Nouvelles approches de la détermination de la rigidité aortique par imagerie : Application dans l'obésité et l'inflammation

Abstract : Nuclear magnetic resonance imaging (MRI) and hybrid imaging with X-ray computed tomography (CT) and 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) permit a new approach for regional aortic stiffness measurement. Arterial stiffness has independent predictive value for total and cardiovascular mortality, coronary morbidity and mortality, fatal stroke in patients with essential hypertension, end-stage renal failure or diabetes. Carotid-femoral pulse wave velocity (PWV) is considered as the "gold-standard" measurement of arterial stiffness. In clinical practice, aortic stiffness can be assessed by transcutaneous waveforms over the right common artery and the right femoral artery. First, the aim of the present work is to confirm the validity of transcutaneous PWV measurements in a population of 32 obese patients (BMI?35kg.m -2), comparing with MRI aortic elastic properties measurements. In fact, obesity is considered as a possible bias for PWV assessment. Second, we confirm the existence of a relationship between inflammatory foci and calcification foci detected by hybrid PET/CT on thoracic aorta (particularly ascending aorta and aortic arch) and arterial stiffness assessed by tonometer. 26 patients referred to our department for FDG-PET/CT imaging have PWV measurements. Aortic inflammation assessed by SUVmax on PET/CT, in these patients, is associated with significant variation in aortic stiffness. These results will allow us to progress for identifying aortic stiffness determinants.
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Laure Joly. Nouvelles approches de la détermination de la rigidité aortique par imagerie : Application dans l'obésité et l'inflammation. Médecine humaine et pathologie. Université Henri Poincaré - Nancy 1, 2009. Français. ⟨NNT : 2009NAN10076⟩. ⟨tel-01748355⟩

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