高密度脂蛋白胆固醇对近红外光谱评估的薄帽纤维粥样硬化病变最大脂质核心负荷指数的影响。
The influence of high-density lipoprotein cholesterol on maximal lipid core burden indexing thin cap fibrous atheroma lesions as assessed by near infrared spectroscopy.
机构信息
Division of Cardiology and Structural Heart Diseases, Medical University of Silesia in Katowice, Poland.
Department of Sports Theory, Jerzy Kukuczka Academy of Physical Education in Katowice, Poland.
出版信息
Cardiol J. 2021;28(6):887-895. doi: 10.5603/CJ.a2019.0126. Epub 2020 Jan 7.
BACKGROUND
Previous studies suggest that higher plasma concentrations of several lipid molecules are associated with higher lipid core burden index (LCBI) near infrared spectroscopy (NIRS) imaging. The aim of this study was to investigate whether an association between plasma lipids depends on plaque morphology (thin cap fibrous atheroma [TCFA] vs. non-TFCA) as measured by near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS).
METHODS
Sixty-four patients retrospectively enrolled were diagnosed with stable coronary artery disease or acute coronary syndrome who underwent NIRS-IVUS imaging. Before percutaneous coronary intervention, blood samples were collected for measurement of serum levels of total cholesterol (TC), lowdensity lipoprotein cholesterol (HDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). Patients were divided into two groups based on maxLCBI4mm and IVUS imaging. Those with maxLCBI4mm ≥ 323 were included into TCFA group (n = 35) while others were assigned to the non-TCFA group (n = 29).
RESULTS
Thin cap fibrous atheroma lesions were significantly longer than the non-TCFA lesions (25.66 ± 9.56 vs. 17.03 ± 9.22, p = 0.001). TCFA characterizes greater plaque burden (78.4 [70.9, 82.2] vs. 72.70 [64.77, 76,05]; p = 0.021) and plaque volume (176.1 [110.75, 247.5] vs. 68.1 [55.58, 143.35]; p = 0.000) as compared to non-TCFA. In TCFA suspected lesions, there was no correlation between max-LCBI4mm and LDL levels (r = 0.105, p = 0.549) nor TC levels (r = -0.035, p = 0.844) but a negative correlation was found between HDL-C and maxLCBI4mm (r = -0.453, p = 0.007).
CONCLUSIONS
The present study showed that there was no correlation between plasma LDL-C, TC and TG level and the amount of lipids in coronary plaque assessed by NIRS in both TCFA and non-TCFA groups. Only HDL-C correlated with maxLCBI4mm in TCFA lesions.
背景
先前的研究表明，几种脂质分子的血浆浓度较高与近红外光谱（NIRS）成像的脂质核心负荷指数（LCBI）较高有关。本研究旨在探讨血浆脂质与斑块形态（薄帽纤维粥样硬化[TCFA]与非-TCFA）之间的相关性，该斑块形态通过近红外光谱-血管内超声（NIRS-IVUS）进行测量。
方法
回顾性纳入 64 名经 NIRS-IVUS 成像诊断为稳定型冠状动脉疾病或急性冠状动脉综合征的患者。在经皮冠状动脉介入治疗前，采集血样测量总胆固醇（TC）、低密度脂蛋白胆固醇（HDL-C）、高密度脂蛋白胆固醇（HDL-C）和甘油三酯（TG）的血清水平。根据 maxLCBI4mm 和 IVUS 成像，将患者分为两组。maxLCBI4mm≥323 的患者纳入 TCFA 组（n=35），其余患者纳入非-TCFA 组（n=29）。
结果
薄帽纤维粥样硬化病变明显长于非-TCFA 病变（25.66±9.56 比 17.03±9.22，p=0.001）。TCFA 斑块负荷更大（78.4[70.9，82.2]比 72.70[64.77，76.05]；p=0.021），斑块体积更大（176.1[110.75，247.5]比 68.1[55.58，143.35]；p=0.000）。与非-TCFA 相比，在疑似 TCFA 病变中，max-LCBI4mm 与 LDL 水平（r=0.105，p=0.549）或 TC 水平（r=-0.035，p=0.844）之间无相关性，但与 HDL-C 呈负相关（r=-0.453，p=0.007）。
结论
本研究表明，在 TCFA 和非-TCFA 两组中，血浆 LDL-C、TC 和 TG 水平与 NIRS 评估的冠状动脉斑块中的脂质量之间均无相关性。只有 HDL-C 与 TCFA 病变的 maxLCBI4mm 相关。
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