Two translational cardiology studies led by Dr James Rudd, Department of Medicine, and published in the latest edition of the Journal of the American College of Cardiology, have developed new PET imaging techniques to identify hypoxia and inflammation in atherosclerosis – the build-up of fatty plaques in the arterial walls that lead to the brain or the heart. These important results could lead to better identification of patients at risk, allowing the treatment of potentially-fatal fatty plaques before they cause a heart attack or stroke.

The CHAI study is the first prospective human study to quantify hypoxia in atherosclerosis using the validated PET tracer, FMISO. Symptomatic carotid plaques were more hypoxic than asymptomatic lesions, perhaps identifying a novel target for drug therapy. The correlation between FDG and FMISO suggests that hypoxia contributes to the FDG signal in atherosclerosis PET studies. Dr Francis Joshi (Department of Medicine), first author, was awarded an American Heart Association Early Career Investigator Award and a British Atherosclerosis Society Binks Trust Award for his work.
 
In the VISION study, the researchers validated 68Ga-DOTATATE PET as a novel marker of atherosclerotic inflammation. Compared to 18F-FDG, 68Ga-DOTATATE offers superior coronary imaging, excellent macrophage specificity and better power to discriminate high-risk vs. low-risk lesions. For his work on the VISION study, Dr Jason Tarkin (Department of Medicine) was awarded the Young Investigator award from the American Heart Association.

Taken together, it is hoped that this research, supported by the Wellcome Trust, The British Heart Foundation and the NIHR Cambridge Biomedical Research Centre, will open up new therapeutic avenues for atherosclerosis, the leading cause of death in the UK and worldwide and the driver of most heart attacks and strokes.