Impact of pericoronary inflammation assessed by coronary computed tomography angiography on the progression of aortic valve calcification

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Misawa ◽  
T Sugiyama ◽  
Y Kanaji ◽  
M Hoshino ◽  
M Yamaguchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Aortic Valve Calcification ◽  
Valve Calcification ◽  
Coronary Computed Tomography ◽  
The Mean ◽  
The Impact

Abstract Background Aortic valve calcification (AVC) has been known as an independent predictor for adverse cardiovascular events and all-cause mortality. Previous studies demonstrated that AVC was associated with aortic valve inflammation and atherosclerosis. However, the relationship between the progression of AVC and pericoronary inflammation remains undetermined. Purpose The purpose of this study was to evaluate the impact of the pericoronary inflammation on the progression of AVC. Methods A total of 107 patients with suspected or known chronic coronary syndromes who underwent clinically indicated serial 320-slice coronary computed tomography angiography (CTA) at Tsuchiura Kyodo General Hospital from January 2011 to June 2019 were retrospectively studied. Pericoronary inflammation was assessed by pericoronary adipose tissue attenuation (PCATA) defined as the mean CT attenuation value of PCATA (−190 to −30 Hounsfield units [HU]) on proximal 40 mm segments of coronary arteries. AVC was quantified by Agatston score on CTA. The mean aortic attenuation (HU Aorta) and the standard deviation (SD) in the region of interest at the level of the sinotubular junction was measured. AVC was defined as the threshold for calcium detection (mean HU Aorta + 2SD). AVC index was calculated as follows: (follow-up/baseline) AVC divided by follow-up period. AVC progression was defined as newly-developed AVC at follow-up or an increased AVC index during follow-up. All patients were divided into two groups according to the presence or absence of AVC progression, and clinical characteristics and CT findings were compared between these two groups. Results AVC progression was observed in 26 patients (24.3%) between 2 serial CT examinations (median, 34 months). There was no significant difference in age, gender and the prevalence of other cardiovascular risk factors between the 2 groups. Patients in AVC progression group were associated with higher prevalence of elevated PCATA-LAD, higher LV mass index at baseline and the initial AVC presence. Receiver-operating characteristic curve analysis revealed that the optimal cut off value of PCATA-LAD for predicting AVC progression was −68.26 HU (area under the curve 0.605; 95% confidence interval [CI], 0.465–0.745). Multivariable logistic regression analysis revealed that baseline PCATA-LAD ≥−68.26 HU (odds ratio [OR], 3.12; 95% CI, 1.04–9.35, p=0.042) and the presence of baseline positive AVC (OR, 6.84; 95% CI, 2.34–20.0, p=0.0004) were independent predictors of AVC progression. Conclusions The increased pericoronary inflammation and the presence of AVC may help identify patients with high risk for future AVC progression. Funding Acknowledgement Type of funding source: None

scholarly journals Serial coronary computed tomography angiography-verified coronary plaque progression: comparison of stented patients with or without diabetes

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Rui Shi ◽  
Ke Shi ◽  
Zhi-gang Yang ◽  
Ying-kun Guo ◽  
Kai-yue Diao ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Diabetic Patients ◽  
Plaque Progression ◽  
Coronary Computed Tomography ◽  
Number Of Patients ◽  
The Impact

Abstract Background Patients with Diabetes mellitus (DM) are susceptible to coronary artery disease (CAD). However, the impact of DM on plaque progression in the non-stented segments of stent-implanted patients has been rarely reported. This study aimed to evaluate the impact of DM on the prevalence, characteristics and severity of coronary computed tomography angiography (CCTA) verified plaque progression in stented patients. A comparison between diabetic and non-diabetic patients was performed. Methods A total of 98 patients who underwent clinically indicated serial CCTAs arranged within 1 month before and at least 6 months after percutaneous coronary intervention (PCI) were consecutively included. All the subjects were categorized into diabetic group (n = 36) and non-diabetic groups (n = 62). Coronary stenosis extent scores, segment involvement scores (SIS), segment stenosis scores (SSS) at baseline and follow-up CCTA were quantitatively assessed. The prevalence, characteristics and severity of plaque progression was evaluated blindly to the clinical data and compared between the groups. Results During the median 1.5 year follow up, a larger number of patients (72.2% vs 40.3%, P = 0.002), more non-stented vessels (55.7% vs 23.2%, P < 0.001) and non-stented segments (10.3% vs 4.4%, P < 0.001) showed plaque progression in DM group, compared to non-DM controls. More progressive lesions in DM patients were found to be non-calcified plaques (31.1% vs 12.8%, P = 0.014) or non-stenotic segments (6.6% vs 3.0%, p = 0.005) and were more widely distributed on left main artery (24.2% vs 5.2%, p = 0.007), the right coronary artery (50% vs 21.1%, P = 0.028) and the proximal left anterior artery (33.3% vs 5.1%, P = 0.009) compared to non-DM patients. In addition, DM patients possessed higher numbers of progressive segments per patient, ΔSIS and ΔSSS compared with non-DM individuals (P < 0.001, P = 0.029 and P < 0.001 respectively). A larger number of patients with at least two progressive lesions were found in the DM group (P = 0.006). Multivariate logistic regression analysis demonstrated that DM (OR: 4.81; 95% CI 1.64–14.07, P = 0.004) was independently associated with plaque progression. Conclusions DM is closely associated with the prevalence and severity of CCTA verified CAD progression. These findings suggest that physicians should pay attention to non-stent segments and the management of non-stent segment plaque progression, particularly to DM patients.

