PET imaging of asymptomatic individuals revealed coronary vascular dysfunction as a functional precursor of coronary artery disease, according to research presented during this week's SNM conference in New Orleans.
The findings were not necessarily accompanied by abnormal increases in the carotid intima media thickness (IMT) or coronary artery calcification (CAC), leading researchers to believe that the dysfunction may precede structural alterations of the arterial wall.
“Assessment of standard coronary risk factors such as arterial hypertension, smoking, hypercholesterolemia or diabetes appears to be limited in defining an individual's future cardiac risk,” said Thomas Schindler, MD, chief of nuclear cardiology at the University Hospitals of Geneva in Switzerland.
In a study of 68 asymptomatic individuals with type 2 diabetes, researchers were able to determine the concurrent prevalence of IMT, CAC, and coronary vascular dysfunction. In these patients—all of whom had coronary vascular dysfunction as determined by PET scans—a 56 percent increase in the prevalence of abnormal carotid IMT was found, while 66 percent also had evidence of CAC.
"PET assessment of functional abnormalities of the coronary circulation, therefore, may allow the earliest identification of developing heart vessel disease,” Schindler said. “This could lead to an optimized identification of the very early stage of the development of coronary artery disease, allowing physicians to initiate and/or reinforce preventive medical therapy strategies in order to improve the long-term cardiovascular outcome in these individuals at risk for heart disease.”