Ghanem Ahmed M, Matta Jatin Raj, Elgarf Reham, Hamimi Ahmed, Muniyappa Ranganath, Ishaq Hadjira, Hadigan Colleen, McConnell Michael V, Gharib Ahmed M, Abd-Elmoniem Khaled Z
Biomedical and Metabolic Imaging Branch (A.M.G., J.R.M., R.E., A.H., H.I., A.M.G., K.Z.A.) and Diabetes, Endocrinology, and Obesity Branch, Clinical Endocrinology Section (R.M.), National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Building 10, Room 3-5340, MSC 1263, 10 Center Drive, Bethesda, MD 20892; Laboratory of Immunoregulation, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md (C.H.); Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, Calif (M.V.M.); and Cardiovascular Health Innovations, Verily Life Sciences/Alphabet, South San Francisco, Calif (M.V.M.).
Radiol Cardiothorac Imaging. 2019 Apr 25;1(1):e180007. doi: 10.1148/ryct.2019180007.
To demonstrate the association between coronary vessel wall thickness (VWT) measured at MRI and coronary artery disease (CAD) risk in asymptomatic groups at low and intermediate risk on the basis of Framingham score.
A total of 131 asymptomatic adults were prospectively enrolled. All participants underwent CT angiography for scoring CAD, and coronary VWT was measured at 3.0-T MRI. Nonlinear single and multivariable regression analyses with consideration for interaction with sex were performed to investigate the association of traditional atherosclerotic risk factors and VWT with CT angiography-based CAD scores.
The analysis included 62 women and 62 men with low or intermediate Framingham score of less than 20%. Age (mean age, 45.0 years ± 14.5 [standard deviation]) and body mass index were not different between the groups. Age, sex, and VWT were individually significantly associated with all CT angiography-based CAD scores ( < .05). Additionally, sex was a significant effect modifier of the associations with all CAD scores. In men, age was the only statistically significant independent risk factor of CAD; in women, VWT was the only statistically significant independent surrogate associated with increased CAD scores ( < .05).
In asymptomatic women, VWT MRI was the primary independent surrogate of CAD, whereas age was the strongest risk factor in men. This study suggests that VWT may be used as a CAD surrogate in women at low or intermediate risk of CAD. Further longitudinal studies are required to determine the potential implication and use of this MRI technique for the preventative management of CAD in women.© RSNA, 2019.
基于弗雷明汉评分，在低风险和中等风险的无症状人群中，证明磁共振成像（MRI）测量的冠状动脉血管壁厚度（VWT）与冠状动脉疾病（CAD）风险之间的关联。
前瞻性纳入131名无症状成年人。所有参与者均接受CT血管造影以对CAD进行评分，并在3.0-T MRI上测量冠状动脉VWT。进行了考虑性别交互作用的非线性单变量和多变量回归分析，以研究传统动脉粥样硬化危险因素和VWT与基于CT血管造影的CAD评分之间的关联。
分析纳入了62名女性和62名男性，其弗雷明汉评分低或中等，低于20%。两组之间的年龄（平均年龄45.0岁±14.5[标准差]）和体重指数无差异。年龄、性别和VWT分别与所有基于CT血管造影的CAD评分显著相关（P<0.05）。此外，性别是所有CAD评分关联的显著效应修饰因素。在男性中，年龄是CAD唯一具有统计学意义的独立危险因素；在女性中，VWT是与CAD评分增加相关的唯一具有统计学意义的独立替代指标（P<0.05）。
在无症状女性中，VWT MRI是CAD的主要独立替代指标，而年龄是男性中最强的危险因素。本研究表明，VWT可作为CAD低风险或中等风险女性的CAD替代指标。需要进一步的纵向研究来确定这种MRI技术在女性CAD预防管理中的潜在意义和用途。©RSNA，2019年。
