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Abstract

BACKGROUND:
Recent studies suggested that perivascular components, such as perivascular adiposetissue (PVAT) and adventitial vasa vasorum (VV), play an important role as a source of various inflammatory mediators in cardiovascular disease.

OBJECTIVES:
The authors tested their hypothesis that coronary artery spasm is associated with perivascular inflammation in patients with vasospastic angina (VSA) using 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT).

METHODS:
This study prospectively examined 27 consecutive VSA patients with acetylcholine-induced diffuse spasm in the left anterior descending artery (LAD) and 13 subjects with suspected angina but without organic coronary lesions or coronary spasm. Using CT coronary angiography and electrocardiogram-gated 18F-FDG PET/CT, coronary PVAT volume and coronary perivascular FDG uptake in the LAD were examined. In addition, adventitial VV formation in the LAD was examined with optical coherence tomography, and Rho-kinase activity was measured in circulating leukocytes.

RESULTS:
Patient characteristics were comparable between the 2 groups. CT coronary angiography and ECG-gated 18F-FDG PET/CT showed that coronary PVAT volume and coronary perivascular FDG uptake significantly increased in the VSA group compared with the non-VSA group. Furthermore, optical coherence tomography showed that adventitial VV formation significantly increased in the VSA group compared with the non-VSA group, as did Rho-kinase activity. Importantly, during the follow-up period with medical treatment, both coronary perivascular FDG uptake and Rho-kinase activity significantly decreased in the VSA group.

CONCLUSIONS:
These results provide the first evidence that coronary spasm is associated with inflammation of coronary adventitia and PVAT, where 18F-FDG PET/CT could be useful for disease activity assessment. (Morphological and Functional Change of Coronary Perivascular Adipose Tissue in Vasospastic Angina [ADIPO-VSA Trial]; UMIN000016675).

Author information

Ohyama K1, Matsumoto Y1, Takanami K2, Ota H2, Nishimiya K1, Sugisawa J1, Tsuchiya S1, Amamizu H1, Uzuka H1, Suda A1, Shindo T1, Kikuchi Y1, Hao K1, Tsuburaya R1, Takahashi J1, Miyata S1, Sakata Y1, Takase K2, Shimokawa H3.

1 Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
2 Department of Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan.
3 Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: shimo@cardio.med.tohoku.ac.jp.