Endothelial dysfunction in recently diagnosed type 2 diabetic patients evaluated by PET.

PURPOSE: To demonstrate the presence of endothelial dysfunction (ED) in asymptomatic patients with type 2 diabetes mellitus (DM) by using (13)N-ammonia-positron emission tomography (PET). PET can identify ED by quantifying myocardial blood flow (MBF) during rest, cold pressor test (CPT), and pharmacologic stress. The endothelial-dependent vasodilation index (EDVI), myocardial flow reserve (MFR), and the percentage of the change between rest and CPT (%DeltaMBF) are markers of endothelial function. PROCEDURES: Thirty-nine subjects were studied (19 women and 20 men); 22 recently diagnosed type 2 diabetic patients and 17 healthy controls (HC). A three-phase (13)N-ammonia-PET was performed. RESULTS: Mean EDVI was 1.208 +/- 0.34 vs. 1.55 +/- 0.37 (diabetic vs. HC group, respectively) (p = 0.002), MFR was 2.803 +/- 1.39 vs. 3.27 +/- 0.72 (p = NS), and the %DeltaMBF was 20 +/- 34% vs. 55 +/- 37% (p = 0.002). Rest MBF and CPT MBF were normalized to the rate pressure product (RPP). EDVI' and %DeltaMBF' were calculated using the corrected values for the RPP. Mean EDVI' was (0.864 +/- 0.250 vs. 1.110 +/- 0.238, p = 0.004) and mean %DeltaMBF' was (-8.2 +/- 14.7% vs. 4.5 +/- 12.1%, p = 0.005). CONCLUSIONS: Asymptomatic, recently diagnosed type 2 diabetes patients present ED that can be quantified by (13)N-ammonia-PET.

Detección de inflamación en placa aterosclerosa: rol de la tomografía por emisión de positrones y de la proteína C reactiva / Detection of inflammation in an atherosclerose plaque: the role of the positron emission tomography and C reactive protein

OBJECTIVES: To demonstrate that inflammatory atheromatose carotid plaques can be visualized with positron emission tomography with 18F-fluorodeoxyglucose (18FDG PET) in symptomatic patients, in order to correlate them with systemic inflammatory markers, such as CRP. METHOD: Fifteen patients with cerebral ischemia due to atherosclerotic carotid disease were studied. 18FDG uptake with PET was considered and blood samples were taken for determining high sensibility C reactive protein (HsCRP). RESULTS: The mean age of the patients was 66 years; 11 of them were males (73%) and 4 were females (27%). 18FDG PET was positive in 12 patients (80%), while 100% of the studied population had low risk HsCRP with normal white cell count. CONCLUSIONS: 18FDG PET proves active inflammation in carotid atheromatose plaques. There was no significant correlation between the presence of ahteromatose carotid plaques, HsCRP serum levels, and 18FDG PET study.

[Detection of inflammation in an atherosclerose plaque: the role of the positron emission tomography and C reactive protein]. / Detección de inflamación en placa aterosclerosa: rol de la tomografía por emisión de positrones y de la proteína C reactiva.

OBJECTIVES: To demonstrate that inflammatory atheromatose carotid plaques can be visualized with positron emission tomography with 18F-fluorodeoxyglucose (18FDG PET) in symptomatic patients, in order to correlate them with systemic inflammatory markers, such as CRP. METHOD: Fifteen patients with cerebral ischemia due to atherosclerotic carotid disease were studied. 18FDG uptake with PET was considered and blood samples were taken for determining high sensibility C reactive protein (HsCRP). RESULTS: The mean age of the patients was 66 years; 11 of them were males (73%) and 4 were females (27%). 18FDG PET was positive in 12 patients (80%), while 100% of the studied population had low risk HsCRP with normal white cell count. CONCLUSIONS: 18FDG PET proves active inflammation in carotid atheromatose plaques. There was no significant correlation between the presence of ahteromatose carotid plaques, HsCRP serum levels, and 18FDG PET study.

[Ischemic heart disease: anatomic and functional evaluation in a single exploration with multi-slice PET-CT]. / Cardiopatía isquémica: evaluación anatomofuncional en una sola exploración con PET-CT multicorte.

A complete evaluation of the patient with ischemic heart disease requires an anatomical and functional assessment of the myocardium and coronary arteries. Recent technological advances have allowed a quantitative and physiological evaluation of the cardiovascular system with Positron Emission Tomography (PET). This method is a valuable tool for the assessment of heart metabolism, myocardial perfusion, ventricular function, coronary blood flow, myocardial viability and endothelial function. One of the major limitations of a PET study is its low spatial resolution. Cardiac Computed Tomography (CCT) is an anatomic study used for coronary calcium quantification, evaluation of wall and lumen of coronary arteries, study of vascular permeability and assessment of composition, extension and severity of atherosclerotic plaques. The main limitation of CCT is the lack of functional information that is obtained with this technique. Both methods are complementary in many ways. That is the reason of the wide spread of PET-CT hybrid equipments that can provide very useful functional and anatomic information of patients with ischemic heart disease in a single exploration.