The cardiovascular PET programme examines non-invasive measurement of inflammation, hypoxia and other markers of high-risk atherosclerotic plaque disease. The BRC has funded a trainee vascular surgeon who is supervising 2 ongoing translational research studies. One prospective study is investigating the determinants of aortic aneurysm expansion over a 3-year period, hypothesising that inflammation, hypoxia or neovascularisation detected by PET/CT or MRI at baseline is predictive of future aneurysm expansion.
A second trial is examining the mechanism of the increased risk of cardiovascular death in patients with rheumatoid arthritis, using PET/CT to detect changes in arterial inflammation in patients on anti-TNF therapy. We have shown that rheumatoid patients have increased aortic inflammation on FDG PET/CT imaging, which is reduced by anti-TNF therapy. Further studies are investigating the effect of anti TNF therapy on aortic and carotid plaque inflammation. We have also shown that supplementation with BH4 improves endothelial function but not aortic stiffness in rheumatoid patients, proving that reduced NO bioavailability is not responsible for increased stiffness. It is likely that these two ongoing studies will yield high-impact papers, and BRC funding for personnel and equipment was key to generating pilot data to allow subsequent substantive grant funding (from the British Heart Foundation (BHF) in both cases).
There are also fruitful collaborations with industry. One study, just completed, was the first multicentre FDG PET/CT vascular imaging study in the world. The BRC-funded PET/CT machine was the hub of this study, with London and Oxford also providing imaging services. 99 subjects with atherosclerosis were recruited and imaged to determine whether a novel anti-atherosclerosis drug was efficacious at lowering baseline inflammation. The study was carried out with GSK, and the results will be presented in late November 2010 at the American Heart Association meeting. BRC funding has also allowed 'discipline hopping' studies, such as the collaborations with Prof Morrell and Dr Pepke-Zaba at Papworth, where PET/CT is being used to investigate pulmonary artery inflammation in subjects with pulmonary hypertension.