Abstract
In this thesis we have investigated different clinical applications of vascular imaging. The identification of the high-risk atherosclerotic plaque is, with increasing vascular imaging modalities, in the spotlight. Another state of cardiovascular risk is the amount of abdominal visceral adipose tissue. We demonstrated a reliable automated method for the analysis of abdominal visceral adipose tissue, using a 18F-FDG PET/CT scan. This method should be used in further investigations.
People with type 2 diabetes suffer from a seriously increased risk of cardiovascular disease. Multimodal imaging with PET/CT provides greater insight into the interrelation of different cardiovascular markers in type 2 diabetes and may be useful for determining targets for treatment to reduce cardiovascular risk. In addition, anti-diabetic drugs with the dual effect of lowering blood glucose levels and enhancing favorable vascular effects are preferred for treatment of type 2 diabetes. In the RELEASE trial we found that linagliptin monotherapy in early type 2 diabetes reduced PWV and arterial 18F-FDG uptake, both markers of subclinical atherosclerosis. This thesis has contributed evidence for the favorable vascular effects of linagliptin on subclinical atherosclerosis; however the challenge for future trials is to investigate whether those favorable vascular effects will translate into a significant reduction in cardiovascular events. Finally, with novel imaging modalities and new specific radiopharmaceutical tracers, the challenge for vascular imaging will be to translate these possibilities for use in personalized medicine.
People with type 2 diabetes suffer from a seriously increased risk of cardiovascular disease. Multimodal imaging with PET/CT provides greater insight into the interrelation of different cardiovascular markers in type 2 diabetes and may be useful for determining targets for treatment to reduce cardiovascular risk. In addition, anti-diabetic drugs with the dual effect of lowering blood glucose levels and enhancing favorable vascular effects are preferred for treatment of type 2 diabetes. In the RELEASE trial we found that linagliptin monotherapy in early type 2 diabetes reduced PWV and arterial 18F-FDG uptake, both markers of subclinical atherosclerosis. This thesis has contributed evidence for the favorable vascular effects of linagliptin on subclinical atherosclerosis; however the challenge for future trials is to investigate whether those favorable vascular effects will translate into a significant reduction in cardiovascular events. Finally, with novel imaging modalities and new specific radiopharmaceutical tracers, the challenge for vascular imaging will be to translate these possibilities for use in personalized medicine.
| Original language | English |
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| Qualification | Doctor of Philosophy |
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| Award date | 27-Sept-2017 |
| Place of Publication | [Groningen] |
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| Print ISBNs | 978-94-034-0085-3 |
| Electronic ISBNs | 978-94-034-0084-6 |
| Publication status | Published - 2017 |