Cardiology Division Massachusetts General Hospital, Harvard Medical School Boston MA.
Cardiac Surgery Division, Department of Surgery Massachusetts General Hospital, Harvard Medical School Boston MA.
J Am Heart Assoc. 2024 Jun 18;13(12):e033224. doi: 10.1161/JAHA.123.033224. Epub 2024 Jun 15.
The left internal mammary artery (LIMA) is protected from developing atherosclerosis. Perivascular inflammation, which is closely associated with atherosclerosis, can be measured by perivascular adipose tissue attenuation on computed tomography angiography. Whether the absence of atherosclerosis in LIMA is related to the lower level of perivascular inflammation is unknown. This study was performed to compare the level of perivascular inflammation between LIMA in situ and native coronary arteries in patients with coronary artery disease.
A total of 573 patients who underwent both computed tomography angiography and optical coherence tomography imaging were included. The level of perivascular adipose tissue attenuation between LIMA in situ and coronary arteries was compared. Perivascular adipose tissue attenuation around LIMA in situ was significantly lower around the 3 coronary arteries (-82.9 [-87.3 to -78.0] versus -70.8 [-75.9 to -65.9]; <0.001), irrespective of the level of pericoronary inflammation or the number of vulnerable features on optical coherence tomography. When patients were divided into high and low pericoronary inflammation groups, those in the high inflammation group had more target vessel failure (hazard ratio, 2.97 [95% CI, 1.16-7.59]; =0.017).
The current study demonstrated that perivascular adipose tissue attenuation was significantly lower around LIMA in situ than around native coronary arteries. The lower level of perivascular inflammation may be related to the low prevalence of atherosclerosis in LIMA.
URL: https://www.clinicaltrials.gov; Unique Identifier: NCT04523194.
左内乳动脉（LIMA）免受动脉粥样硬化的影响。血管周围炎症与动脉粥样硬化密切相关，可以通过计算机断层血管造影术测量血管周围脂肪组织衰减来评估。LIMA 中不存在动脉粥样硬化是否与较低水平的血管周围炎症有关尚不清楚。本研究旨在比较冠心病患者 LIMA 原位与自身冠状动脉之间的血管周围炎症水平。
共纳入 573 例同时接受计算机断层血管造影和光学相干断层成像检查的患者。比较了 LIMA 原位与冠状动脉之间血管周围脂肪组织衰减程度。LIMA 原位周围的血管周围脂肪组织衰减值在 3 支冠状动脉周围明显较低（-82.9 [-87.3 至-78.0] 与-70.8 [-75.9 至-65.9]；<0.001），与冠状血管周围炎症程度或光学相干断层成像上的易损特征数量无关。当患者被分为高和低冠状动脉周围炎症组时，高炎症组的靶血管失败更多（危险比，2.97 [95%CI，1.16-7.59]；=0.017）。
本研究表明，LIMA 原位周围的血管周围脂肪组织衰减明显低于自身冠状动脉周围。较低水平的血管周围炎症可能与 LIMA 中动脉粥样硬化的低患病率有关。
