Carter Jessica, Heseltine Thomas D, Meah Mohammed N, Tzolos Evangelos, Kwiecinski Jacek, Doris Mhairi, McElhinney Priscilla, Moss Alastair J, Adamson Philip D, Hunter Amanda, Alam Shirjel, Shah Anoop S V, Pawade Tania, Wang Chengjia, Weir-McCall Jonathan R, Roditi Giles, van Beek Edwin J R, Nicol Edward D, Shaw Leslee J, Berman Daniel S, Slomka Piotr J, Mills Nicholas L, Dweck Marc R, Newby David E, Murray Scott W, Dey Damini, Williams Michelle C
University/BHF Centre for Cardiovascular Science, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, Scotland EH16 SUF, (J.C., M.N.M., E.T., J.K., M.D., A.J.M., P.D.A., A.H., S.A., A.S.V.S., T.P., C.W., N.L.M., M.R.D., D.E.N., M.C.W.); Liverpool Centre for Cardiovascular Science, Liverpool, England (T.D.H., S.W.M.); Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland (J.K.); Biomedical Imaging Research Institute and Division of Artificial Intelligence in Medicine, Cedars-Sinai Medical Center, Los Angeles, Calif (P.M., D.S.B., P.J.S., D.D.); Christchurch Heart Institute, University of Otago, Christchurch, New Zealand (P.D.A.); Department of Radiology, University of Cambridge, Cambridge, England (J.R.W.M.); Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland (G.R.); Edinburgh Imaging Facility QMRI, University of Edinburgh, Edinburgh, Scotland (E.J.R.v.B., M.R.D., D.E.N., M.C.W.); Royal Brompton and Harefield NHS Foundation Trust Departments of Cardiology and Radiology, London, England and the National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, England (E.D.N.); and Icahn School of Medicine, Weill Cornell Medical College, New York, NY (L.J.S.).
Radiol Cardiothorac Imaging. 2022 Apr 28;4(2):e210260. doi: 10.1148/ryct.210260. eCollection 2022 Apr.
To assess the association between nonalcoholic fatty liver disease (NAFLD) and quantitative atherosclerotic plaque at CT.
In this post hoc analysis of the prospective Scottish Computed Tomography of the HEART trial (November 2010 to September 2014), hepatosteatosis and coronary artery calcium score were measured at noncontrast CT. Presence of stenoses, visually assessed high-risk plaque, and quantitative plaque burden were assessed at coronary CT angiography. Multivariable models were constructed to assess the impact of hepatosteatosis and cardiovascular risk factors on coronary artery disease.
Images from 1726 participants (mean age, 58 years ± 9 [SD]; 974 men) were included. Participants with hepatosteatosis (155 of 1726, 9%) had a higher body mass index, more hypertension and diabetes mellitus, and higher cardiovascular risk scores ( < .001 for all) compared with those without hepatosteatosis. They had increased coronary artery calcium scores (median, 43 Agatston units [AU] [interquartile range, 0-273] vs 19 AU [0-225], = .046), more nonobstructive disease (48% vs 37%, = .02), and higher low-attenuation plaque burden (5.11% [0-7.16] vs 4.07% [0-6.84], = .04). However, these associations were not independent of cardiovascular risk factors. Over a median of 4.7 years, there was no evidence of a difference in myocardial infarction between those with and without hepatosteatosis (1.9% vs 2.4%, = .92).
Hepatosteatosis at CT was associated with an increased prevalence of coronary artery disease at CT, but this was not independent of the presence of cardiovascular risk factors. CT, Cardiac, Nonalcoholic Fatty Liver Disease, Coronary Artery Disease, Hepatosteatosis, Plaque QuantificationClinical trial registration no. NCT01149590 © RSNA, 2022See also commentary by Abohashem and Blankstein in this issue.
评估非酒精性脂肪性肝病（NAFLD）与CT定量动脉粥样硬化斑块之间的关联。
在对前瞻性苏格兰心脏计算机断层扫描试验（2010年11月至2014年9月）的这项事后分析中，在非增强CT上测量肝脂肪变性和冠状动脉钙化积分。在冠状动脉CT血管造影中评估狭窄的存在、视觉评估的高危斑块和定量斑块负荷。构建多变量模型以评估肝脂肪变性和心血管危险因素对冠状动脉疾病的影响。
纳入了1726名参与者的图像（平均年龄58岁±9[标准差]；974名男性）。与无肝脂肪变性的参与者相比，有肝脂肪变性的参与者（1726名中的155名，9%）体重指数更高，高血压和糖尿病更多，心血管风险评分更高（所有P均<0.001）。他们的冠状动脉钙化积分增加（中位数，43阿加斯顿单位[AU][四分位间距，0 - 273]对比19 AU[0 - 225]，P = 0.046），非阻塞性疾病更多（48%对比37%，P = 0.02），低衰减斑块负荷更高（5.11%[0 - 7.16]对比4.07%[0 - 6.84]，P = 0.04）。然而，这些关联并非独立于心血管危险因素。在中位4.7年的时间里，没有证据表明有和没有肝脂肪变性的参与者之间心肌梗死存在差异（1.9%对比2.4%，P = 0.92）。
CT上的肝脂肪变性与CT上冠状动脉疾病患病率增加相关，但这并非独立于心血管危险因素的存在。CT、心脏、非酒精性脂肪性肝病、冠状动脉疾病、肝脂肪变性、斑块定量临床试验注册号：NCT01149590 ©RSNA，2022另见本期Abohashem和Blankstein的评论。
