Aortic dilatation in patients with large vessel vasculitis: A longitudinal case control study using PET/CT |
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| Affiliation: | 1. Rheumatology Unit, Azienda Unità Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy;2. Radiology Unit, Azienda Unità Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy;3. Nuclear Medicine Unit, Azienda Unità Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy;4. Unit of Clinical Immunology, Allergy and Advanced Biotechnologies, Azienda Unità Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy;5. University of Modena and Reggio Emilia, Modena, Italy;6. Department of Medicine and Surgery, University of Parma, Parma, Italy;1. Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 10 Center Drive, Building 10, Rm 216G, Bethesda, MD 20892, USA;2. Radiology and Imaging Sciences, National Institutes of Health, 10 Center Drive Building 10, Bethesda, MD 20892, USA;3. Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison WI, USA;3. Mayo Clinic Rochester, Department of Biomedical Statistics and Informatics, Rochester, Minnesota;4. Mayo Clinic Rochester, Division of Primary Care Internal Medicine, Rochester, Minnesota;5. Mayo Clinic Rochester, Division of Rheumatogy, Rochester, Minnesota;6. Mayo Clinic Rochester, Division of Cardiovascular Surgery, Rochester, Minnesota;1. University of Modena and Reggio Emilia, Modena, Italy;2. Rheumatology Unit, Department of Specialistic Medicine, Azienda USL-IRCCS di Reggio Emilia, Italy;3. Operative Unit of Pathologic Anatomy, Azienda USL-IRCCS di Reggio Emilia, Italy;4. Nuclear Medicine Unit, Department of Oncology and Advanced Technology, Azienda USL-IRCCS di Reggio Emilia, Italy;5. Department of Radiology, Azienda USL-IRCCS di Reggio Emilia, Italy;6. Unit of Vascular Surgery, Department of Specialistic and General Surgery, Azienda USL-IRCCS di Reggio Emilia, Italy;7. Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda USL-IRCCS di Reggio Emilia, Italy |
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| Abstract: | ObjectiveTo evaluate aortic diameter and predictors of aortic dilatation using 18FDG-PET/CT in a longitudinally followed cohort of patients with large vessel vasculitis (LVV) compared with controls.MethodsAll consecutive patients with LVV who underwent at least 2 PET/CT scans between January 2008 and May 2015 were included. The first and last PET/CT study was evaluated by a radiologist and a nuclear medicine physician. Diameter and FDG uptake of the aorta was measured at 4 different levels: ascending, descending thoracic, suprarenal and infrarenal abdominal aorta. Twenty-nine age- and sex-matched patients with lymphoma who underwent at least 2 PET/CT scans in the same time interval were selected as controls.Results93 patients with LVV were included in the study. In the time interval between first and last PET/CT study (median time 31 months), the diameter of the ascending, descending thoracic and suprarenal abdominal aorta significantly increased in LVV patients but not in controls. At last PET/CT, patients with LVV compared with controls had higher diameter of ascending [35.41 (5.54) vs 32.97 (4.11) mm, p = 0.029], descending thoracic [28.42 (4.82) vs 25.72 (3.55) mm, p = 0.007] and suprarenal abdominal aorta, mean [25.34 (7.01) vs 22.16 (3.26) mm, p = 0.005] and more frequently had aortic dilatation [19% vs 3%, p = 0.023]. Significant predictors of aortic dilatation were male sex [OR 7.27, p = 0.001] and, only for GCA, hypertension [OR 6.30, p = 0.031]. Finally, GCA patients with aortic FDG uptake grade 3 at first PET/CT, compared to those with aortic FDG uptake ≤2, had significantly higher aortic diameter.ConclusionsPatients with LVV are at increased risk of aortic dilatation compared with age- and sex-matched controls. Significant predictors of aortic dilatation are male sex and, only for GCA, hypertension. GCA patients with aortic FDG uptake grade 3 are at increased risk of aortic dilatation. |
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