Presentation Comprehensive assessment of impaired coronary and peripheral artery vascular function in smokers using Oxygen-15 Labeled Water PET and Brachial Artery Ultrasound

Yoshinaga, Keiichiro  ,  Ochi, Noriki  ,  Tomiyama, Yuuki  ,  Katoh, Chietsugu  ,  Inoue, Mamiko  ,  Suzuki, Eriko  ,  Manabe, Osamu  ,  M Ito, Yoichi  ,  Tamaki, Nagara

Background: Cigarette smoking has impact on vascular function. Comprehensive evaluation of endothelial dependent (End) and endothelium independent (Endind) vascular function in coronary artery and peripheral artery in smokers has never been studied. The purpose of the present study was to evaluate the relationship between the coronary and peripheral vascular function in smokers using O-15 labeled water PET and brachial artery ultrasound.Methods: Eight active smokers (Brinkman index: 219.4±230.7) and 10 healthy individuals underwent brachial artery ultrasound at rest, reactive hyperemia [250 mmHg cuff occlusion (FMD)], and sublingual nitroglycerin (NTG) administration. Delta arterial diameter and %change of arterial diameter were calculated. Myocardial blood flow (MBF) was evaluated at rest, during adenosine triphosphate (ATP) administration, and cold pressor test (CPT) with O-15 water dynamic PET. Rest MBF and CPT MBF were corrected by rate pressure product (RPP).Results: Smokers significantly reduced End vasodilatation compared to control using ultrasound (delta FMD: 0.31±0.12 mm vs 0.44±0.11 mm, P=0.026, %FMD: 6.62±2.28% vs 11.29±2.75%, P=0.0014) and using O-15 water PET (RPP corrected CPT response: -18.0±10.1% vs 1.4±20.3%, P=0.04).There was no significant difference in NTG response (delta:0.73±0.30 mm vs 0.88±0.25 mm, P=0.27, %NTG: 15.9±6.8% vs 22.4±6.2%, P=0.055) and RPP corrected coronary flow reserve (3.19±1.22 vs 3.77±1.14, P=0.32) between the two groups. On the other hand, there was no relationship between coronary and peripheral End function (R=0.40, P=0.1) and Endind vascular function (R=0.24, P=0.3).Conclusions: Smokers exhibited impaired coronary endothelial function as well as peripheral endothelial function. In contrast, smokers did not show alteration in endothelial independent vasodilation . In addition, there was no correlation between PET and ultrasound measurements, possibly implying that while smokers may have systemic vascular endothelial dysfunction, the characteristics of that dysfunction may be different in coronary and peripheral arteries.
ICNC 12, Nuclear Cardiology and Cardiac CT

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