Sex Differences in Factors Associated With Progression of Aortic Valve Calcification in the General Population

2022 ◽  
Author(s):  
Axel Diederichsen ◽  
Jes Sanddal Lindholt ◽  
Jacob Eifer Møller ◽  
Oke Gerke ◽  
Lars Melholt Rasmussen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Sex Differences ◽  
Aortic Valve ◽  
General Population ◽  
Incidence Rate ◽  
Interquartile Range ◽  
Aortic Valve Calcification ◽  
Valve Calcification ◽  
Factors Associated

Background: Guidelines recommend measurement of the aortic valve calcification (AVC) score to help differentiate between severe and nonsevere aortic stenosis, but a paucity exists in data about AVC in the general population. The aim of this study was to describe the natural history of AVC progression in the general population and to identify potential sex differences in factors associated with this progression rate. Methods: Noncontrast cardiac computed tomography was performed in 1298 randomly selected women and men aged 65 to 74 years who participated in the DANCAVAS trial (Danish Cardiovascular Screening). Participants were invited to attend a reexamination after 4 years. The AVC score was measured at the computed tomography, and AVC progression (ΔAVC) was defined as the difference between AVC scores at baseline and follow-up. Multivariable regression analyses were performed to identify factors associated with ΔAVC. Results: Among the 1298 invited citizens, 823 accepted to participate in the follow-up examination. The mean age at follow-up was 73 years. Men had significantly higher AVC scores at baseline (median AVC score 13 Agatston Units [AU; interquartile range, 0–94 AU] versus 1 AU [interquartile range, 0–22 AU], P <0.001) and a higher ΔAVC (median 26 AU [interquartile range, 0–101 AU] versus 4 AU [interquartile range, 0–37 AU], P <0.001) than women. In the fully adjusted model, the most important factor associated with ΔAVC was the baseline AVC score. However, hypertension was associated with ΔAVC in women (incidence rate ratios, 1.58 [95% CI, 1.06–2.34], P =0.024) but not in men, whereas dyslipidemia was associated with ΔAVC in men (incidence rate ratio: 1.66 [95% CI, 1.18–2.34], P =0.004) but not in women. Conclusions: The magnitude of the AVC score was the most important marker of AVC progression. However, sex differences were significant; hence, dyslipidemia was associated with AVC progression only among men; hypertension with AVC progression only among women. REGISTRATION: URL: https://www.isrctn.com ; Unique identifier: ISRCTN12157806.

scholarly journals Prognostic Value of Standard Coronary Computed Tomography Angiography Reporting System (CAD-RADS)

2021 ◽  
Author(s):  
Sedat Altay
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Risk Analysis ◽  
Computed Tomography Angiography ◽  
Proportional Hazards ◽  
Reporting System ◽  
Coronary Computed Tomography Angiography ◽  
Cox Proportional Hazards ◽  
Coronary Computed Tomography

Abstract Aims This study evaluated the clinical prospects of Coronary Artery Disease—Reporting and Data System (CAD-RADS) scoring in coronary computed tomography angiography (CTA). The aim of the study was to determine the guidance value of CAD-RADS scoring in patient follow-up after CTA. Methods and Materials Reports of cases reported between 2010 and 2013 were reevaluated with CAD-RADS scoring. Clinical risk analysis was performed with initial forms of anamnesis. Clinical follow-up was performed on 7 to 10 years (mean: 8 years, 4 months) hospital records. Univariate and multivariate Cox modeling was performed with Kaplan–Meier method to define the relationship between clinical (age, gender, diabetes mellitus, hypertension, smoking, family history) and CAD-RADS variables, and for risk analysis based on these causes. Cox proportional-hazards analysis results were presented as a hazard ratio with a 95% confidence interval. CAD-RADS scores were evaluated as meaningful determinants of univariate and multivariate Cox proportional survival analysis. Results Totally, 359 cases were evaluated in the study. Severe coronary pathology development rate was observed as CAD-RADS 0to 1%, CAD-RADS 1 to 3%, CAD-RADS 2 to 4%, CAD-RADS 3 to 9%, CAD-RADS 4A to 21%, 4B to 25%, CAD-RADS 5 to 50%. There were no coronary artery deaths in CAD-RADS 1,2,3 cases in 10 years of follow-up. Two cases with CAD-RADS 4 A score, three cases with 4 B score, and four patients with CAD-RADS 5 had a history of death as a result of coronary disease. Conclusions The cases with a high risk of side effects with CAD-RADS scores were clearly shown. CAD-RADS score accurately identifies risks in postimaging follow-up and is a reliable reporting system in the required treatment planning.

