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主动脉粥样硬化或心外膜脂肪组织体积能否用作预测冠状动脉疾病的标志物?

Can aortic atherosclerosis or epicardial adipose tissue volume be used as a marker for predicting coronary artery disease?

作者信息

Yüce Gökhan, Türkvatan Aysel, Yener Özlem

机构信息

Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.

Department of Radiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.

出版信息

J Cardiol. 2015 Feb;65(2):143-9. doi: 10.1016/j.jjcc.2014.03.017. Epub 2014 Jun 19.

Abstract

PURPOSE

To investigate whether aortic atherosclerosis or epicardial adipose tissue (EAT) volume on multidetector computed tomography (CT) can predict the presence of significant coronary artery disease (CAD).

MATERIALS AND METHODS

Coronary CT angiography was performed in 202 cases of CAD that were known or based on suspicion. Based on coronary CT angiography results, the patients with significant stenosis (≥50%) and without significant stenosis (<50%) were compared in terms of demographic characteristics, traditional cardiovascular risk factors, aortic atherosclerosis, and EAT volume.

RESULTS

Significant coronary artery stenosis was detected in 92 cases (45.5%). Although EAT volume was higher in the patients with significant stenosis, the difference between the two groups was not statistically significant. The presence of calcification in the descending aorta was significantly higher in the patients with significant stenosis than the patients without significant stenosis (50.4% and 15.4%, respectively, p=0.0001). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy rates of the presence of calcification in the descending aorta in predicting the presence of significant coronary artery stenosis were respectively found as 53.8%, 84.4%, 74.6%, 68.1%, and 70.3%. The sensitivity, specificity, PPV, NPV, and accuracy rates of the ≥2.45mm wall thickness of the descending aorta in predicting the presence of significant coronary artery stenosis were respectively found as 75.3%, 74.3%, 71.4%, 77.9%, and 74.8%.

CONCLUSION

There is a strong relationship between thoracic aortic atherosclerosis and CAD. However, the relationship between EAT volume and CAD is not significant. The presence of aortic atherosclerosis can be used as an additional marker together with traditional cardiovascular risk factors for predicting CAD.

摘要

目的

研究在多排螺旋计算机断层扫描(CT)上,主动脉粥样硬化或心外膜脂肪组织(EAT)体积能否预测显著冠状动脉疾病(CAD)的存在。

材料与方法

对202例已知或疑似CAD的患者进行冠状动脉CT血管造影。根据冠状动脉CT血管造影结果,比较有显著狭窄(≥50%)和无显著狭窄(<50%)患者的人口统计学特征、传统心血管危险因素、主动脉粥样硬化和EAT体积。

结果

92例(45.5%)检测到显著冠状动脉狭窄。虽然有显著狭窄患者的EAT体积较高,但两组之间的差异无统计学意义。有显著狭窄患者降主动脉钙化的发生率显著高于无显著狭窄患者(分别为50.4%和15.4%,p = 0.0001)。降主动脉钙化存在时预测显著冠状动脉狭窄的敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和准确率分别为53.8%、84.4%、74.6%、68.1%和70.3%。降主动脉壁厚度≥2.45mm时预测显著冠状动脉狭窄的敏感性、特异性、PPV、NPV和准确率分别为75.3%、74.3%、71.4%、77.9%和74.8%。

结论

胸主动脉粥样硬化与CAD之间存在密切关系。然而,EAT体积与CAD之间的关系不显著。主动脉粥样硬化的存在可与传统心血管危险因素一起用作预测CAD的额外标志物。

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