Interrelation between cardiac and brain small-vessel disease: a pilot quantitative PET and MRI study

Bianca Mazini; Matthieu Dietz; Bénédicte Maréchal; Ricardo Corredor-Jerez; John O Prior; Vincent Dunet

doi:10.1186/s41824-023-00180-7

Interrelation between cardiac and brain small-vessel disease: a pilot quantitative PET and MRI study

Eur J Hybrid Imaging. 2023 Nov 6;7(1):20. doi: 10.1186/s41824-023-00180-7.

Authors

Bianca Mazini¹, Matthieu Dietz^{2

3}, Bénédicte Maréchal^{1

4

5}, Ricardo Corredor-Jerez^{1

4

5}, John O Prior^{6

7}, Vincent Dunet^{1

8}

Affiliations

¹ Department of Diagnostic and Interventional Radiology, Neuroradiology Unit, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
² Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
³ INSERM U1060, CarMeN Laboratory, University of Lyon, Lyon, France.
⁴ Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland.
⁵ LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
⁶ Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland. [email protected].
⁷ University of Lausanne, Lausanne, Switzerland. [email protected].
⁸ University of Lausanne, Lausanne, Switzerland.

Abstract

Background: Small-vessel disease (SVD) plays a crucial role in cardiac and brain ischemia, but little is known about potential interrelation between both. We retrospectively evaluated 370 patients, aiming at assessing the interrelation between cardiac and brain SVD by using quantitative ⁸²Rb cardiac PET/CT and brain MRI.

Results: In our population of 370 patients, 176 had normal myocardial perfusion, 38 had pure cardiac SVD and 156 had obstructive coronary artery disease. All underwent both a cardiac ⁸²Rb PET/CT and a brain 1.5T or 3T MRI. Left-ventricle myocardial blood flow (LV-MBF) and flow reserve (LV-MFR) were recorded from ⁸²Rb PET/CT, while Fazekas score, white matter lesion (WMab) volume, deep gray matter lesion (GMab) volume, and brain morphometry (for z-score calculation) using the MorphoBox research application were derived from MRI. Groups were compared with Kruskal-Wallis test, and the potential interrelation between heart and brain SVD markers was assessed using Pearson's correlation coefficient. Patients with cardiac SVD had lower stress LV-MBF and MFR (P < 0.001) than patients with normal myocardial perfusion; Fazekas scores and WMab volumes were similar in those two groups (P > 0.45). In patients with cardiac SVD only, higher rest LV-MBF was associated with a lower left-putamen (rho = - 0.62, P = 0.033), right-thalamus (rho = 0.64, P = 0.026), and right-pallidum (rho = 0.60, P = 0.039) z-scores and with a higher GMab volume. Lower stress LV-MBF was associated with lower left-caudate z-score (rho = 0.69, P = 0.014), while lower LV-MFR was associated with lower left (rho = 0.75, P = 0.005)- and right (rho = 0.59, P = 0.045)-putamen z-scores, as well as higher right-thalamus GMab volume (rho = - 0.72, P = 0.009).

Conclusion: Significant interrelations between cardiac and cerebral SVD markers were found, especially regarding deep gray matter alterations, which supports the hypothesis of SVD as a systemic disease.

Keywords: Coronary artery disease; MRI; Morphometry; PET; Small-vessel disease.