Peri-coronary inflammation is associated with findings on coronary computed tomography angiography and fractional flow reserve
Peri-coronary inflammation is associated with findings on coronary computed tomography angiography and fractional flow reserve
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DOI：
10.1016/j.jcct.2020.02.002
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发表时间：
2020-11-01
影响因子：
5.4
通讯作者：
Kakuta, Tsunekazu
中科院分区：
文献类型：
--
作者：
Hoshino, Masahiro;Yang, Seokhun;Kakuta, Tsunekazu
目的：冠状动脉CT血管造影（CCTA）上脂肪衰减指数（FAI）表示的冠状动脉周围脂肪组织衰减反映了冠状动脉周围炎症，并与心脏死亡率相关。目的：探讨FAI与CCTA全血管及病变斑块定量的相关性。方法：对187支中度狭窄的左前降支（LAD）进行血流储备分数（FFR）测量和CCTA。FAI通过对CCTA上LAD平均CT衰减值的粗略分析来评估。探索FAI和FFR的决定因素。此外，组合的基线数据，CTA衍生的病变斑块评估，全血管量化，心脏质量和FAI对缺血的区分效力的影响进行了评估，作为FFR用于参考standard.Results：平均FAI和中位数FFR值分别为-73.0和0.77。多变量分析显示，男性、源自CTA的正性重塑、较低的最小管腔面积、较高的靶血管总心脏质量和较低的FFR是FAI的独立预测因素。CTA衍生的二维和三维分析以及FAI与FFR值独立且显著相关。对于FFR < 0.75的病变，当将FAI添加到基线模型中时，净重新分类指数和综合辨别力改善指数均显著改善，但对于FFR则无改善
Purpose: Peri-coronary adipose tissue attenuation expressed by fat attenuation index (FAI) on coronary CT angiography (CCTA) reflects peri-coronary inflammation and is associated with cardiac mortality. We aimed to investigate the association between FAI and whole vessel and lesion plaque quantification on CCTA in stable patients with intermediate epicardial stenosis evaluated by fractional flow reserve (FFR).Methods: A total of 187 left anterior descending arteries (LAD) with intermediate stenosis who underwent FFR measurement and CCTA were studied. FAI was assessed by the crude analysis of the mean CT attenuation value of LAD on CCTA. Determinants of FAI and FFR were explored. Furthermore, the impact of combined baseline data, CCTA-derived lesion plaque assessment, whole vessel quantification, cardiac mass and FAI on discrimination efficacy for ischemia was evaluated as FFR used for a reference standard.Results: The mean FAI and the median FFR values were -73.0 and 0.77, respectively. Multivariate analysis revealed that male, CCTA-derived positive remodeling, lower minimum lumen area, higher target vessel total cardiac mass, and lower FFR were independent predictors of FAI. CCTA-derived two-dimensional and threedimensional analysis and FAI were independently and significantly associated with FFR values. Net reclassification index and integrated discrimination improvement index were both significantly improved when FAI was added to the baseline model for lesions with FFR < 0.75, but not for FFR