Curillova Zelmira, Yaman Bettina F, Dorbala Sharmila, Kwong Raymond Y, Sitek Arkadius, El Fakhri Georges, Anagnostopoulos Constantinos, Di Carli Marcelo F
Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham & Women's Hospital, Boston, MA, USA.
Eur J Nucl Med Mol Imaging. 2009 Oct;36(10):1603-10. doi: 10.1007/s00259-009-1121-1. Epub 2009 Apr 22.
To evaluate the relationship between coronary artery calcium (CAC) and coronary vasodilator function.
We evaluated 136 patients without known coronary artery disease (CAD) undergoing vasodilator stress (82)Rb PET/CT and CAC scoring who showed normal myocardial perfusion. The CAC score, resting and hyperemic myocardial blood flow (MBF), coronary flow reserve (CFR) and coronary vascular resistance were analyzed.
Global and regional CAC scores showed significant but weak inverse correlations with hyperemic MBF (r=-0.31 and r=-0.26, p< or =0.0002 respectively) and CFR (r=-0.28 and r=-0.2, p< or =0.001 respectively). With increasing CAC score, there was a modest stepwise decline in CFR on a per-patient basis (1.8+/-0.5 vs 1.7+/-0.5 vs 1.5+/-0.4, p=0.048, with total CAC=0, 1-400 and >400, respectively) and on a per-vessel basis. In multivariable modeling only body mass index and CAC score were predictive of CFR.
In patients with an intermediate likelihood of, but without overt, CAD, there is a statistically significant but weak inverse correlation between CAC content and coronary vasodilator function. The strength of this association weakens after adjusting CAC scores for age, gender and coronary risk factors. This suggests that CAC and coronary vasodilator function provide biologically different information regarding atherosclerosis.
评估冠状动脉钙化（CAC）与冠状动脉舒张功能之间的关系。
我们评估了136例无已知冠状动脉疾病（CAD）且接受血管扩张应激（82）Rb PET/CT和CAC评分的患者，这些患者心肌灌注正常。分析了CAC评分、静息和充血心肌血流量（MBF）、冠状动脉血流储备（CFR）和冠状动脉血管阻力。
整体和局部CAC评分与充血MBF（r = -0.31和r = -0.26，p分别≤0.0002）和CFR（r = -0.28和r = -0.2，p分别≤0.001）呈显著但微弱的负相关。随着CAC评分增加，每位患者的CFR呈适度逐步下降（分别为1.8±0.5 vs 1.7±0.5 vs 1.5±0.4，p = 0.048，总CAC分别为0、1 - 400和>400），且在每条血管基础上也是如此。在多变量建模中，只有体重指数和CAC评分可预测CFR。
在有中等CAD可能性但无明显CAD的患者中，CAC含量与冠状动脉舒张功能之间存在统计学上显著但微弱的负相关。在对年龄、性别和冠状动脉危险因素调整CAC评分后，这种关联的强度减弱。这表明CAC和冠状动脉舒张功能在动脉粥样硬化方面提供了生物学上不同的信息。
