Projects per year
Abstract / Description of output
BACKGROUND: Bioprosthetic valve thrombosis may have implications for valve function and durability.
OBJECTIVES: Using a novel glycoprotein IIb/IIIa receptor radiotracer 18F-GP1, we investigated whether positron emission tomography (PET)-computed tomography (CT) could detect thrombus formation on bioprosthetic aortic valves.
METHODS: Ex vivo experiments were performed on human platelets and explanted bioprosthetic aortic valves. In a prospective cross-sectional study, patients with either bioprosthetic or normal native aortic valves underwent echocardiography, CT angiography, and 18F-GP1 PET-CT.
RESULTS: Flow cytometric analysis, histology, immunohistochemistry, and autoradiography demonstrated selective binding of 18F-GP1 to activated platelet glycoprotein IIb/IIIa receptors and thrombus adherent to prosthetic valves. In total, 75 participants were recruited: 53 with bioprosthetic valves (median time from implantation 37 months [IQR: 12-80 months]) and 22 with normal native aortic valves. Three participants had obstructive valve thrombosis, and a further 3 participants had asymptomatic hypoattenuated leaflet thickening on CT angiography. All bioprosthetic valves, but none of the native aortic valves, demonstrated focal 18F-GP1 uptake on the valve leaflets: median maximum target-to-background ratio 2.81 (IQR: 2.29-3.48) vs 1.43 (IQR: 1.28-1.53) (P < 0.001). Higher 18F-GP1 uptake was independently associated with duration of valve implantation and hypoattenuated leaflet thickening. All 3 participants with obstructive valve thrombosis were anticoagulated for 3 months, leading to resolution of their symptoms, improvement in mean valve gradients, and a reduction in 18F-GP1 uptake.
CONCLUSIONS: Adherence of activated platelets is a common and sustained finding on bioprosthetic aortic valves. 18F-GP1 uptake is higher in the presence of thrombus, regresses with anticoagulation, and has potential use as an adjunctive clinical tool. (18F-GP1 PET-CT to Detect Bioprosthetic Aortic Valve Thrombosis; NCT04073875).
Original language | English |
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Pages (from-to) | 1107-1120 |
Journal | JACC: Cardiovascular Imaging |
Volume | 15 |
Issue number | 6 |
Early online date | 11 Jan 2022 |
DOIs | |
Publication status | Published - 12 Jan 2022 |
Keywords / Materials (for Non-textual outputs)
- 18F-GP1
- bioprosthetic aortic valve replacement
- positron emission tomography-computed tomography
- thrombus
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Incidence, consequences and natural history of left ventricular thrombus after acute anterior myocardial infarction
Dweck, M., Newby, D. & Tzolos, E.
1/02/20 → 31/01/22
Project: Research
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Bioprosthetic Valve Thrombosis
Newby, D., Dweck, M., Tavares, A. & van Beek, E.
1/06/19 → 31/05/21
Project: Research
Equipment
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Edinburgh Imaging Facility
Anne Grant (Manager), Edwin van Beek (Manager) & Scott Semple (Manager)
Deanery of Clinical SciencesFacility/equipment: Facility
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Edinburgh Preclinical Imaging
Carmel Moran (Manager), Adrian Thomson (Manager), Ross J Lennen (Manager), Adriana Tavares (Manager), Carlos J. Alcaide-Corral (Manager), Tim Morgan (Other), Islay Cranston (Other) & Kerry O'Rourke (Other)
Deanery of Clinical SciencesFacility/equipment: Facility