• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

冠状动脉和全胸钙评分可预测 COVID-19 患者的死亡率，并提供病理生理学见解。

Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients.

机构信息

GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy.

GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy.

出版信息

J Cardiovasc Comput Tomogr. 2021 Sep-Oct;15(5):421-430. doi: 10.1016/j.jcct.2021.03.003. Epub 2021 Mar 11.

DOI:10.1016/j.jcct.2021.03.003
PMID:33744175
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7946543/
Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) has spread worldwide determining dramatic impacts on healthcare systems. Early identification of high-risk parameters is required in order to provide the best therapeutic approach. Coronary, thoracic aorta and aortic valve calcium can be measured from a non-gated chest computer tomography (CT) and are validated predictors of cardiovascular events and all-cause mortality. However, their prognostic role in acute systemic inflammatory diseases, such as COVID-19, has not been investigated.

OBJECTIVES

The aim was to evaluate the association of coronary artery calcium and total thoracic calcium on in-hospital mortality in COVID-19 patients.

METHODS

1093 consecutive patients from 16 Italian hospitals with a positive swab for COVID-19 and an admission chest CT for pneumonia severity assessment were included. At CT, coronary, aortic valve and thoracic aorta calcium were qualitatively and quantitatively evaluated separately and combined together (total thoracic calcium) by a central Core-lab blinded to patients' outcomes.

RESULTS

Non-survivors compared to survivors had higher coronary artery [Agatston (467.76 ​± ​570.92 vs 206.80 ​± ​424.13 ​mm, p ​< ​0.001); Volume (487.79 ​± ​565.34 vs 207.77 ​± ​406.81, p ​< ​0.001)], aortic valve [Volume (322.45 ​± ​390.90 vs 98.27 ​± ​250.74 mm, p ​< ​0.001; Agatston 337.38 ​± ​414.97 vs 111.70 ​± ​282.15, p ​< ​0.001)] and thoracic aorta [Volume (3786.71 ​± ​4225.57 vs 1487.63 ​± ​2973.19 mm, p ​< ​0.001); Agatston (4688.82 ​± ​5363.72 vs 1834.90 ​± ​3761.25, p ​< ​0.001)] calcium values. Coronary artery calcium (HR 1.308; 95% CI, 1.046-1.637, p ​= ​0.019) and total thoracic calcium (HR 1.975; 95% CI, 1.200-3.251, p ​= ​0.007) resulted to be independent predictors of in-hospital mortality.

CONCLUSION

Coronary, aortic valve and thoracic aortic calcium assessment on admission non-gated CT permits to stratify the COVID-19 patients in-hospital mortality risk.

摘要

背景

2019 年冠状病毒病（COVID-19）已在全球范围内传播，对医疗系统造成了巨大影响。为了提供最佳的治疗方法，需要早期识别高危参数。冠状动脉、胸主动脉和主动脉瓣钙可以从非门控胸部计算机断层扫描（CT）中测量，并且是心血管事件和全因死亡率的有效预测指标。然而，它们在 COVID-19 等急性全身性炎症性疾病中的预后作用尚未得到研究。

目的

旨在评估冠状动脉钙和总胸钙与 COVID-19 患者住院死亡率的相关性。

方法

纳入了来自意大利 16 家医院的 1093 例连续患者，这些患者的 COVID-19 拭子检测呈阳性，并因肺炎严重程度评估而行入院胸部 CT。在 CT 上，通过中央核心实验室对冠状动脉、主动脉瓣和胸主动脉钙进行定性和定量评估，并将其分别与（总胸钙）结合在一起，该实验室对患者的结局不知情。

