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冠状动脉 CT 血管造影评估的心外膜脂肪组织密度与冠状动脉斑块特征的相关性。

Association between epicardial adipose tissue density and characteristics of coronary plaques assessed by coronary computed tomographic angiography.

机构信息

Department of Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang, 050005, Hebei, People's Republic of China.

Department of Imaging, Xingtai People's Hospital, Xingtai, 054001, Hebei, People's Republic of China.

出版信息

Int J Cardiovasc Imaging. 2022 Mar;38(3):673-681. doi: 10.1007/s10554-021-02428-4. Epub 2021 Oct 15.

Abstract

To investigate the relationship between the epicardial adipose tissue density (EATD) and the coronary plaque components as assessed by coronary computed tomographic angiography (CCTA). The study cohort included 240 patients with chest pain or precardiac discomfort (mean age 62.01 ± 7.45 years, 55.83% male). Patients were assigned to the high-risk plaque (HRP) group (n = 133) or non-HRP group (n = 107). All patients underwent CCTA to assess plaque composition, and quantitative analysis of EATD and epicardial adipose tissue volume (EATV). Age, gender, EATV, EATD, diabetes history and family history were all correlated with HRP. There was no linear correlation between EATD and EATV among the subjects (R = 0.008, p = 0.177), but there was a curvilinear correlation (R = 0.102, p < 0.001). After adjusting other traditional factors, and we observed robust associations of EAT volume and density with HRP (all p < 0.05). For per 1 standard deviation increase in EATD, the risk of HRP was 3.120 times the risk than that of non-HRP. For per 1 standard deviation increase in EATV, the risk of HRP was 1.499 times the risk than that of non-HRP. The receiver operating characteristic curve showed that EATD was more predictive of HRP than EATV (AUC = 0.761, 95% CI 0.701-0.822). Our study found that EATD and EATV are both independent factors affecting the presence of HRPs, and EATD had a high predictive value for the presence of HRP.

摘要

探讨了冠状动脉计算机断层血管造影术(CCTA)评估的心外膜脂肪组织密度(EATD)与冠状动脉斑块成分之间的关系。该研究队列纳入了 240 例胸痛或心前区不适患者(平均年龄 62.01±7.45 岁,55.83%为男性)。患者被分为高危斑块(HRP)组(n=133)和非 HRP 组(n=107)。所有患者均接受 CCTA 评估斑块成分,并对心外膜脂肪组织密度和心外膜脂肪组织体积(EATV)进行定量分析。年龄、性别、EATV、EATD、糖尿病史和家族史均与 HRP 相关。在研究对象中,EATD 与 EATV 之间无线性相关(R=0.008,p=0.177),但存在曲线相关(R=0.102,p<0.001)。调整其他传统因素后,我们观察到 EAT 体积和密度与 HRP 存在稳健关联(均 p<0.05)。EATD 每增加 1 个标准差,HRP 的风险是无 HRP 的 3.120 倍。EATV 每增加 1 个标准差,HRP 的风险是无 HRP 的 1.499 倍。受试者工作特征曲线显示,EATD 对 HRP 的预测价值高于 EATV(AUC=0.761,95%CI 0.701-0.822)。本研究发现,EATD 和 EATV 均为影响 HRP 存在的独立因素,EATD 对 HRP 的存在具有较高的预测价值。

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