Parel Philip M, Berg Alexander R, Hong Christin G, Florida Elizabeth M, O'Hagan Ross, Sorokin Alexander V, Mehta Nehal N
Inflammation and Cardiometabolic Diseases, Clinical Research Center, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, USA.
Curr Cardiol Rep. 2022 Apr;24(4):317-326. doi: 10.1007/s11886-022-01651-2. Epub 2022 Feb 16.
In this review, we focus on the clinical and epidemiological studies pertaining to systemic and vascular inflammation by positron emission tomography (PET) in patients with chronic inflammatory conditions such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), and psoriasis to highlight the importance of chronic systemic inflammation on vascular inflammation by PET in these disease states.
Recent clinical and translation advancements have demonstrated the durable relationship between chronic systemic inflammation and cardiovascular disease (CVD). In chronic inflammatory states, this relationship is robustly evident in the form of increased vascular inflammation, yet traditional risk estimates often underestimate the subclinical cardiovascular risk conferred by chronic inflammation. PET has emerged as a novel, non-invasive imaging modality capable of both quantifying the degree of systemic and vascular inflammation and detecting residual inflammation prior to cardiovascular events. We begin by demonstrating the role of inflammation in the pathogenesis of atherosclerosis, discussing how PET has been utilized to measure systemic and vascular inflammation and their effect on subclinical atherosclerosis, and finally reviewing recent applications of PET in constructing improved risk stratification for patients at high risk for stroke and CVD.
在本综述中,我们重点关注正电子发射断层扫描(PET)在类风湿关节炎(RA)、系统性红斑狼疮(SLE)、人类免疫缺陷病毒(HIV)和银屑病等慢性炎症性疾病患者中与全身及血管炎症相关的临床和流行病学研究,以突出在这些疾病状态下慢性全身炎症对PET检测血管炎症的重要性。
近期的临床和转化研究进展已证明慢性全身炎症与心血管疾病(CVD)之间存在持久关系。在慢性炎症状态下,这种关系以血管炎症增加的形式明显存在,但传统风险评估往往低估了慢性炎症所带来的亚临床心血管风险。PET已成为一种新型的非侵入性成像方式,既能量化全身和血管炎症程度,又能在心血管事件发生前检测残余炎症。我们首先阐述炎症在动脉粥样硬化发病机制中的作用,讨论PET如何用于测量全身和血管炎症及其对亚临床动脉粥样硬化的影响,最后回顾PET在为中风和CVD高危患者构建改进的风险分层方面的最新应用。