Emfietzoglou Maria, Mavrogiannis Michail C, Samaras Athanasios, Rampidis Georgios P, Giannakoulas George, Kampaktsis Polydoros N
Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom.
Aristotle University of Thessaloniki, Thessaloniki, Greece.
Front Cardiovasc Med. 2022 Jul 15;9:920119. doi: 10.3389/fcvm.2022.920119. eCollection 2022.
Cardiac computed tomography (CCT) is now considered a first-line diagnostic test for suspected coronary artery disease (CAD) providing a non-invasive, qualitative, and quantitative assessment of the coronary arteries and pericoronary regions. CCT assesses vascular calcification and coronary lumen narrowing, measures total plaque burden, identifies plaque composition and high-risk plaque features and can even assist with hemodynamic evaluation of coronary lesions. Recent research focuses on computing coronary endothelial shear stress, a potent modulator in the development and progression of atherosclerosis, as well as differentiating an inflammatory from a non-inflammatory pericoronary artery environment using the simple measurement of pericoronary fat attenuation index. In the present review, we discuss the role of the above in the diagnosis of coronary atherosclerosis and the prediction of adverse cardiovascular events. Additionally, we review the current limitations of cardiac computed tomography as an imaging modality and highlight how rapid technological advancements can boost its capacity in predicting cardiovascular risk and guiding clinical decision-making.
心脏计算机断层扫描（CCT）现在被认为是疑似冠状动脉疾病（CAD）的一线诊断测试，可对冠状动脉和冠状动脉周围区域进行非侵入性、定性和定量评估。CCT可评估血管钙化和冠状动脉管腔狭窄，测量总斑块负荷，识别斑块成分和高危斑块特征，甚至可协助对冠状动脉病变进行血流动力学评估。最近的研究集中在计算冠状动脉内皮剪切应力，这是动脉粥样硬化发生和发展中的一种重要调节因子，以及使用冠状动脉周围脂肪衰减指数的简单测量来区分炎症性和非炎症性冠状动脉周围环境。在本综述中，我们讨论了上述内容在冠状动脉粥样硬化诊断和不良心血管事件预测中的作用。此外，我们回顾了心脏计算机断层扫描作为一种成像方式目前的局限性，并强调技术的快速进步如何能够提高其预测心血管风险和指导临床决策的能力。
