Jinzhou Medical University, Liaoning, China.
Department of Medical Imaging Center, Shiyan Renmin Hospital, Hubei University of Medicine, Hubei, China.
Anatol J Cardiol. 2023 Feb;27(2):100-105. doi: 10.14744/AnatolJCardiol.2022.2576.
The objective of the study was to measure pericoronal adipose tissue parameters, fractional flow reserve with coronary artery computed tomographic angiography (CTA), and difference of fractional flow reserve with coronary artery CTA, by using high-performance 320-slice coronary CTA combined with semiautomatic quantitative software and explore the relationship between them and progression of coronary artery disease.
According to the inclusion criteria, 118 patients with complete data were selected. According to the results of coronary angiography during follow-up review, the patients were divided into coronary artery disease progression group (n = 43) and coronary artery disease stable group (n = 75), and the clinical baseline data, pericoronal adipose tissue volume, pericoronal adipose tissue fat attenuation index, fractional flow reserve with coronary artery CTA, and difference of fractional flow reserve with coronary artery CTA were compared between the 2 groups. According to univariate and multivariate logistic regression analyses, the risk factors related to coronary artery disease progression were screened out from pericoronal adipose tissue parameters and noninvasive hemodynamic characteristics (fractional flow reserve with coronary artery CTA and difference of fractional flow reserve with coronary artery CTA).
There was no significant difference in baseline clinical data between the progression group and the stable group (P >.05). The left anterior descending artery-fat attenuation index-40 mm, left anterior descending artery-fat attenuation index-70 mm, left circumflex artery-fat attenuation index-70 mm, right coronary artery-fat attenuation index-70 mm, and difference of fractional flow reserve with coronary artery CTA in the progression group were higher than those in the stable group, while fractional flow reserve with coronary artery CTA was lower than that in the stable group, and the differences were statistically significant (P <.05). After adjusting for several factors, the results showed that left anterior descending artery-fat attenuation index-40 mm (P =.002; odds ratio = 1.237; 95% CI: 1.081-1.415), right coronary artery-fat attenuation index-70 mm (P =.039; odds ratio = 1.119; 95% CI: 1.006-1.246), fractional flow reserve with coronary artery CTA (P =.001; odds ratio = 0.708; 95% CI: 0.581-0.846), and difference of fractional flow reserve with coronary artery CTA (P <.001; odds ratio = 1.846; 95% CI: 1.394-2.445) were related to the progression of coronary artery disease. Compared with the above 5 indicators, the area under curve (AUC) of the above indicators combined is larger (0.897).
Quantitative pericoronal adipose tissue parameters and noninvasive hemodynamic characteristics based on 320-slice coronary CTA can be used as the basis for predicting the progression of coronary artery disease.
本研究旨在通过使用高性能 320 层冠状动脉 CT 血管造影（CTA）结合半自动定量软件测量冠周脂肪组织参数、冠状动脉 CTA 的血流储备分数（fractional flow reserve with coronary artery computed tomographic angiography，FFRCTA）和 FFRCTA 的差异，并探讨它们与冠状动脉疾病进展的关系。
根据纳入标准，选择了 118 例数据完整的患者。根据随访时冠状动脉造影结果，将患者分为冠状动脉疾病进展组（n = 43）和冠状动脉疾病稳定组（n = 75），比较两组患者的临床基线资料、冠周脂肪组织体积、冠周脂肪组织脂肪衰减指数、FFRCTA 和 FFRCTA 的差异。采用单因素和多因素逻辑回归分析，从冠周脂肪组织参数和无创血流动力学特征（FFRCTA 和 FFRCTA 的差异）中筛选出与冠状动脉疾病进展相关的危险因素。
进展组与稳定组患者的基线临床数据差异无统计学意义（P >.05）。进展组左前降支脂肪衰减指数-40mm、左前降支脂肪衰减指数-70mm、左回旋支脂肪衰减指数-70mm、右冠状动脉脂肪衰减指数-70mm 和 FFRCTA 的差异均高于稳定组，而 FFRCTA 低于稳定组，差异均有统计学意义（P <.05）。调整多个因素后，结果显示左前降支脂肪衰减指数-40mm（P =.002；比值比=1.237；95%可信区间：1.081-1.415）、右冠状动脉脂肪衰减指数-70mm（P =.039；比值比=1.119；95%可信区间：1.006-1.246）、FFRCTA（P =.001；比值比=0.708；95%可信区间：0.581-0.846）和 FFRCTA 的差异（P <.001；比值比=1.846；95%可信区间：1.394-2.445）与冠状动脉疾病的进展有关。与上述 5 项指标相比，上述指标联合的曲线下面积（area under the curve，AUC）更大（0.897）。
基于 320 层冠状动脉 CTA 的定量冠周脂肪组织参数和无创血流动力学特征可作为预测冠状动脉疾病进展的依据。
