Wang Jingyue, Zhang Huicong, Wang Zihao, Liu Wenyun, Cao Dianbo, Tong Qian
Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China.
Department of Radiology, The First Hospital of Jilin University, Changchun, China.
Front Cardiovasc Med. 2024 Oct 23;11:1451807. doi: 10.3389/fcvm.2024.1451807. eCollection 2024.
Pericoronary adipose tissue (PCAT) plays a significant role in the occurrence and progression of coronary artery disease (CAD). This study investigates the relationship between PCAT and CAD, focusing on the occurrence of the disease, the severity of vascular narrowing, and the characteristics of arterial plaques.
We analyzed a cohort of 152 individuals with CAD and 55 individuals with non-coronary artery disease (N-CAD). Participants underwent both coronary computed tomography angiography (CCTA) and digital subtraction angiography (DSA). Utilizing United Imaging software for artificial intelligence delineation, we measured the fat attenuation index (FAI) and volume of PCAT in the left anterior descending (LAD), left circumflex (LCX), and right coronary arteries (RCA).
Our findings demonstrate that while CCTA is effective in diagnosing CAD compared to DSA, its diagnostic power for individual coronary arteries remains limited. Further analysis revealed that the FAI of the RCA and the overall PCAT volume independently influenced CAD (OR: 1.057, 95% CI: 1.002 to 1.116; OR: 0.967, 95% CI: 0.936 to 0.999). FAI showed a significant independent effect on RCA stenosis (OR: 1.041, 95% CI: 1.003 to 1.081), while the fat volume of the LAD had a significant independent effect on LAD stenosis (OR: 0.884, 95% CI: 0.809 to 0.965). A higher FAI and a lower fat volume were significantly correlated with more severe vascular stenosis percentages in all three arteries ( < 0.05), except for the fat volume and stenosis of the LCX. Moreover, we found the significant differences in the fat volume of the LCX between different plaque types ( = 8.869, = 0.012), with calcified plaques consistently exhibiting the lowest fat volume across all three arteries. Finally, the likelihood ratio test confirmed that incorporating the PCAT fat volume parameter of LAD significantly improved the diagnostic ability of CCTA for both CAD ( = 0.01543) and LAD stenosis ( = 0.001585).
The quantification of PCAT has potential application value in the comprehensive assessment of CAD. It is recommended that cardiology and radiology departments consider incorporating PCAT into the assessment criteria for patients suspected of having CAD.
冠状动脉周围脂肪组织（PCAT）在冠状动脉疾病（CAD）的发生和发展中起重要作用。本研究调查PCAT与CAD之间的关系，重点关注疾病的发生、血管狭窄的严重程度以及动脉斑块的特征。
我们分析了152例CAD患者和55例非冠状动脉疾病（N-CAD）患者的队列。参与者均接受了冠状动脉计算机断层扫描血管造影（CCTA）和数字减影血管造影（DSA）。利用联影软件进行人工智能描绘，我们测量了左前降支（LAD）、左旋支（LCX）和右冠状动脉（RCA）中PCAT的脂肪衰减指数（FAI）和体积。
我们的研究结果表明，虽然与DSA相比，CCTA在诊断CAD方面有效，但其对单支冠状动脉的诊断能力仍然有限。进一步分析显示，RCA的FAI和总的PCAT体积独立影响CAD（OR：1.057，95%CI：1.002至1.116；OR：0.967，95%CI：0.936至0.999）。FAI对RCA狭窄有显著独立影响（OR：1.041，95%CI：1.003至1.081），而LAD的脂肪体积对LAD狭窄有显著独立影响（OR：0.884，95%CI：0.809至0.965）。除LCX的脂肪体积和狭窄外，所有三支动脉中，较高的FAI和较低的脂肪体积与更严重的血管狭窄百分比显著相关（<0.05）。此外，我们发现不同斑块类型之间LCX的脂肪体积存在显著差异（=8.869，=0.012），在所有三支动脉中，钙化斑块的脂肪体积始终最低。最后，似然比检验证实，纳入LAD的PCAT脂肪体积参数显著提高了CCTA对CAD（=0.01543）和LAD狭窄（=0.001585）的诊断能力。
PCAT的量化在CAD的综合评估中具有潜在应用价值。建议心内科和放射科考虑将PCAT纳入疑似CAD患者的评估标准。
