Relationship between changes in pericoronary adipose tissue attenuation and coronary plaque burden quantified from coronary computed tomography angiography
Relationship between changes in pericoronary adipose tissue attenuation and coronary plaque burden quantified from coronary computed tomography angiography
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DOI：
10.1093/ehjci/jez013
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发表时间：
2019-06-01
影响因子：
6.2
通讯作者：
Dey, Damini
中科院分区：
文献类型：
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作者：
Goeller, Markus;Tamarappoo, Balaji K.;Dey, Damini
目的冠状动脉CT血管成像(CTA)显示右冠状动脉近端(RCA)周围的冠脉周围脂肪组织(PCAT)密度增加与冠脉炎症有关，并改善了斑块特征对心脏死亡的预测。我们的目的是研究PCAT CT衰减是否与冠状动脉斑块负荷的进展有关。方法和结果我们分析了111名稳定的患者(年龄59.2+/-9.8岁，77%男性)的CTA研究，他们接受了顺序CTA(扫描间隔3.4+/-1.6年)，采用相同的采集方案。用半自动软件对总斑块(TP)、钙化斑块(CP)、非钙化斑块(NCP)和低密度非钙化斑块(LD-NCP)的体积和相应的负荷(斑块体积×100%/血管体积)进行量化。PCAT CT衰减(HU)是在RCA近端周围测量的，这是PCAT分析最标准化的方法。NCP负荷增加的患者(n=51)的PCAT衰减增加，而NCP负荷减少的患者(n=60)的PCAT衰减比-2.78(95%CI-4.6to-1.0)HU，P<；0.0001减少。PCAT衰减值与NCP(r=0.001.55，P<0.0 1)和LD-NCP(r=0.2 4，P=0.0 1)负荷变化相关，而与CP负荷变化无关(P=0.3)。基线PCAT衰减&Gt；=-75HU与NCP(优势比3.0 7，95%可信区间1.4~7.0；P<；0.008)和TP负荷增加对随访CTA的影响独立相关。这种成像生物标记物可能有助于识别高危斑块进展风险增加的患者，并允许监测药物治疗的有益变化。
Aims Increased attenuation of pericoronary adipose tissue (PCAT) around the proximal right coronary artery (RCA) from coronary computed tomography angiography (CTA) has been shown to be associated with coronary inflammation and improved prediction of cardiac death over plaque features. Our aim was to investigate whether PCAT CT attenuation is related to progression of coronary plaque burden.Methods and results We analysed CTA studies of 111 stable patients (age 59.2 +/- 9.8 years, 77% male) who underwent sequential CTA (3.4 +/- 1.6 years between scans) with identical acquisition protocols. Total plaque (TP), calcified plaque (CP), non-calcified plaque (NCP), and low-density non-calcified plaque (LD-NCP) volumes and corresponding burden (plaque volume x 100%/vessel volume) were quantified using semi-automated software. PCAT CT attenuation (HU) was measured around the proximal RCA, the most standardized method for PCAT analysis. Patients with an increase in NCP burden (n = 51) showed an increase in PCAT attenuation, whereas patients with a decrease in NCP burden (n = 60) showed a decrease {4.4 [95% confidence interval (CI) 2.6-6.2] vs. -2.78 (95% CI -4.6 to -1.0) HU, P < 0.0001}. Changes in PCAT attenuation correlated with changes in the burden of NCP (r = 0.55, P < 0.001) and LD-NCP (r = 0.24, P = 0.01); but not CP burden (P = 0.3). Increased baseline PCAT attenuation >=-75 HU was independently associated with increase in NCP (odds ratio 3.07, 95% CI 1.4-7.0; P < 0.008) and TP burden on follow-up CTA.Conclusion PCAT attenuation measured from routine CTA is related to the progression of NCP and TP burden. This imaging biomarker may help to identify patients at increased risk of high-risk plaque progression and allow monitoring of beneficial changes from medical therapy.