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肌肉减少症与冠状动脉疾病严重程度及冠状动脉周围脂肪组织衰减的相关性:一项冠状动脉 CT 研究。

Correlation of Sarcopenia with Coronary Artery Disease Severity and Pericoronary Adipose Tissue Attenuation: A Coronary CT Study.

机构信息

IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy.

Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università Degli Studi di Milano, 20122 Milan, Italy.

出版信息

Tomography. 2024 Oct 30;10(11):1744-1753. doi: 10.3390/tomography10110128.

Abstract

OBJECTIVE

To investigate the association between sarcopenia, as appraised with CT-derived muscle metrics, and cardiovascular status, as assessed via coronary CT angiography (CCTA) using the Coronary Artery Disease-Reporting and Data System (CAD-RADS) and with pericoronary adipose tissue (pCAT) metrics.

METHODS

A retrospective observational study conducted on patients who underwent CCTA. The cross-sectional area (CSA) and attenuation values of the paravertebral muscles at the T8 level and the pectoralis major muscles at the T6 level were measured. The patient height was employed for the normalization of the skeletal muscle CSA. The pCAT attenuation around the coronary arteries was assessed, and the CAD severity was graded using the CAD-RADS reporting system. Regression analyses were performed to assess the impact of demographics, clinical factors, and CT variables on the CAD-RADS and pCAT.

RESULTS

A total of 220 patients were included (132 males, median age 65 years). Regression analyses showed the associations of CAD with age and sex ( < 0.001). Familiarity with CAD was related to the left anterior descending artery pCAT ( = 0.002) and circumflex artery pCAT ( = 0.018), whereas age was related to the left anterior descending artery pCAT ( = 0.032). Weak positive correlations were found between the lower muscle density and lower pCAT attenuation (ρ = 0.144-0.240, < 0.039).

CONCLUSIONS

This study demonstrated weak associations between the sarcopenia indicators and the cardiovascular risk, as assessed by the CAD severity and pCAT inflammation. However, these correlations were not strong predictors of CAD severity, as age and traditional cardiovascular risk factors overshadowed the impact of sarcopenia in the cardiovascular risk assessment.

摘要

目的

通过冠状动脉 CT 血管造影(CCTA)使用冠状动脉疾病报告和数据系统(CAD-RADS)评估心血管状态,以及通过冠状动脉周围脂肪组织(pCAT)评估,探讨 CT 衍生肌肉指标评估的肌肉减少症与心血管状况之间的关系。

方法

这是一项回顾性观察性研究,纳入了接受 CCTA 的患者。测量第 8 胸椎水平椎旁肌肉的横截面积(CSA)和衰减值以及第 6 胸椎水平胸大肌的 CSA 和衰减值。患者身高用于骨骼肌肉 CSA 的归一化。评估冠状动脉周围 pCAT 的衰减,并使用 CAD-RADS 报告系统对 CAD 严重程度进行分级。进行回归分析,以评估人口统计学、临床因素和 CT 变量对 CAD-RADS 和 pCAT 的影响。

结果

共纳入 220 例患者(男性 132 例,中位年龄 65 岁)。回归分析显示,CAD 与年龄和性别相关(<0.001)。对 CAD 的熟悉程度与左前降支 pCAT(=0.002)和回旋支 pCAT(=0.018)相关,而年龄与左前降支 pCAT 相关(=0.032)。较低的肌肉密度与较低的 pCAT 衰减之间存在弱正相关(ρ=0.144-0.240,<0.039)。

结论

本研究表明,肌肉减少症指标与心血管风险之间存在弱相关性,这种相关性可通过 CAD 严重程度和 pCAT 炎症来评估。然而,这些相关性并不是 CAD 严重程度的强有力预测因素,因为年龄和传统心血管危险因素掩盖了肌肉减少症在心血管风险评估中的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7a7/11598005/59b2ff4c16fc/tomography-10-00128-g001.jpg

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