Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Faculty of Medicine, Department of Cardiology, Erlangen, Germany; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia.
Eur J Radiol. 2020 Apr;125:108874. doi: 10.1016/j.ejrad.2020.108874. Epub 2020 Feb 7.
South Asian (SA) have been observed to have higher cardiovascular mortality rates compared to East Asians (EA) and Caucasians. Pericoronary adipose tissue (PCAT) attenuation around the right coronary artery (RCA) from coronary CT angiography (CTA) has been associated with coronary inflammation and cardiac death. We aimed to investigate i) the relationship between plaque characteristics and PCAT attenuation and ii) to assess gender and ethnic differences in PCAT attenuation using a matched cohort of SA, EA and Caucasians.
Three-hundred symptomatic patients who underwent CTA were matched for age, gender, BMI and diabetes (100 in each ethnic group). Semi-automated software was used to quantify the total volumes and burden of non-calcified plaque (NCP), low-density non-calcified plaque (LD-NCP) and calcified plaque (CP) in blinded core-lab analysis. PCAT CT attenuation was measured around the RCA (10-50 mm from RCA ostium), the most standardized model for PCAT analysis.
The total volumes and burden of NCP, LD-NCP and CP were comparable in the ethnic groups (each p > 0.05). PCAT attenuation was higher in patients with coronary plaque. PCAT attenuation correlated with the total volumes and burden of NCP, LD-NCP and CP (r>0.17; p < 0.003). Within the RCA this correlation persisted only for NCP features (r>0.39;p < 0.001). Males showed higher PCAT attenuation (p < 0.001). PCAT attenuation was similar between Caucasian, EA and SA (p = 0.32).
PCAT CT attenuation correlated most with its surrounded NCP features further highlighting its role as surrogate measure of coronary inflammation. As coronary plaque burden and RCA PCAT attenuation did not differ between ethnic groups, causes of increased cardiac mortality in South Asians needs further investigations.
与东亚人和高加索人相比，南亚人（SA）的心血管死亡率更高。冠状动脉 CT 血管造影（CTA）显示右冠状动脉（RCA）周围的冠状脂肪组织（PCAT）衰减与冠状动脉炎症和心脏死亡有关。我们旨在研究：i）斑块特征与 PCAT 衰减之间的关系，ii）使用南亚、东亚和高加索人的匹配队列评估 PCAT 衰减的性别和种族差异。
对 300 例接受 CTA 的有症状患者进行年龄、性别、BMI 和糖尿病匹配（每组 100 例）。使用半自动软件对非钙化斑块（NCP）、低密非钙化斑块（LD-NCP）和钙化斑块（CP）的总容积和负荷进行定量分析，在盲法核心实验室分析中进行。在 RCA（RCA 开口 10-50mm 处）周围测量 PCAT CT 衰减，这是 PCAT 分析最标准化的模型。
在不同种族中，NCP、LD-NCP 和 CP 的总容积和负荷相似（p > 0.05，均为）。有冠状动脉斑块的患者 PCAT 衰减较高。PCAT 衰减与 NCP、LD-NCP 和 CP 的总容积和负荷呈正相关（r > 0.17；p < 0.003）。在 RCA 内，这种相关性仅持续存在于 NCP 特征（r > 0.39；p < 0.001）。男性的 PCAT 衰减较高（p < 0.001）。高加索人、东亚人和南亚人的 PCAT 衰减相似（p = 0.32）。
PCAT CT 衰减与周围的 NCP 特征相关性最强，进一步突出了其作为冠状动脉炎症替代测量指标的作用。由于不同种族之间的冠状动脉斑块负担和 RCA PCAT 衰减没有差异，南亚人心脏死亡率增加的原因需要进一步研究。
