FDG-PET-CT as a Biomarker for Aortic Valve Inflammation

Calcific aortic stenosis (AS) is the most common heart valve disorder in the Western world. Invasive valve replacement (via surgery or percutaneously) is the sole therapy available at present in patients with symptomatic AS. In the past decade several animal and clinical studies have provided new insights into the pathogenesis of AS, suggesting it to be a consequence of an active inflammatory process similar to atherosclerosis. This knowledge has stimulated new hypotheses regarding a role for anti-inflammatory therapies in management of AS. Currently, anatomical imaging with echocardiography is the recommended modality for assessment and surveillance of AS. Biological imaging with newer molecular imaging techniques may be helpful in assessing valvular inflammation and may subsequently help in assessment of valvular effects of anti-inflammatory therapies. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is an emerging tool for quantifying inflammation within an atherosclerotic plaque. In this review, we discuss the role of anti-inflammatory therapy with statin drugs in management of AS with a focus on FDG-PET as a possible biomarker for aortic inflammation.