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Purpose <p>Our study aims to investigate the associations between stress-related neural activity (SNA), a quantified imaging biomarker in processing stress responses assessed by <sup>18</sup>F-FDG-PET/CT, and cardiovascular (CV) outcomes based on available evidence.</p> Methods <p>We searched databases from inception to December 1, 2024. Studies assessing the associations between SNA, as quantified by measuring FDG uptake values in the amygdala using <sup>18</sup>F-FDG-PET/CT, and CV outcomes were included. Risk of bias was evaluated using the Newcastle–Ottawa Scale. Random-effects model was implemented for pooled effect sizes (ESs) and heterogeneity evaluation.</p> Results <p>Ten studies with 3523 patients with <sup>18</sup>F-FDG-PET/CT were included in our analysis (mean age: 58.5 years; 48.9% female). The ESs included in the analysis comprised hazard ratios (HR) and standardized mean differences (SMD). Among the studies reporting HR, 192 (11.5%) patients experienced composite adverse CV events during a mean follow-up period of 3.8 years. SNA significantly correlated with an increased risk of composite adverse CV events (pooled adjusted HR: 1.61, 95% confidence interval [CI]: 1.12, 2.32). Among the studies reported SMD, individuals experienced composite adverse CV events had significantly higher SNA values than those who did not (Hedges’s g = 0.55, 95% CI: 0.14, 0.96).</p> Conclusions <p>SNA, as a noninvasive quantified indicator of processing stress responses assessed by brain <sup>18</sup>F-FDG-PET/CT, is associated with an increased risk of CV outcomes. Further research is warranted to validate these findings and to investigate the clinical utility of SNA across various demographic groups.</p>

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The relation between stress-related neural activity assessed by brain 18F-FDG-PET/CT and cardiovascular outcomes: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年4月2日

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  • Xinyuan Zhang,
  • Hengxin Li,
  • Xiaoyu Niu,
  • Hang Fu,
  • Rong Xu,
  • Ke Xu,
  • Weifeng Yuan,
  • Ting Xu,
  • Jiangyao Zeng,
  • Ziqi Zhou,
  • Yu Song,
  • Suming Zhang,
  • Yingkun Guo,
  • Shan Huang,
  • Huayan Xu

摘要

Purpose

Our study aims to investigate the associations between stress-related neural activity (SNA), a quantified imaging biomarker in processing stress responses assessed by 18F-FDG-PET/CT, and cardiovascular (CV) outcomes based on available evidence.

Methods

We searched databases from inception to December 1, 2024. Studies assessing the associations between SNA, as quantified by measuring FDG uptake values in the amygdala using 18F-FDG-PET/CT, and CV outcomes were included. Risk of bias was evaluated using the Newcastle–Ottawa Scale. Random-effects model was implemented for pooled effect sizes (ESs) and heterogeneity evaluation.

Results

Ten studies with 3523 patients with 18F-FDG-PET/CT were included in our analysis (mean age: 58.5 years; 48.9% female). The ESs included in the analysis comprised hazard ratios (HR) and standardized mean differences (SMD). Among the studies reporting HR, 192 (11.5%) patients experienced composite adverse CV events during a mean follow-up period of 3.8 years. SNA significantly correlated with an increased risk of composite adverse CV events (pooled adjusted HR: 1.61, 95% confidence interval [CI]: 1.12, 2.32). Among the studies reported SMD, individuals experienced composite adverse CV events had significantly higher SNA values than those who did not (Hedges’s g = 0.55, 95% CI: 0.14, 0.96).

Conclusions

SNA, as a noninvasive quantified indicator of processing stress responses assessed by brain 18F-FDG-PET/CT, is associated with an increased risk of CV outcomes. Further research is warranted to validate these findings and to investigate the clinical utility of SNA across various demographic groups.