Pericardial fat burden on ECG-gated noncontrast CT in asymptomatic patients who subsequently experience adverse cardiovascular events.
Pericardial fat burden on ECG-gated noncontrast CT in asymptomatic patients who subsequently experience adverse cardiovascular events.
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DOI：
10.1016/j.jcmg.2009.12.013
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发表时间：
2010-04
影响因子：
14
通讯作者：
Berman, Daniel S.
中科院分区：
文献类型：
--
作者：
Cheng, Victor Y.;Dey, Damini;Tamarappoo, Balaji;Nakazato, Ryo;Gransar, Heidi;Miranda-Peats, Romalisa;Ramesh, Amit;Wong, Nathan D.;Shaw, Leslee J.;Slomka, Piotr J.;Berman, Daniel S.
心包脂肪体积（PFV）和胸脂肪体积（TFV）可以通过非对比CT （NCT）常规测量，用于计算冠状动脉钙评分（CCS），并可预测主要不良心血管事件（MACE）风险。从2751名无已知CAD的无症状患者和NCT后MACE（心源性死亡、心肌梗死、卒中、晚期血运重建）4年随访中，我们比较了58名MACE患者（“事件”）和174名同性无事件对照者，并通过倾向评分来匹配年龄、危险因素和CCS。自动计算TFV，人工辅助确定心包轮廓计算PFV，其中脂肪体素自动识别。采用条件多变量logistic回归评估PFV和TFV与MACE的独立关系。事件的平均PFV（101.8±49.2 cm3 vs. 84.9±37.7 cm3, p=0.007）和TFV（204.7±90.3 cm3 vs. 177±80.3 cm3, p=0.029）较高，PFV>125 cm3 （33% vs. 14%, p=0.002）和TFV>250 cm3 （31% vs. 17%, p=0.025）的频率较高。在调整Framingham Risk Score、CCS和身体质量指数后，PFV和TFV与MACE显著相关(PFV每增加一倍，优势比（OR） 1.74, 95%CI 1.03-2.95；OR为1.78,95%CI为1.01-3.14)。受试者工作特征分析的曲线下面积显示，当PFV加入FRS和CCS时，MACE预测有改善的趋势（0.73 vs 0.68, p=0.058）。在FRS和CCS中加入PFV，而不是TFV，提高了预测MACE的估计特异性（0.72 vs 0.66, p=0.008）和总体准确性（0.70 vs 0.65, p=0.009）。经历过MACE的无症状患者在MACE前NCT上表现出更大的PFV，与无事件的对照组相比，心血管风险概况相似。我们的初步研究结果表明，PFV可能有助于改善MACE的预测。
Pericardial fat volume (PFV) and thoracic fat volume (TFV) can be routinely measured from noncontrast CT (NCT) performed for calculating coronary calcium score (CCS) and may predict major adverse cardiovascular event (MACE) risk. From a registry of 2751 asymptomatic patients without known CAD and 4-year follow-up for MACE (cardiac death, myocardial infarction, stroke, late revascularization) after NCT, we compared 58 patients with MACE (“EVENTS”) to 174 same-sex event-free controls matched by a propensity score to account for age, risk factors, and CCS. TFV was automatically calculated, and PFV was calculated with manual assistance in defining the pericardial contour, within which fat voxels were automatically identified. Independent relationships of PFV and TFV to MACE were evaluated using conditional multivariable logistic regression. EVENTS had higher mean PFV (101.8±49.2 cm3 vs. 84.9±37.7 cm3, p=0.007) and TFV (204.7±90.3 cm3 vs. 177±80.3 cm3, p=0.029) and higher frequencies of PFV>125 cm3 (33% vs. 14%, p=0.002) and TFV>250 cm3 (31% vs. 17%, p=0.025). After adjusting for Framingham Risk Score, CCS, and body-mass-index, PFV and TFV were significantly associated with MACE (odds ratio (OR) 1.74, 95%CI 1.03–2.95 for each doubling of PFV; OR 1.78, 95%CI 1.01–3.14 for TFV). Areas-under-the-curve from receiver operating characteristic analyses showed a trend of improved MACE prediction when PFV was added to FRS and CCS (0.73 vs 0.68, p=0.058). Addition of PFV, but not TFV, to FRS and CCS improved estimated specificity (0.72 vs 0.66, p=0.008) and overall accuracy (0.70 vs 0.65, p=0.009) in predicting MACE. Asymptomatic patients who experience MACE exhibit greater PFV on pre-MACE NCT when compared to event-free controls with similar cardiovascular risk profiles. Our preliminary findings suggest that PFV may help improve prediction of MACE.
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影响因子：
19.7
作者：
Yoshizumi, T;Nakamura, T;Matsuzawa, Y
通讯作者：
Matsuzawa, Y
影响因子：
37.8
作者：
D'Agostino, Ralph B., Jr.
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D'Agostino, Ralph B., Jr.
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37.8
作者：
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158.5
作者：
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Lauer, MS
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作者：
KVIST, H;CHOWDHURY, B;SJOSTROM, L
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SJOSTROM, L