scholarly journals Diagnostic Phase of Calcium Scoring Scan Applied as the Center of Acquisition Window of Coronary Computed Tomography Angiography Improves Image Quality in Minimal Acquisition Window Scan (Target CTA Mode) Using the Second Generation 320-Row CT

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Eriko Maeda ◽  
Kodai Yamamoto ◽  
Shigeaki Kanno ◽  
Kenji Ino ◽  
Nobuo Tomizawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Computed Tomography Angiography ◽  
Cardiac Ct ◽  
Coronary Computed Tomography Angiography ◽  
Calcium Scoring ◽  
Acquisition Window ◽  
Coronary Computed Tomography ◽  
The Mean

Objective.To compare the image quality of coronary computed tomography angiography (CCTA) acquired under two conditions: 75% fixed as the acquisition window center (Group 75%) and the diagnostic phase for calcium scoring scan as the center (CS; Group CS).Methods.320-row cardiac CT with a minimal acquisition window (scanned using “Target CTA” mode) was performed on 81 patients. In Group 75% (n= 40), CS was obtained and reconstructed at 75% and the center of the CCTA acquisition window was set at 75%. In Group CS (n= 41), CS was obtained at 75% and the diagnostic phase showing minimal artifacts was applied as the center of the CCTA acquisition window. Image quality was evaluated using a four-point scale (4-excellent) and the mean scores were compared between groups.Results.The CCTA scan diagnostic phase occurred significantly earlier in CS (75.7 ± 3.2% vs. 73.6 ± 4.5% for Groups 75% and CS, resp.,p= 0.013). The mean Group CS image quality score (3.58 ± 0.63) was also higher than that for Group 75% (3.19 ± 0.66,p< 0.0001).Conclusions.The image quality of CCTA in Target CTA mode was significantly better when the center of acquisition window is adjusted using CS.

P5637A novel bioresorbable magnesium-based stent: initial clinical results and 6-months follow-up by coronary computed tomography angiography scan

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Ghafari ◽  
N Brassart ◽  
P Delmotte ◽  
P Brunner ◽  
K Thayse ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Lumen Area ◽  
Coronary Computed Tomography ◽  
Coronary Syndrome ◽  
Stent Restenosis ◽  
Minimal Lumen Area ◽  
In Stent Restenosis

Abstract Background Drug-eluting stents (DES) are the gold standard in percutaneous coronary interventions (PCI), but leave a permanent metallic “caging” of the treated vessels limiting further assessment of in-stent lumen patency by coronary computed tomography angiography (CCTA) due to artifacts. Absorbable scaffolds were designed to overcome the caging limitation but the first generation made of poly-L-lactic acid demonstrated higher thrombosis rates. A novel bioresorbable magnesium-based (Mg-)stent coated with a biodegradable polymer eluting sirolimus has been developed, with promising results in the BIOSOLVEII-III studies. Aim We sought to characterize PCI results by CCTA at 6-mo follow-up of patients treated with at least one Mg-stent in our institution. Methods Prospective observational registry started since January 2017 of younger patients with de novo lesions preferably treated with Mg-stents after balloon pre-dilatation. Procedural data and major adverse clinical events (MACE) at hospital discharge and 6-mo follow-up were collected. Reference vessel and in-stent minimal lumen area were measured on a CCTA performed at 6-mo. Results 34 Mg-stents (mean diameter: 3.2±0.2 mm, length 21.3±4.1 mm) were successfully implanted in 29 patients (mean age 54±6 years with male:female ratio 3:1). Acute coronary syndrome was the presenting diagnosis in 76% (n=22) with STEMI in 31% (n=9). The left anterior descending artery was treated in 62% (n=21). Calcifications on angiography were found in 14 lesions (41%). Intravascular imaging was performed in 3 PCI. With CCTA at 7.1±3.5 months (n=15 up to date, ongoing further follow-up to be presented), proximal and distal stent markers were well visualized while scaffold struts were not discernible. Mean proximal and distal reference lumen area were respectively 8.5±4.2 mm2 and 6.1±2.8 mm2. Mean in-stent minimal lumen area (MLA) was 6.3±2.9 mm2, with no statistical difference with the mean of the proximal and distal references (7.3±3.3 mm2, p=0.155, Wilcoxon rank test) demonstrating minimal instent hyperplasia at 6-mo: significant in-stent restenosis was noted in only one patient who remains so far asymptomatic (MLA 1.1 mm2; reference vessel lumen area 5.5 mm2). CCTA were non interpretable in 2 patients due to artifacts unrelated to the Mg-stents. One death secondary to a complicated cardiac tamponade was reported. No further MACE at 6-mo were noted. CCTA cross sectional cut Conclusion 6-mo CCTA of patients treated with a Mg-stent are fully interpretable to detect in-stent restenosis, without blooming artifacts. Accurate non-invasive assessment of the late results of our monocentric observational registry demonstrated 1 asymptomatic instent restenosis in 34 Mg-stents (3%) and overall optimal stent deployment and late artery patency, achieved with only 1 MACE in 29 patients (3.4%). This highlights the potentials of this new Mg-bioresorbable stent and the use of CCTA for clinical follow-up of the treated patients.

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