Sex Differences in Coronary Inflammation and Atherosclerosis Phenotypes in Response to Imaging Marker of Stress-Related Neural Activity-Reference-Cited by-同舟云学术

Sex Differences in Coronary Inflammation and Atherosclerosis Phenotypes in Response to Imaging Marker of Stress-Related Neural Activity

Published:2024-02 Issue:2 Volume:17 Page:
ISSN:1941-9651
Container-title:Circulation: Cardiovascular Imaging
language:en
Short-container-title:Circ: Cardiovascular Imaging

Author:

Dai Neng¹²^ORCID,Tang Xianglin¹²,Weng Xinyu¹²^ORCID,Cai Haidong³,Zhuang Jianhui⁴,Yang Guangjie⁵^ORCID,Zhou Fan⁶^ORCID,Wu Ping⁷⁸^ORCID,Liu Bao⁹¹⁰¹¹,Duan Shaofeng¹²,Yu Yongfu¹³^ORCID,Guo Weifeng¹⁴¹⁵^ORCID,Ju Zhiguo¹⁶,Zhang Longjiang⁶^ORCID,Wang Zhenguang⁵,Wang Yuetao⁹¹⁰^ORCID,Lu Bin¹⁷^ORCID,Shi Hongcheng¹⁸,Qian Juying¹²,Ge Junbo¹²

Affiliation:

1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, China (N.D., X.T., X.W., J.Q., J.G.).

2. National Clinical Research Center for Interventional Medicine, Shanghai, China (N.D., X.T., X.W., J.Q., J.G.).

3. Department of Nuclear Medicine (H.C.), Shanghai Tenth People’s Hospital, China.

4. Department of Cardiology (J.Z.), Shanghai Tenth People’s Hospital, China.

5. Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Shandong, China (G.Y., Z.W.).

6. Department of Radiology, Jinling Hospital, Medical School of Nanjing University, Jiangsu, China (F.Z., L.Z.).

7. Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China (P.W.).

8. Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, China (P.W.).

9. Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China (B.L., Y.W.).

10. The Nuclear Medicine and Molecular Imaging Clinical Translation Institute of Soochow University, Changzhou, China (B.L., Y.W.).

11. Department of Radiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (B.L.).

12. GE Healthcare China, Shanghai, China (S.D.).

13. School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education (Y.Y.), Fudan University, Shanghai, China.

14. Department of Radiology, Zhongshan Hospital (W.G.), Fudan University, Shanghai, China.

15. Shanghai Institute of Medical Imaging, China (W.G.).

16. College of Medical Imaging, Shanghai University of Medicine and Health Science, China (Z.J.).

17. State Key Laboratory of Cardiovascular Disease and National Center for Cardiovascular Diseases, Beijing, China (B.L.).

18. Department of Nuclear Medicine, Zhongshan Hospital (H.S.), Fudan University, Shanghai, China.

Abstract

BACKGROUND: Sex-specific differences in coronary phenotypes in response to stress have not been elucidated. This study investigated the sex-specific differences in the coronary computed tomography angiography-assessed coronary response to mental stress. METHODS: This retrospective study included patients with coronary artery disease and without cancer who underwent resting 18 F-fluorodexoyglucose positron emission tomography/computed tomography and coronary computed tomography angiography within 3 months. 18 F-flourodeoxyglucose resting amygdalar uptake, an imaging biomarker of stress-related neural activity, coronary inflammation (fat attenuation index), and high-risk plaque characteristics were assessed by coronary computed tomography angiography. Their correlation and prognostic values were assessed according to sex. RESULTS: A total of 364 participants (27.7% women and 72.3% men) were enrolled. Among those with heightened stress-related neural activity, women were more likely to have a higher fat attenuation index (43.0% versus 24.0%; P =0.004), while men had a higher frequency of high-risk plaques (53.7% versus 39.3%; P =0.036). High amygdalar 18 F-flourodeoxyglucose uptake (B-coefficient [SE], 3.62 [0.21]; P <0.001) was selected as the strongest predictor of fat attenuation index in a fully adjusted linear regression model in women, and the first-order interaction term consisting of sex and stress-related neural activity was significant ( P <0.001). Those with enhanced imaging biomarkers of stress-related neural activity showed increased risk of major adverse cardiovascular event both in women (24.5% versus 5.1%; adjusted hazard ratio, 3.62 [95% CI, 1.14–17.14]; P =0.039) and men (17.2% versus 6.9%; adjusted hazard ratio, 2.72 [95% CI, 1.10–6.69]; P =0.030). CONCLUSIONS: Imaging-assessed stress-related neural activity carried prognostic values irrespective of sex; however, a sex-specific mechanism linking psychological stress to coronary plaque phenotypes existed in the current hypothesis-generating study. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT05545618.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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