Tu Yong-Bo, Gu Min, Zhou Shao-Quan, Xie Gang, Liu Li-Li, Deng Feng-Bin, Li Kang
Department of Radiology, Chongqing General Hospital, Chongqing, China.
Quant Imaging Med Surg. 2024 Jan 3;14(1):31-42. doi: 10.21037/qims-23-253. Epub 2023 Nov 23.
Periaortic fat is associated with coronary disease. Thus, it was hypothesized that the inflammation associated with acute aortic dissection (AAD) spreads to pericoronary adipose tissue (PCAT) via thoracic periaortic fat. Pericoronary adipose tissue attenuation (PCATa) serves as a marker for inflammation of perivascular adipose tissue (PVAT). This study sought to examine PCATa in individuals diagnosed with AAD.
Consecutive patients with chest pain from May 2020 to September 2022 were prospectively enrolled in this study and underwent coronary computed tomography angiography (CCTA) and/or aorta computed tomography angiography (CTA). Based on the results of the CTA, the patients were divided into the following two groups: (I) the AAD group; and (II) the non-AAD group. PCATa of the right coronary angiography (RCA), left anterior descending (LAD), and left circumflex (LCx) was quantified for each patient using semi-automated software. The PCATa values were compared between the AAD and non-AAD patients according to the atherosclerosis of the coronary arteries. Similarly, the PCATa values of the AAD patients were compared between the preoperative and postoperative steady states.
A total of 136 patients (42 female, 94 male; mean age: 63.3±11.9 years) were divided into the two groups according to the presence of aortic dissection on CTA. The RCA, LAD, and LCx values were significantly higher in the AAD subjects than the non-AAD subjects, regardless of the presence or absence of atherosclerosis in the coronary arteries [-85.1±9.3 -92.9±10.0 Hounsfield unit (HU); -83.2±7.4 -89.9±9.1 HU; -77.5±8.4 -85.6±7.9 HU, all P<0.001). The preoperative RCA, LAD, and LCx values were higher in the AAD patients than the postoperative steady-state patients (-82.9±8.7 -97.6±8.8 HU; -79.8±7.6 -92.8±6.8 HU; -74.6±7.1 -87.7±6.9 HU, all P0.001). According to the multivariable logistic regression analysis, high RCA and LAD values were associated with AAD regardless of the degree of stenosis [odds ratio (OR) =0.014; 95% confidence interval (CI): 0.001-0.177; P=0.001 and OR =0.010; 95% CI: 0.001-0.189; P=0.002].
PCATa on computed tomography was increased in patients with AAD regardless of the presence or absence of coronary artery disease (CAD). This suggests that vascular inflammation is present in AAD independent of CAD. Further research should be conducted to investigate the potential of this imaging biomarker to predict AAD and monitor patients' responses to therapies for AAD.
主动脉周围脂肪与冠状动脉疾病相关。因此，有人提出假说，与急性主动脉夹层（AAD）相关的炎症通过胸段主动脉周围脂肪扩散至冠状动脉周围脂肪组织（PCAT）。冠状动脉周围脂肪组织衰减（PCATa）可作为血管周围脂肪组织（PVAT）炎症的标志物。本研究旨在检测AAD患者的PCATa。
对2020年5月至2022年9月因胸痛连续就诊的患者进行前瞻性研究，这些患者均接受了冠状动脉计算机断层扫描血管造影（CCTA）和/或主动脉计算机断层扫描血管造影（CTA）。根据CTA结果，将患者分为以下两组：（I）AAD组；（II）非AAD组。使用半自动软件对每位患者右冠状动脉造影（RCA）、左前降支（LAD）和左旋支（LCx）的PCATa进行定量分析。根据冠状动脉粥样硬化情况，比较AAD患者和非AAD患者的PCATa值。同样，比较AAD患者术前和术后稳定状态下的PCATa值。
根据CTA上是否存在主动脉夹层，共136例患者（42例女性，94例男性；平均年龄：63.3±11.9岁）被分为两组。无论冠状动脉有无粥样硬化，AAD组患者的RCA、LAD和LCx值均显著高于非AAD组患者[-85.1±9.3 -92.9±10.0亨氏单位（HU）；-83.2±7.4 -89.9±9.1 HU；-77.5±8.4 -85.6±7.9 HU，P均<0.001]。AAD患者术前的RCA、LAD和LCx值高于术后稳定状态患者[-82.9±8.7 -97.6±8.8 HU；-79.8±7.6 -92.8±6.8 HU；-74.6±...
