Evaluating the role of pericoronary adipose tissue on coronary artery disease: insights from CCTA on risk assessment, vascular stenosis, and plaque characteristics.

IF 2.8 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Frontiers in Cardiovascular Medicine Pub Date : 2024-10-23 eCollection Date: 2024-01-01 DOI:10.3389/fcvm.2024.1451807
Jingyue Wang, Huicong Zhang, Zihao Wang, Wenyun Liu, Dianbo Cao, Qian Tong
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Abstract

Introduction: Pericoronary adipose tissue (PCAT) plays a significant role in the occurrence and progression of coronary artery disease (CAD). This study investigates the relationship between PCAT and CAD, focusing on the occurrence of the disease, the severity of vascular narrowing, and the characteristics of arterial plaques.

Methods: We analyzed a cohort of 152 individuals with CAD and 55 individuals with non-coronary artery disease (N-CAD). Participants underwent both coronary computed tomography angiography (CCTA) and digital subtraction angiography (DSA). Utilizing United Imaging software for artificial intelligence delineation, we measured the fat attenuation index (FAI) and volume of PCAT in the left anterior descending (LAD), left circumflex (LCX), and right coronary arteries (RCA).

Results: Our findings demonstrate that while CCTA is effective in diagnosing CAD compared to DSA, its diagnostic power for individual coronary arteries remains limited. Further analysis revealed that the FAI of the RCA and the overall PCAT volume independently influenced CAD (OR: 1.057, 95% CI: 1.002 to 1.116; OR: 0.967, 95% CI: 0.936 to 0.999). FAI showed a significant independent effect on RCA stenosis (OR: 1.041, 95% CI: 1.003 to 1.081), while the fat volume of the LAD had a significant independent effect on LAD stenosis (OR: 0.884, 95% CI: 0.809 to 0.965). A higher FAI and a lower fat volume were significantly correlated with more severe vascular stenosis percentages in all three arteries (p < 0.05), except for the fat volume and stenosis of the LCX. Moreover, we found the significant differences in the fat volume of the LCX between different plaque types (H = 8.869, p = 0.012), with calcified plaques consistently exhibiting the lowest fat volume across all three arteries. Finally, the likelihood ratio test confirmed that incorporating the PCAT fat volume parameter of LAD significantly improved the diagnostic ability of CCTA for both CAD (p = 0.01543) and LAD stenosis (p = 0.001585).

Conclusion: The quantification of PCAT has potential application value in the comprehensive assessment of CAD. It is recommended that cardiology and radiology departments consider incorporating PCAT into the assessment criteria for patients suspected of having CAD.

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评估冠状动脉周围脂肪组织对冠状动脉疾病的作用:CCTA 对风险评估、血管狭窄和斑块特征的启示。
导言:冠状动脉周围脂肪组织(PCAT)在冠状动脉疾病(CAD)的发生和发展中起着重要作用。本研究调查了 PCAT 与 CAD 之间的关系,重点关注疾病的发生、血管狭窄的严重程度以及动脉斑块的特征:我们对 152 名患有冠状动脉粥样硬化症(CAD)的患者和 55 名患有非冠状动脉疾病(N-CAD)的患者进行了分析。参与者接受了冠状动脉计算机断层扫描(CCTA)和数字减影血管造影(DSA)检查。我们利用 United Imaging 软件进行人工智能划线,测量了左前降支(LAD)、左环挠(LCX)和右冠状动脉(RCA)的脂肪衰减指数(FAI)和 PCAT 容量:我们的研究结果表明,虽然与 DSA 相比,CCTA 能有效诊断 CAD,但其对单支冠状动脉的诊断能力仍然有限。进一步分析表明,RCA 的 FAI 和 PCAT 总体积对 CAD 有独立影响(OR:1.057,95% CI:1.002 至 1.116;OR:0.967,95% CI:0.936 至 0.999)。FAI对RCA狭窄有明显的独立影响(OR:1.041,95% CI:1.003至1.081),而LAD脂肪量对LAD狭窄有明显的独立影响(OR:0.884,95% CI:0.809至0.965)。较高的 FAI 和较低的脂肪体积与所有三条动脉中更严重的血管狭窄百分比均有显著相关性(p H = 8.869,p = 0.012),钙化斑块在所有三条动脉中始终表现出最低的脂肪体积。最后,似然比检验证实,加入 LAD 的 PCAT 脂肪体积参数可显著提高 CCTA 对 CAD(p = 0.01543)和 LAD 狭窄(p = 0.001585)的诊断能力:结论:PCAT 的量化在全面评估 CAD 方面具有潜在的应用价值。建议心脏科和放射科考虑将 PCAT 纳入疑似 CAD 患者的评估标准。
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来源期刊
Frontiers in Cardiovascular Medicine
Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine
CiteScore
3.80
自引率
11.10%
发文量
3529
审稿时长
14 weeks
期刊介绍: Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.
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