结果

与幸存者相比，非幸存者的冠状动脉 [Agatston（467.76 ± 570.92 比 206.80 ± 424.13 毫米，p < 0.001）；体积（487.79 ± 565.34 比 207.77 ± 406.81，p < 0.001）]、主动脉瓣 [体积（322.45 ± 390.90 比 98.27 ± 250.74 毫米，p < 0.001；Agatston 337.38 ± 414.97 比 111.70 ± 282.15，p < 0.001）]和胸主动脉 [体积（3786.71 ± 4225.57 比 1487.63 ± 2973.19 毫米，p < 0.001；Agatston（4688.82 ± 5363.72 比 1834.90 ± 3761.25，p < 0.001）]钙值更高。冠状动脉钙（HR 1.308；95%CI，1.046-1.637，p = 0.019）和总胸钙（HR 1.975；95%CI，1.200-3.251，p = 0.007）是住院死亡率的独立预测因素。

结论

入院非门控 CT 上的冠状动脉、主动脉瓣和胸主动脉钙评估可使 COVID-19 患者的住院死亡率风险分层。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad7b/7946543/4124c437327a/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad7b/7946543/c758869b89a9/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad7b/7946543/4b15bcf34b1d/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad7b/7946543/4124c437327a/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad7b/7946543/c758869b89a9/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad7b/7946543/4b15bcf34b1d/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad7b/7946543/4124c437327a/gr3_lrg.jpg

相似文献

1
Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients.冠状动脉和全胸钙评分可预测 COVID-19 患者的死亡率，并提供病理生理学见解。
J Cardiovasc Comput Tomogr. 2021 Sep-Oct;15(5):421-430. doi: 10.1016/j.jcct.2021.03.003. Epub 2021 Mar 11.
2
Association of progressive thoracic aortic calcification with future cardiovascular events and all-cause mortality: ability to improve risk prediction? Results of the Heinz Nixdorf Recall (HNR) study.胸主动脉进行性钙化与未来心血管事件和全因死亡率的关系：改善风险预测的能力？海因茨·尼克斯多夫召回研究（HNR）的结果。
Eur Heart J Cardiovasc Imaging. 2019 Jun 1;20(6):709-717. doi: 10.1093/ehjci/jey173.
3
Sex Differences in Coronary Artery and Thoracic Aorta Calcification and Their Association With Cardiovascular Mortality in Heavy Smokers.重度吸烟者冠状动脉和胸主动脉钙化的性别差异及其与心血管死亡率的关系。
JACC Cardiovasc Imaging. 2019 Sep;12(9):1808-1817. doi: 10.1016/j.jcmg.2018.10.026. Epub 2019 Jan 16.
4
The impact of gender on cardiovascular system calcification in very elderly patients with severe aortic stenosis.性别对高龄重度主动脉瓣狭窄患者心血管系统钙化的影响。
Int J Cardiovasc Imaging. 2016 Jan;32(1):173-9. doi: 10.1007/s10554-015-0752-5. Epub 2015 Aug 29.
5
Development of a Risk Score Based on Aortic Calcification to Predict 1-Year Mortality After Transcatheter Aortic Valve Replacement.基于主动脉钙化的风险评分模型预测经导管主动脉瓣置换术后 1 年死亡率。
JACC Cardiovasc Imaging. 2019 Jan;12(1):123-132. doi: 10.1016/j.jcmg.2018.03.018. Epub 2018 May 16.
6
Prognostic Value of Thoracic Aorta Calcification Burden in Patients Treated With TAVR.经导管主动脉瓣置换术治疗患者胸主动脉钙化负荷的预后价值
JACC Cardiovasc Imaging. 2019 Jan;12(1):216-217. doi: 10.1016/j.jcmg.2018.08.030. Epub 2018 Nov 15.
7
Estimation of cardiovascular risk on routine chest CT: Ordinal coronary artery calcium scoring as an accurate predictor of Agatston score ranges.常规胸部CT评估心血管风险：序贯冠状动脉钙化积分作为阿加斯顿积分范围的准确预测指标。
J Cardiovasc Comput Tomogr. 2017 Jan-Feb;11(1):8-15. doi: 10.1016/j.jcct.2016.10.001. Epub 2016 Oct 5.
8
Computed tomography-derived cardiovascular risk markers, incident cardiovascular events, and all-cause mortality in nondiabetics: the Multi-Ethnic Study of Atherosclerosis.计算机断层扫描衍生的心血管风险标志物、非糖尿病患者的心血管事件发生率和全因死亡率：动脉粥样硬化多民族研究
Eur J Prev Cardiol. 2014 Oct;21(10):1233-41. doi: 10.1177/2047487313492065. Epub 2013 May 20.
9
Extra-coronary calcification (aortic valve calcification, mitral annular calcification, aortic valve ring calcification and thoracic aortic calcification) in HIV seropositive and seronegative men: Multicenter AIDS Cohort Study.HIV 血清阳性和血清阴性男性的冠状动脉外钙化（主动脉瓣钙化、二尖瓣环钙化、主动脉瓣环钙化和胸主动脉钙化）：多中心艾滋病队列研究
J Cardiovasc Comput Tomogr. 2016 May-Jun;10(3):229-236. doi: 10.1016/j.jcct.2016.02.002. Epub 2016 Feb 27.
10
Greater Volume but not Higher Density of Abdominal Aortic Calcium Is Associated With Increased Cardiovascular Disease Risk: MESA (Multi-Ethnic Study of Atherosclerosis).腹主动脉钙化体积增大而非密度增加与心血管疾病风险升高相关：动脉粥样硬化多民族研究（MESA）
Circ Cardiovasc Imaging. 2016 Nov;9(11). doi: 10.1161/CIRCIMAGING.116.005138.

