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接受冠状动脉计算机断层扫描血管造影的患者中,冠状动脉疾病或外周动脉疾病的存在与左心室质量之间的关联。

Association Between the Presence of Coronary Artery Disease or Peripheral Artery Disease and Left Ventricular Mass in Patients Who Have Undergone Coronary Computed Tomography Angiography.

作者信息

Tachibana Tetsuro, Shiga Yuhei, Hirata Tetsuo, Tashiro Kohei, Higashi Sara, Kawahira Yuto, Kato Yuta, Kuwano Takashi, Sugihara Makoto, Miura Shin-Ichiro

机构信息

Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.

Department of Cardiology, Fukuoka University Nishijin Hospital, Fukuoka, Japan.

出版信息

Cardiol Res. 2023 Oct;14(5):387-395. doi: 10.14740/cr1532. Epub 2023 Oct 21.

Abstract

BACKGROUND

Left ventricular mass (LVM) is a critical marker of future cardiovascular risk. We determined the association between LVM measured by coronary computed tomography angiography (CCTA) and the presence of coronary artery disease (CAD) or peripheral artery disease (PAD) in patients who had undergone CCTA for screening of CAD.

METHODS

We enrolled 1,307 consecutive patients (66 ± 12 years old, 49% males) who underwent CCTA for screening of CAD at the Fukuoka University Hospital (FU-CCTA registry), and either were clinically suspected of having CAD or had at least one cardiovascular risk factor. Patients with coronary stenosis of ≥ 50% by CCTA were diagnosed as CAD. Patients with an ankle brachial pressure index < 0.9 or who had already been diagnosed with PAD were considered to have PAD. Left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume (ESV) were measured. The patients were divided into CAD (-) and CAD (+) or PAD (-) and PAD (+) groups.

RESULTS

The prevalences of CAD and PAD in all patients were 50% and 4.8%, respectively. Age, %males, %hypertension (HTN), %dyslipidemia (DL), %diabetes mellitus (DM), %smoking and %chronic kidney disease in the CAD (+) group were significantly higher than those in the CAD (-) group. Age, %males, %HTN, %DM and %smoking in the PAD (+) group were significantly higher than those in the PAD (-) group. CAD was independently associated with LVMI (odds ratio (OR): 1.01, 95% confidence interval (CI): 1.01 - 1.02, P < 0.01) in addition to age, male, HTN, DL, DM, and smoking. PAD was also independently associated with LVMI (OR: 1.01, 95% CI: 1.0 - 1.02, P = 0.018) in addition to age, DM, and smoking.

CONCLUSIONS

LVMI determined by CCTA may be useful for predicting atherosclerotic cardiovascular diseases including both CAD and PAD, although there were considerable differences between %CAD and %PAD in all patients.

摘要

背景

左心室质量(LVM)是未来心血管疾病风险的关键标志物。我们确定了在因冠状动脉疾病(CAD)筛查而接受冠状动脉计算机断层扫描血管造影(CCTA)检查的患者中,通过CCTA测量的LVM与CAD或外周动脉疾病(PAD)的存在之间的关联。

方法

我们纳入了1307例连续的患者(66±12岁,49%为男性),他们在福冈大学医院(FU-CCTA登记处)因CAD筛查而接受CCTA检查,且临床上怀疑患有CAD或至少有一项心血管危险因素。CCTA显示冠状动脉狭窄≥50%的患者被诊断为CAD。踝臂指数<0.9或已被诊断为PAD的患者被认为患有PAD。测量左心室质量指数(LVMI)、左心室射血分数(LVEF)、舒张末期容积(EDV)和收缩末期容积(ESV)。将患者分为CAD(-)和CAD(+)组或PAD(-)和PAD(+)组。

结果

所有患者中CAD和PAD的患病率分别为50%和4.8%。CAD(+)组的年龄、男性比例、高血压(HTN)比例、血脂异常(DL)比例、糖尿病(DM)比例、吸烟比例和慢性肾病比例显著高于CAD(-)组。PAD(+)组的年龄、男性比例、HTN比例、DM比例和吸烟比例显著高于PAD(-)组。除年龄、男性、HTN、DL、DM和吸烟外,CAD还与LVMI独立相关(优势比(OR):1.01,95%置信区间(CI):1.01 - 1.02,P<0.01)。除年龄、DM和吸烟外,PAD也与LVMI独立相关(OR:1.01,95%CI:1.0 - 1.02,P = 0.018)。

结论

尽管所有患者中CAD和PAD的比例存在相当大的差异,但通过CCTA测定的LVMI可能有助于预测包括CAD和PAD在内的动脉粥样硬化性心血管疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b6f/10627378/ed335a59f8ac/cr-14-387-g001.jpg

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