol P, Wouters BG, Daemen MJ, Bijnens AP (2008) Hypoxia, hypoxia-inducible transcription factor, and macrophages in human atherosclerotic plaques are correlated with intraplaque angiogenesis. J Am Coll Cardiol 51(13):1258–1265. https://​doi.​org/​10.​1016/​j.​jacc.​2007.​12.​025 CrossRefPubMed
44.
Zurück zum Zitat Curry BD, Bain JL, Yan JG, Zhang LL, Yamaguchi M, Matloub HS, Riley DA (2002) Vibration injury damages arterial endothelial cells. Muscle Nerve 25(4):527–534CrossRefPubMed Curry BD, Bain JL, Yan JG, Zhang LL, Yamaguchi M, Matloub HS, Riley DA (2002) Vibration injury damages arterial endothelial cells. Muscle Nerve 25(4):527–534CrossRefPubMed
45.
Zurück zum Zitat Lee SA, Amis TC, Byth K, Larcos G, Kairaitis K, Robinson TD, Wheatley JR (2008) Heavy snoring as a cause of carotid artery atherosclerosis. Sleep 31(9):1207–1213PubMedPubMedCentral Lee SA, Amis TC, Byth K, Larcos G, Kairaitis K, Robinson TD, Wheatley JR (2008) Heavy snoring as a cause of carotid artery atherosclerosis. Sleep 31(9):1207–1213PubMedPubMedCentral
46.
Zurück zum Zitat Puig F, Rico F, Almendros I, Montserrat JM, Navajas D, Farre R (2005) Vibration enhances interleukin-8 release in a cell model of snoring-induced airway inflammation. Sleep 28(10):1312–1316CrossRefPubMed Puig F, Rico F, Almendros I, Montserrat JM, Navajas D, Farre R (2005) Vibration enhances interleukin-8 release in a cell model of snoring-induced airway inflammation. Sleep 28(10):1312–1316CrossRefPubMed
49.
Zurück zum Zitat Rosen CL, Auckley D, Benca R, Foldvary-Schaefer N, Iber C, Kapur V, Rueschman M, Zee P, Redline S (2012) A multisite randomized trial of portable sleep studies and positive airway pressure autotitration versus laboratory-based polysomnography for the diagnosis and treatment of obstructive sleep apnea: the HomePAP study. Sleep 35(6):757–767. https://doi.org/10.5665/sleep.1870 CrossRefPubMedPubMedCentral Rosen CL, Auckley D, Benca R, Foldvary-Schaefer N, Iber C, Kapur V, Rueschman M, Zee P, Redline S (2012) A multisite randomized trial of portable sleep studies and positive airway pressure autotitration versus laboratory-based polysomnography for the diagnosis and treatment of obstructive sleep apnea: the HomePAP study. Sleep 35(6):757–767. https://​doi.​org/​10.​5665/​sleep.​1870 CrossRefPubMedPubMedCentral
52.
Zurück zum Zitat McEvoy RD, Antic NA, Heeley E, Luo Y, Ou Q, Zhang X, Mediano O, Chen R, Drager LF, Liu Z, Chen G, Du B, McArdle N, Mukherjee S, Tripathi M, Billot L, Li Q, Lorenzi-Filho G, Barbe F, Redline S, Wang J, Arima H, Neal B, White DP, Grunstein RR, Zhong N, Anderson CS, Investigators S, Coordinators (2016) CPAP for prevention of cardiovascular events in obstructive sleep apnea. N Engl J Med 375(10):919–931. https://doi.org/10.1056/NEJMoa1606599 CrossRefPubMed McEvoy RD, Antic NA, Heeley E, Luo Y, Ou Q, Zhang X, Mediano O, Chen R, Drager LF, Liu Z, Chen G, Du B, McArdle N, Mukherjee S, Tripathi M, Billot L, Li Q, Lorenzi-Filho G, Barbe F, Redline S, Wang J, Arima H, Neal B, White DP, Grunstein RR, Zhong N, Anderson CS, Investigators S, Coordinators (2016) CPAP for prevention of cardiovascular events in obstructive sleep apnea. N Engl J Med 375(10):919–931. https://​doi.​org/​10.​1056/​NEJMoa1606599 CrossRefPubMed
Metadaten
Titel
Assessment of atherosclerotic plaque activity in patients with sleep apnea using hybrid positron emission tomography/magnetic resonance imaging (PET/MRI): a feasibility study
verfasst von
Vaishnavi Kundel
Maria Giovanna Trivieri
Nicolas A. Karakatsanis
Phillip M. Robson
Venkatesh Mani
Jorge R. Kizer
Robert Kaplan
Zahi Fayad
Neomi Shah
Publikationsdatum
05.03.2018
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 4/2018
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-018-1646-2

Weitere Artikel der Ausgabe 4/2018

Sleep and Breathing 4/2018 Zur Ausgabe

Sleep Breathing Physiology and Disorders • Original Article

The predictive value of drug-induced sleep endoscopy for CPAP titration in OSA patients

Sleep Breathing Physiology and Disorders • Original Article

Antero-cervical thermophysiological characterization of obstructive sleep apnea patients

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.