Department of Medicine and Imaging, Heart Institute, Cardiac Imaging, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Am J Cardiol. 2012 May 1;109(9):1283-7. doi: 10.1016/j.amjcard.2011.12.024. Epub 2012 Feb 13.
Controversy exists concerning the relation between diagonal ear lobe crease (DELC) and coronary artery disease (CAD). We examined whether DELC is associated with CAD using coronary computed tomography (CT) angiography. We studied 430 consecutive patients without a history of coronary artery intervention who underwent CT angiography on a dual-source scanner. Presence of DELC was agreed by 2 blinded observers. Two blinded readers evaluated CT angiography images for presence of CAD and for significant CAD (≥50% stenosis). Chi-square and t tests were used to assess demographic differences between subgroups with and without DELC and the relation of DELC to 4 measurements of CAD: any CAD, significant CAD, multivessel disease (cutoff ≥2), and number of segments with plaque (cutoff ≥3). Multivariable logistic regression was performed to adjust for CAD confounders: age, gender, symptoms, and CAD risk factors. Mean age was 61 ± 13 and 61% were men. DELC was found in 71%, any CAD in 71%, and significant CAD in 17% of patients. After adjusting for confounders, DELC remained a significant predictor of all 4 measurements of CAD (odds ratio 1.8 to 3.3, p = 0.002 to 0.017). Sensitivity, specificity, and positive and negative predictive values for DELC in detecting any CAD were 78%, 43%, 77%, and 45%. Test accuracy was calculated at 67%. Area under the receiver operator characteristic curve was 61% (p = 0.001). In conclusion, in this study of patients imaged with CT angiography, finding DELC was independently and significantly associated with increased prevalence, extent, and severity of CAD.
耳折痕（DELC）与冠状动脉疾病（CAD）之间的关系存在争议。我们使用冠状动脉计算机断层扫描（CT）血管造影检查，检查了 DELC 是否与 CAD 相关。我们研究了 430 例连续无冠状动脉介入史的患者，他们在双源扫描仪上进行了 CT 血管造影检查。两名盲法观察者一致同意存在 DELC。两名盲法读者评估 CT 血管造影图像中 CAD 的存在情况和显著 CAD（≥50%狭窄）。使用卡方检验和 t 检验评估了有和无 DELC 亚组之间的人口统计学差异，以及 DELC 与 CAD 的 4 个测量值之间的关系：任何 CAD、显著 CAD、多血管疾病（≥2 支血管）和斑块节段数（≥3 个节段）。进行多变量逻辑回归以调整 CAD 混杂因素：年龄、性别、症状和 CAD 危险因素。平均年龄为 61±13 岁，61%为男性。71%的患者存在 DELC，71%的患者有任何 CAD，17%的患者有显著 CAD。在调整了混杂因素后，DELC 仍然是所有 4 个 CAD 测量值的显著预测因素（比值比 1.8 至 3.3，p=0.002 至 0.017）。DELC 检测任何 CAD 的敏感性、特异性、阳性预测值和阴性预测值分别为 78%、43%、77%和 45%。测试准确率计算为 67%。接收者操作特征曲线下的面积为 61%（p=0.001）。总之，在这项使用 CT 血管造影成像的患者研究中，发现 DELC 与 CAD 的患病率、程度和严重程度增加独立且显著相关。
