Relationship Between Thoracic Aortic Structure Assessed B PET/CT Scan and Arterial Stiffness in Elderly Patients

NCT01963221 | Completed DMC

• 1 other identifier: CentralHNF
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to determine the relationship between thoracic aortic inflammation and arterial stiffness in elderly patients. Vascular-aging is accompanied by a gradual remodeling affecting both cardiac and arterial walls. Arterial hypertension, an established cardiovascular risk factor, has been suggested to exert pro-inflammatory actions threw several biological mediators enhancing arterial stiffness. Both effects of aging and hypertension are associated with higher levels of arterial stiffness, but their respective role is not well established in the pathophysiology of arterial stiffening. Few data are available neither on the real anatomic aortic impact of aging and hypertension on aortic compliance and ventricular function and its relationship to arterial stiffness assessed by carotid-femoral pulse wave velocity, nor on the reliability of cine phase contrast magnetic resonance imaging arterial stiffness measurements. Recent studies using positron emission tomography imaging (PET) with 18 F fluorodeoxyglucose (FDG) has been advocated as a means of measuring arterial wall inflammation in various population referred for oncology staging. FDG uptake is correlated with the number of cardiovascular risk factors and even the risk of future cardiovascular events. This method, combined with X-ray computed tomography (CT), has also demonstrated that aortic calcifications quantified by CT and local signs of inflammation detected by FDG uptake contribute to arterial stiffness. A strong relationship between large vessels stiffening assessed by carotid-femoral pulse wave velocity measurement, aortic calcifications quantified by CT and inflammation evaluated by FDG uptake has been demonstrated. Therefore, in the current study, we use FDG PET associated to CT to characterize aortic inflammation and aortic calcifications coupled to pulse wave velocity measurement and cardiac function in elderly individuals. In fact, if vascular aging promoting a local inflammatory process is a risk factor for cardiovascular disease, then vascular changes assessed by non-invasive vascular imaging (MRI,FDG PET) could represent a potential target for treatment and prevention Thirty individuals ≥ 65 years of age were examined, 15 hypertensive subjects and 15 controls. Pulse wave velocity, a surrogate for aortic stiffness, was measured both by cine phase contrast magnetic resonance imaging and applanation tonometry. Brachial pulse pressure, carotid calculated pulse pressure and pulse pressure amplification (brachial to carotid ratio), predictors of cardiovascular mortality were also quantified. Thoracic aorta local inflammation and calcification were measured by 18 F-fluorodeoxyglucose positron emission tomography/computed tomography imaging. Moreover, biomarkers of low grade inflammation (high-sensitivity C-reactive protein, interleukin 6 were also determined).

Conditions

Aging; Inflammation

Keywords

elderly; aorta; inflammation; arterial stiffness; PET/CT Imaging; hypertension; MRI

Outcome Measures

Primary Outcomes (1)

• Aortic inflammation assessed by 18 F FDG maximal standard uptake value measurement

  Combined FDG PET/CT imaging was performed using a hybrid scanner hybrid system. For analysis, the thoracic aorta was divided into three segments: the ascending aorta, the aortic arch and the descending aorta. The standard uptake value (SUV) was calculated by dividing the activity measured in each voxel by the total injected activity, which was expressed per g of body weight and corrected for radioactive decay. Aortic activity was quantified using a conventional method on consecutive slices, which were orientated perpendicular to the aorta like described in previous publication. Region of interest (ROI) were drawn around the aorta on each trans-axial slice, allowing mean (SUVmean) and maximal aortic SUV (SUVmax) to be determined on every slice. These values were averaged to determine SUVmean and SUVmax for the ascending aorta, the aortic arch and the descending aorta. All PET scans were analyzed independently by two trained observers (VR, PM).

  one year

Secondary Outcomes (1)

• parietal thoracic aorta volume of calcification measured by computed tomography

  one year

Other Outcomes (1)

• carotid femoral pulse wave velocity

  at the time of the measurement

Study Arms (1)

fluodeoxyglucose (18f)

OTHER

Radiation: fludeoxyglucose(18f); Other: blood sample; Other: cardiac and aortic magnetic resonance imaging; Other: carotid femoral pulse wave velocity; Radiation: positron emission tomography; Radiation: computed tomography

Interventions

fludeoxyglucose(18f) RADIATION

Also known as: GLUSCAN, solution for injection, 600 MBq/ml : 564 461-8, ADVANCED ACCELERATOR APPLICATIONS (AAA) Laboratory

fluodeoxyglucose (18f)

blood sample OTHER

fluodeoxyglucose (18f)

cardiac and aortic magnetic resonance imaging OTHER

fluodeoxyglucose (18f)

carotid femoral pulse wave velocity OTHER

fluodeoxyglucose (18f)

positron emission tomography RADIATION

fluodeoxyglucose (18f)

computed tomography RADIATION

fluodeoxyglucose (18f)

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• age \>=65 years old

You may not qualify if:

• blood glucose\> 200 mg/dl before the PET/CT scanning
• inflammatory disease
• cancer
• all forms of secondary hypertension
• renal hepatic or pulmonary insufficiency
• absence of cardiac sinus rhythm
• diabetes mellitus
• contraindication to MRI

Sponsors & Collaborators

• Central Hospital, Nancy, France: lead
• French Cardiology Society: collaborator

Study Sites (1)

University Hospital of Nancy

Vandœuvre-lès-Nancy, 54511, France

Location

Related Publications (1)

• Joly L, Mandry D, Verger A, Labat C, Watfa G, Roux V, Karcher G, Marie PY, Benetos A. Influence of Thoracic Aortic Inflammation and Calcifications on Arterial Stiffness and Cardiac Function in Older Subjects. J Nutr Health Aging. 2016 Mar;20(3):347-54. doi: 10.1007/s12603-015-0574-0.

  PMID: 26892585 DERIVED

MeSH Terms

Conditions

Inflammation; Hypertension

Interventions

Fluorodeoxyglucose F18; Solutions; Injections; Laboratories; Blood Specimen Collection; Magnetic Resonance Spectroscopy

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Vascular Diseases; Cardiovascular Diseases

Intervention Hierarchy (Ancestors)

Deoxyglucose; Deoxy Sugars; Carbohydrates; Pharmaceutical Preparations; Drug Administration Routes; Drug Therapy; Therapeutics; Non-Medical Public and Private Facilities; Health Facilities; Health Care Facilities Workforce and Services; Specimen Handling; Clinical Laboratory Techniques; Diagnostic Techniques and Procedures; Diagnosis; Punctures; Surgical Procedures, Operative; Investigative Techniques; Spectrum Analysis; Chemistry Techniques, Analytical

Study Officials

• Laure JOLY, MD, PhD

  Institut National de la Santé Et de la Recherche Médicale, France

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MCU-PH, MD, PhD

Study Record Dates

• First Submitted: October 6, 2013
• First Posted: October 16, 2013
• Study Start: January 1, 2010
• Primary Completion: August 1, 2011
• Study Completion: September 1, 2013
• Last Updated: October 16, 2013

Record last verified: 2013-10

Locations

FR (1)