引用本文的文献

1
Multidimensional Radiological Assessment of Delirium in the Emergency Department.急诊科谵妄的多维放射学评估
Healthcare (Basel). 2025 Jul 31;13(15):1871. doi: 10.3390/healthcare13151871.
2
Beyond the Heart: The Predictive Role of Coronary Artery Calcium Scoring in Non-Cardiovascular Disease Risk Stratification.心脏之外：冠状动脉钙化评分在非心血管疾病风险分层中的预测作用
Diagnostics (Basel). 2024 Oct 22;14(21):2349. doi: 10.3390/diagnostics14212349.
3
Prognostic Value of Coronary Artery Calcification in Patients with COVID-19 and Interstitial Pneumonia: A Case-Control Study.

本文引用的文献

1
Incidence and characterization of acute pulmonary embolism in patients with SARS-CoV-2 pneumonia: A multicenter Italian experience.严重急性呼吸综合征冠状病毒 2 型肺炎患者急性肺栓塞的发生率和特征：一项多中心意大利经验。
PLoS One. 2021 Jan 22;16(1):e0245565. doi: 10.1371/journal.pone.0245565. eCollection 2021.
2
Chest CT-derived pulmonary artery enlargement at the admission predicts overall survival in COVID-19 patients: insight from 1461 consecutive patients in Italy.入院时胸部CT显示的肺动脉增宽可预测COVID-19患者的总生存期：来自意大利1461例连续患者的见解
Eur Radiol. 2021 Jun;31(6):4031-4041. doi: 10.1007/s00330-020-07622-x. Epub 2020 Dec 23.
3
新型冠状病毒肺炎合并间质性肺炎患者冠状动脉钙化的预后价值：一项病例对照研究
J Cardiovasc Dev Dis. 2024 Oct 11;11(10):319. doi: 10.3390/jcdd11100319.
4
Coronary artery calcification score as a prognostic indicator for COVID-19 mortality: evidence from a retrospective cohort study in Iran.冠状动脉钙化评分作为COVID-19死亡率的预后指标：来自伊朗一项回顾性队列研究的证据。
Ann Med Surg (Lond). 2024 Apr 4;86(6):3227-3232. doi: 10.1097/MS9.0000000000001661. eCollection 2024 Jun.
5
Epicardial Adipose Tissue as a Prognostic Marker in COVID-19.心外膜脂肪组织作为 COVID-19 的预后标志物。
In Vivo. 2024 Jan-Feb;38(1):281-285. doi: 10.21873/invivo.13436.
6
CT coronary artery calcification score as a prognostic marker in COVID-19.CT冠状动脉钙化评分作为COVID-19的预后标志物
J Thorac Dis. 2023 Oct 31;15(10):5559-5565. doi: 10.21037/jtd-23-728. Epub 2023 Oct 20.
7
Chest CT opportunistic biomarkers for phenotyping high-risk COVID-19 patients: a retrospective multicentre study.胸部 CT 机会性生物标志物用于表型分析 COVID-19 高危患者：一项回顾性多中心研究。
Eur Radiol. 2023 Nov;33(11):7756-7768. doi: 10.1007/s00330-023-09702-0. Epub 2023 May 11.
8
