Assessment of coronary plaque progression in coronary computed tomography angiography using a semiquantitative score.
Assessment of coronary plaque progression in coronary computed tomography angiography using a semiquantitative score.
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DOI：
10.1016/j.jcmg.2009.07.007
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发表时间：
2009-11
影响因子：
14
通讯作者：
Hoffmann, Udo
中科院分区：
文献类型：
--
作者：
Lehman, Sam J.;Schlett, Christopher L.;Bamberg, Fabian;Lee, Hang;Donnelly, Patrick;Shturman, Leon;Kriegel, Matthias F.;Brady, Thomas J.;Hoffmann, Udo
通过计算机断层扫描（CT）血管造影描述冠状动脉粥样硬化斑块随时间的进展，分层斑块组成及其与心血管风险概况的关系。通过CT无创评估斑块组成分层的动脉粥样硬化进展数据有限，并且由于测量的高度可变性而受到阻碍。该分析纳入了以急性胸痛就诊于急诊室但最初没有急性冠状动脉综合征证据的患者。所有患者在基线和2年后使用类似的方案进行了对比增强64层CT检查。CT数据集被共同登记并评估在每条主要冠状动脉近40mm的1mm横截面上是否存在钙化和非钙化斑块。确定斑块随时间的进展及其与危险因素的关系。在一部分患者中进行了测量的可重复性和与斑块体积的相关性。我们纳入了69例患者（平均年龄55±12岁，59%为男性），并比较了基线和随访时共登记的8,311个横截面。在基线时，每个患者在12.5%、10.1%和2.4%的横截面上检测到任何斑块、钙化斑块和非钙化斑块。含有斑块（16.5±25.3比18.6±25.5,p=0.01）和非钙化斑块（3.1±5.8比4.4±7.0,p=0.04）的平均横截面数有显著增加，但没有钙化斑块（13.3±23.1比14.2±22.0,p=0.2）。在纵向回归分析中，在调整年龄、性别和随访时间间隔后，基线斑块的存在、心血管危险因素的数量和吸烟与斑块进展独立相关。基于横截面的半定量评分与斑块体积进展密切相关（r=0.75, p<0.0001），并显示出良好的观察者内部和观察者之间的一致性（回顾性分析，κ=0.95和κ=0.93）。急性胸痛患者冠脉斑块负荷在两年内显著增加。随着时间的推移，进展取决于斑块组成和心血管风险概况。需要更大规模的研究来证实这些结果，并确定药物治疗对进展的影响。
To describe progression of coronary atherosclerotic plaque over time by computed tomography (CT) angiography stratified by plaque composition and its association with cardiovascular risk profiles. Data on the progression of atherosclerosis stratified by plaque composition using non-invasive assessment by CT are limited and hampered by high measurement variability. This analysis included patients who presented with acute chest pain to the emergency room but had initially no evidence for acute coronary syndrome. All patients underwent contrast enhanced 64-slice CT at baseline and after 2-years using a similar protocol. CT datasets were co-registered and assessed for presence of calcified and non-calcified plaque at 1mm cross-sections of the proximal 40mm of each major coronary artery. Plaque progression over time and its association to risk factors were determined. Measurement reproducibility and correlation to plaque volume was performed in a subset of patients. We included 69 patients (mean age 55±12years, 59% male) and compared 8,311 co-registered cross-sections at baseline and follow-up. At baseline, any plaque, calcified plaque, and non-calcified were detected in 12.5%, 10.1%, and 2.4% of cross-sections per patient. There was significant progression in the mean number of cross-sections containing any plaque (16.5±25.3 versus 18.6±25.5, p=0.01) and non-calcified plaque (3.1±5.8 versus 4.4±7.0, p=0.04), but not calcified plaque (13.3±23.1 versus 14.2±22.0, p=0.2). In longitudinal regression analysis, the presence of baseline plaque, number of cardiovascular risk factors and smoking were independently associated with plaque progression after adjustment for age, gender and follow-up time interval. The semi-quantitative score based on cross-sections correlated close with plaque volume progression (r=0.75, p<0.0001) and demonstrated an excellent intra- and inter-observer agreement (κ=0.95 and κ=0.93, retrospectively). Coronary plaque burden of patients with acute chest pain significantly increases over two years. Progression over time is dependent on plaque composition and cardiovascular risk profile. Larger studies are needed to confirm these results and to determine the effect of medical treatment on progression.
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影响因子：
37.8
作者：
Wang, JC;Normand, SLT;Kuntz, RE
通讯作者：
Kuntz, RE
影响因子：
37.8
作者：
Wilson, PWF;D'Agostino, RB;Kannel, WB
通讯作者：
Kannel, WB
影响因子：
120.7
作者：
Nicholls, Stephen J.;Tuzcu, E. Murat;Nissen, Steven E.
通讯作者：
Nissen, Steven E.
DOI：
10.1161/atvbaha.107.155010
发表时间：
2008-03-01
影响因子：
8.7
作者：
Bamberg, Fabian;Dannemann, Nina;Hoffmann, Udo
通讯作者：
Hoffmann, Udo
影响因子：
37.8
作者：
Berry, Colin;L'Allier, Philippe L.;Tardif, Jean-Claude
通讯作者：
Tardif, Jean-Claude