Department of Cardiology, Albert Einstein Medical Center, Philadelphia, PA, USA.
EuroIntervention. 2017 Jun 20;13(3):312-319. doi: 10.4244/EIJ-D-16-00139.
There is a lack of a reliable technique to quantify coronary artery calcification (CAC). Hence, we used optical coherence tomography (OCT) to quantitate three-dimensional CAC volume to examine its association with plaque characteristics.
A total of 250 patients with stable angina undergoing OCT imaging before PCI were included. CAC volume was calculated from every frame of the culprit lesion and divided into tertiles (low, intermediate and high). Quantitative calcium characteristics were assessed in 107 patients who underwent both OCT and IVUS. Increase in CAC volume was associated with reduced lipid volume index, lipid length and number of lipid plaques. Diabetes and LDL cholesterol predicted less coronary calcification whereas age and prior MI predicted increased CAC after adjusting for all clinical factors. Lipid volume index (ρ=-0.001 [-0.003 to -0.00003]; p=0.04) and mean calcium depth (ρ=-0.02 [-0.02 to -0.01]; p=0.000) were inversely related to CAC volume after adjusting for all OCT characteristics, whereas cap thickness increased with increase in CAC volume (ρ=0.01 [0.002-0.03]; p=0.02) only in unadjusted analysis. Regression analysis demonstrated a significant correlation between calcium length (ρ=0.83; p<0.001) and calcium arc (ρ=0.86; p<0.001) measured by IVUS and OCT.
Target lesions with high CAC volume are characterised by reduced plaque lipid content and calcium closer to the luminal border. Fibrous cap thickness increased with increase in calcium volume.
目前缺乏一种可靠的技术来定量冠状动脉钙化（CAC）。因此，我们使用光学相干断层扫描（OCT）来定量三维 CAC 体积，以检查其与斑块特征的关系。
共纳入 250 例接受 PCI 前 OCT 成像的稳定型心绞痛患者。从罪犯病变的每一帧计算 CAC 体积，并将其分为三分位数（低、中、高）。在 107 例同时接受 OCT 和 IVUS 的患者中评估了定量钙特征。CAC 体积的增加与脂质体积指数、脂质长度和脂质斑块数量的减少有关。糖尿病和 LDL 胆固醇预测冠状动脉钙化减少，而年龄和既往 MI 预测在调整所有临床因素后 CAC 增加。脂质体积指数（ρ=-0.001 [-0.003 至-0.00003]；p=0.04）和平均钙深度（ρ=-0.02 [-0.02 至-0.01]；p=0.000）与调整所有 OCT 特征后的 CAC 体积呈负相关，而在未调整分析中，帽厚度随 CAC 体积的增加而增加（ρ=0.01 [0.002-0.03]；p=0.02）。回归分析显示，IVUS 和 OCT 测量的钙长度（ρ=0.83；p<0.001）和钙弧（ρ=0.86；p<0.001）之间存在显著相关性。
CAC 体积高的靶病变斑块的脂质含量减少，靠近管腔边界的钙也减少。纤维帽厚度随钙体积的增加而增加。
