血管周围脂肪组织密度变化与斑块进展之间的关联。

Association Between Changes in Perivascular Adipose Tissue Density and Plaque Progression.

作者信息

Lee Sang-Eun, Sung Ji Min, Andreini Daniele, Al-Mallah Mouaz H, Budoff Matthew J, Cademartiri Filippo, Chinnaiyan Kavitha, Choi Jung Hyun, Chun Eun Ju, Conte Edoardo, Gottlieb Ilan, Hadamitzky Martin, Kim Yong Jin, Lee Byoung Kwon, Leipsic Jonathon A, Maffei Erica, Marques Hugo, de Araújo Gonçalves Pedro, Pontone Gianluca, Shin Sanghoon, Kitslaar Pieter H, Reiber Johan H C, Stone Peter H, Samady Habib, Virmani Renu, Narula Jagat, Berman Daniel S, Shaw Leslee J, Bax Jeroen J, Lin Fay Y, Min James K, Chang Hyuk-Jae

机构信息

Division of Cardiology, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea; Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.

Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.

出版信息

JACC Cardiovasc Imaging. 2022 Oct;15(10):1760-1767. doi: 10.1016/j.jcmg.2022.04.016. Epub 2022 Jun 15.

DOI:10.1016/j.jcmg.2022.04.016

PMID:36202455

Abstract

BACKGROUND

The association between the change in vessel inflammation, as quantified by perivascular adipose tissue (PVAT) density, and the progression of coronary atherosclerosis remains to be determined.

OBJECTIVES

The purpose of this study was to explore the association between the change in PVAT density and the progression of total and compositional plaque volume (PV).

METHODS

Patients were selected from a prospective multinational registry. Patients who underwent serial coronary computed tomography angiography studies with ≥2-year intervals and were scanned with the same tube voltage at baseline and follow-up were included. Total and compositional PV and PVAT density at baseline and follow-up were quantitatively analyzed for every lesion. Multivariate linear regression models using cluster analyses were constructed.

RESULTS

A total of 1,476 lesions were identified from 474 enrolled patients (mean age 61.2 ± 9.3 years; 65.0% men). The mean PVAT density was -74.1 ± 11.5 HU, and total PV was 48.1 ± 83.5 mm (19.2 ± 44.8 mm of calcified PV and 28.9 ± 51.0 mm of noncalcified PV). On multivariate analysis (adjusted for clinical risk factors, medication use, change in lipid levels, total PV at baseline, luminal HU attenuation, location of lesions, and tube voltage), the increase in PVAT density was positively associated with the progression of total PV (estimate = 0.275 [95% CI: 0.004-0.545]; P = 0.047), driven by the association with fibrous PV (estimate = 0.245 [95% CI: 0.070-0.420]; P = 0.006). Calcified PV progression was not associated with the increase in PVAT density (P > 0.050).

CONCLUSIONS

Increase in vessel inflammation represented by PVAT density is independently associated with the progression of the lipid component of coronary atherosclerotic plaques. (Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging [PARADIGM]; NCT02803411).

摘要

背景

血管周围脂肪组织（PVAT）密度量化的血管炎症变化与冠状动脉粥样硬化进展之间的关联尚待确定。

目的

本研究旨在探讨PVAT密度变化与总斑块体积（PV）及斑块成分体积进展之间的关联。

方法

从一项前瞻性跨国登记研究中选取患者。纳入那些接受了间隔≥2年的系列冠状动脉计算机断层扫描血管造影研究，且在基线和随访时使用相同管电压进行扫描的患者。对每个病变在基线和随访时的总PV、斑块成分PV及PVAT密度进行定量分析。构建使用聚类分析的多变量线性回归模型。

结果

从474名纳入患者（平均年龄61.2±9.3岁；65.0%为男性）中识别出1476个病变。平均PVAT密度为-74.1±11.5 HU，总PV为48.1±83.5 mm（钙化PV为19.2±44.8 mm，非钙化PV为28.9±51.0 mm）。在多变量分析中（校正了临床危险因素、药物使用、血脂水平变化、基线时的总PV、管腔HU衰减、病变位置及管电压），PVAT密度增加与总PV进展呈正相关（估计值=0.275[95%CI：0.004-0.545]；P=0.047），这一关联由与纤维性PV的关联所驱动（估计值=0.245[95%CI：0.070-0.420]；P=0.006）。钙化PV进展与PVAT密度增加无关（P>0.050）。