Pericoronary and periaortic adipose tissue density are associated with inflammatory disease activity in Takayasu arteritis and atherosclerosis.
Pericoronary and periaortic adipose tissue density are associated with inflammatory disease activity in Takayasu arteritis and atherosclerosis.
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冠状动脉周围和主动脉周围脂肪组织密度与大动脉炎和动脉粥样硬化的炎症性疾病活动有关。
DOI：
10.1093/ehjopen/oeab019
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发表时间：
2021-09
期刊：
影响因子：
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通讯作者：
Tarkin JM
中科院分区：
文献类型：
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作者：
Wall C;Huang Y;Le EPV;Ćorović A;Uy CP;Gopalan D;Ma C;Manavaki R;Fryer TD;Aloj L;Graves MJ;Tombetti E;Ariff B;Bambrough P;Hoole SP;Rusk RA;Jayne DR;Dweck MR;Newby D;Fayad ZA;Bennett MR;Peters JE;Slomka P;Dey D;Mason JC;Rudd JHF;Tarkin JM
通过冠状动脉计算机断层扫描血管造影检查冠状动脉周围脂肪组织（PCAT）和主动脉周围脂肪组织（PAAT）密度，以评估大动脉炎（TAK）和动脉粥样硬化的动脉炎症。测量了108例受试者冠状动脉（n = 1016）和主动脉（n = 108）节段的PCAT和PAAT密度[TAK +冠状动脉疾病（CAD），n = 36; TAK，n = 18;动脉粥样硬化性CAD，n = 32;匹配对照，n = 22]。各组间的中位PCAT和PAAT密度不同（mPCAT：P < 0.0001; PAAT：P = 0.0002）。TAK + CAD患者冠状动脉节段的PCAT密度为7.01 ±平均值标准误（SEM）1.78 Hounsfield单位（HU），高于稳定型CAD患者（P = 0.0002），TAK + CAD患者的PCAT密度为8.20 ± SEM 2.04 HU，高于对照组（P = 0.0001）。mPCAT密度与Indian Takayasu临床活动评分（r = 0.43，P = 0.001）和C反应蛋白（r = 0.41，P < 0.0001）相关，活性TAK组高于非活性TAK组（P = 0.002）。高于−74 HU的mPCAT密度对于区分活性TAK与对照组具有100%的灵敏度和95%的特异性[曲线下面积= 0.99（95%置信区间0.97-1）]。PCAT密度与通过68 Ga-DOTATATE正电子发射断层扫描（PET）测量的冠状动脉炎症的相关性相当于68 Ga-DOTATATE最大组织-血液比每增加一个单位，PCAT密度增加2.44 ± SEM 0.77 HU（P = 0.002）。这些结果仍然存在于针对潜在混杂因素调整的多变量敏感性分析中。TAK组的PCAT和PAAT密度高于动脉粥样硬化性CAD或对照组，并与炎症的临床、生化和PET标志物相关。由于具有出色的诊断准确性，PCAT密度可用作评估TAK疾病活动性的临床辅助手段。在这项观察性研究中，冠状动脉周围脂肪组织（PCAT）密度证明了对大动脉炎±冠状动脉疾病（CAD）的良好诊断准确性，并与炎症和疾病活动的临床标志物相关。显示所有主要心外膜冠状动脉段的中位PCAT密度值。
To examine pericoronary adipose tissue (PCAT) and periaortic adipose tissue (PAAT) density on coronary computed tomography angiography for assessing arterial inflammation in Takayasu arteritis (TAK) and atherosclerosis. PCAT and PAAT density was measured in coronary (n = 1016) and aortic (n = 108) segments from 108 subjects [TAK + coronary artery disease (CAD), n = 36; TAK, n = 18; atherosclerotic CAD, n = 32; matched controls, n = 22]. Median PCAT and PAAT densities varied between groups (mPCAT: P < 0.0001; PAAT: P = 0.0002). PCAT density was 7.01 ± standard error of the mean (SEM) 1.78 Hounsfield Unit (HU) higher in coronary segments from TAK + CAD patients than stable CAD patients (P = 0.0002), and 8.20 ± SEM 2.04 HU higher in TAK patients without CAD than controls (P = 0.0001). mPCAT density was correlated with Indian Takayasu Clinical Activity Score (r = 0.43, P = 0.001) and C-reactive protein (r = 0.41, P < 0.0001) and was higher in active vs. inactive TAK (P = 0.002). mPCAT density above −74 HU had 100% sensitivity and 95% specificity for differentiating active TAK from controls [area under the curve = 0.99 (95% confidence interval 0.97–1)]. The association of PCAT density and coronary arterial inflammation measured by 68Ga-DOTATATE positron emission tomography (PET) equated to an increase of 2.44 ± SEM 0.77 HU in PCAT density for each unit increase in 68Ga-DOTATATE maximum tissue-to-blood ratio (P = 0.002). These findings remained in multivariable sensitivity analyses adjusted for potential confounders. PCAT and PAAT density are higher in TAK than atherosclerotic CAD or controls and are associated with clinical, biochemical, and PET markers of inflammation. Owing to excellent diagnostic accuracy, PCAT density could be useful as a clinical adjunct for assessing disease activity in TAK. In this observational study, pericoronary adipose tissue (PCAT) density demonstrated good diagnostic accuracy for Takayasu arteritis ± coronary artery disease (CAD) and was associated with clinical markers of inflammation and disease activity. Median PCAT density values for all major epicardial coronary artery segments displayed.