Sex differences in cardiovascular complications and mortality in hospital patients with covid-19: registry based observational study.新冠肺炎住院患者心血管并发症及死亡率的性别差异：基于登记处的观察性研究
BMJ Med. 2023 Feb 14;2(1):e000245. doi: 10.1136/bmjmed-2022-000245. eCollection 2023.
9
Relationship between Muscle Mass, Bone Density and Vascular Calcifications in Elderly People with SARS-CoV-2 Pneumonia.感染新型冠状病毒肺炎的老年人肌肉量、骨密度与血管钙化之间的关系
J Clin Med. 2023 Mar 19;12(6):2372. doi: 10.3390/jcm12062372.
10
Coronary artery calcification as a predictor of adverse outcomes in patients hospitalized with COVID-19.冠状动脉钙化作为新冠病毒疾病住院患者不良结局的预测指标。
Am Heart J Plus. 2023 Apr;28:100288. doi: 10.1016/j.ahjo.2023.100288. Epub 2023 Mar 8.
Chest CT in the emergency department for suspected COVID-19 pneumonia.
急诊科疑似 COVID-19 肺炎的胸部 CT。
Radiol Med. 2021 Mar;126(3):498-502. doi: 10.1007/s11547-020-01302-y. Epub 2020 Nov 9.
4
Association of inflammatory markers with the severity of COVID-19: A meta-analysis.炎症标志物与 COVID-19 严重程度的相关性：一项荟萃分析。
Int J Infect Dis. 2020 Jul;96:467-474. doi: 10.1016/j.ijid.2020.05.055. Epub 2020 May 18.
5
Coagulation abnormalities and thrombosis in patients with COVID-19.新型冠状病毒肺炎患者的凝血异常与血栓形成
Lancet Haematol. 2020 Jun;7(6):e438-e440. doi: 10.1016/S2352-3026(20)30145-9. Epub 2020 May 11.
6
Assessment of Deaths From COVID-19 and From Seasonal Influenza.对新冠病毒肺炎死亡病例和季节性流感死亡病例的评估。
JAMA Intern Med. 2020 Aug 1;180(8):1045-1046. doi: 10.1001/jamainternmed.2020.2306.
7
Endothelial cell infection and endotheliitis in COVID-19.新型冠状病毒肺炎中的内皮细胞感染与内皮炎
Lancet. 2020 May 2;395(10234):1417-1418. doi: 10.1016/S0140-6736(20)30937-5. Epub 2020 Apr 21.
8
Well-aerated Lung on Admitting Chest CT to Predict Adverse Outcome in COVID-19 Pneumonia.胸部 CT 显示充气良好的肺可预测 COVID-19 肺炎的不良结局。
Radiology. 2020 Aug;296(2):E86-E96. doi: 10.1148/radiol.2020201433. Epub 2020 Apr 17.
9
Understanding pathways to death in patients with COVID-19.了解新冠病毒肺炎患者的死亡途径。
Lancet Respir Med. 2020 May;8(5):430-432. doi: 10.1016/S2213-2600(20)30165-X. Epub 2020 Apr 6.
10
Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy.意大利伦巴第地区 1591 名 ICU 收治的 SARS-CoV-2 感染患者的基线特征和结局。
JAMA. 2020 Apr 28;323(16):1574-1581. doi: 10.1001/jama.2020.5394.