Dual-layer spectral detector CT to study the correlation between pericoronary adipose tissue and coronary artery stenosis

Abstract Background To investigate the relationship of pericoronary adipose tissue (PCAT) with coronary artery stenosis using dual-layer spectral detector CT (SDCT). Methods 99 patients were retrospectively divided into normal group, non-significant stenosis group and significant stenosis group (n = 33 in each group). Fat attenuation index (FAI) 40kev, spectral curve slope (λHU), effective atomic number (Eff-Z) and epicardial fat volume (EFV) were quantitatively evaluated of the narrowest part of the lesion tissue by SDCT. Results There were significant differences in PCAT parameters on SDCT (FAI40keV, λHU, Eff-Z and EFV) among the three groups (P < 0.05). FAI40keV, λHU, and Eff-Z in significant stenosis group were statistically different from those in normal group and non-significant stenosis group (P < 0.05). FAI40keV, λHU, and Eff-Z in non-significant stenosis group were statistically different from significant stenosis group (P < 0.05). EFV in normal group were significantly lower in non-significant stenosis group and significant stenosis group (P < 0.001). Univariate and multivariate logistic regression analyses identified FAI40keV (OR = 1.50, 95%CI 1.01 to 1.09) and λHU (OR = 6.81, 95%CI 1.87 to 24.86) as independent predictors of significant stenosis. FAI40keV and λHU had quite good discrimination, with an AUC of 0.84 and 0.80 respectively. Conclusion FAI40keV, λHU, and Eff-Z on SDCT in significant stenosis group were significantly different from normal and non-significant stenosis group while EFV in normal group were significantly different from non-significant stenosis group and significant stenosis group. FAI40kev and λHU were risk factors for significant stenosis.

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Association of Pericoronary Adipose Tissue Quality Determined by Dual-Layer Spectral Detector CT With Severity of Coronary Artery Disease: A Preliminary Study

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.720127 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yuxue Dang ◽

Xujiao Chen ◽

Shaowei Ma ◽

Yue Ma ◽

Quanmei Ma ◽

...

Keyword(s):

Coronary Artery Disease ◽

Adipose Tissue ◽

Coronary Artery ◽

Multivariate Logistic Regression Analysis ◽

Effective Atomic Number ◽

Tissue Quality ◽

Attenuation Index ◽

Spectral Detector Ct ◽

Vascular Stenosis ◽

Artery Disease

Background: Pericoronary adipose tissue (PCAT) is considered as a source of inflammatory mediators, leading to the development of coronary atherosclerosis. The study aimed to investigate the correlation between PCAT quality derived from dual-layer spectral detector CT (SDCT) and the severity of coronary artery disease (CAD), and whether PCAT parameters were independently associated with the presence of CAD.Materials and Methods: A total of 403 patients with symptoms of chest pain who underwent SDCT were included. PCAT quality including fat attenuation index (FAI) measured from conventional polychromatic CT images (FAI120kvp) and spectral virtual mono-energetic images at 40 keV (FAI40keV), slope of spectral HU curve (λHU), and effective atomic number (Eff-Z) were measured around the lesions representing the maximal degree of vascular stenosis in each patient. Meanwhile, overall epicardial adipose tissue (EAT) attenuation was acquired in the conventional polychromatic energy imaging.Results: FAI40keV, λHU, Eff-Z, and FAI120kvp increased along with the degree of CAD in general and were superior to the overall EAT attenuation for detecting the presence of CAD. Multivariate logistic regression analysis indicated that FAI40keV was the most powerful independent indicator (odds ratio 1.058, 95% CI 1.044–1.073; p < 0.001) of CAD among these parameters. Using an optimal cut-off (−131.8 HU), FAI40keV showed higher diagnostic accuracy of 80.6% compared with the other parameters.Conclusions: These preliminary findings suggest that FAI40keV on SDCT may be an appealing surrogate maker to allow monitoring of PCAT changes in the development of CAD.

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Relationship between Whole Blood Viscosity and Lesion Severity in Coronary Artery Disease

International Journal of Angiology ◽

10.1055/s-0040-1720968 ◽

2021 ◽

Author(s):

Gökhan Ceyhun ◽

Oğuzhan Birdal

Keyword(s):

Coronary Artery ◽

Shear Rate ◽

Confidence Interval ◽

Odds Ratio ◽

Coronary Artery Stenosis ◽

Artery Stenosis ◽

Significant Stenosis ◽

Whole Blood Viscosity ◽

Significant Coronary Artery Stenosis ◽

Coronary Syndrome

Abstract Objective This article investigates the relationship of fractional flow reserve (FFR) with whole blood viscosity (WBV) in patients who were diagnosed with chronic coronary syndrome and significant stenosis in the major coronary arteries and underwent the measurement of FFR. Material and Method In the FFR measurements performed to evaluate the severity of coronary artery stenosis, 160 patients were included in the study and divided into two groups as follows: 80 with significant stenosis and 80 with nonsignificant stenosis. WBVs at low shear rate (LSR) and high shear rate (HSR) were compared between the patients in the significant and nonsignificant coronary artery stenosis groups. Results In the group with FFR < 0.80 and significant coronary artery stenosis, WBV was significantly higher compared with the group with nonsignificant coronary artery stenosis in terms of both HSR (19.33 ± 0.84) and LSR (81.19 ± 14.20) (p < 0.001). In the multivariate logistic regression analysis, HSR and LSR were independent predictors of significant coronary artery stenosis (HSR: odds ratio: 1.67, 95% confidence interval: 1.17–2.64; LSR: odds ratio: 2.46, 95% confidence interval: 2.19–2.78). In the receiver operating characteristic (ROC) curve analysis, when the cutoff value of WBV at LSR was taken as 79.23, it had 58.42% sensitivity and 62.13% specificity for the prediction of significant coronary artery stenosis (area under the ROC curve: 0.628, p < 0.001). Conclusion WBV, an inexpensive biomarker that can be easily calculated prior to coronary angiography, was higher in patients with functionally severe coronary artery stenosis, and thus could be a useful marker in predicting the hemodynamic severity of coronary artery stenosis in patients with chronic coronary syndrome.

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Effect of Significant Coronary Artery Stenosis on Prognosis in Patients with Vasospastic Angina: A Propensity Score-Matched Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10153341 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3341

Author(s):

Hyun-Jin Kim ◽

Min-Ho Lee ◽

Sang-Ho Jo ◽

Won-Woo Seo ◽

Hack-Lyoung Kim ◽

...

Keyword(s):

Coronary Artery ◽

Propensity Score ◽

Clinical Outcomes ◽

Coronary Artery Stenosis ◽

Study Data ◽

Artery Stenosis ◽

Vasospastic Angina ◽

Significant Stenosis ◽

Significant Coronary Artery Stenosis ◽

Increased Risk

Vasospastic angina (VA) is a functional disease of the coronary artery and occurs in an angiographically normal coronary artery. However, it may also occur with coronary artery stenosis. We investigated the effect of coronary artery stenosis on clinical outcomes in VA patients. Study data were obtained from a prospective multicenter registry that included patients who had symptoms of VA. Patients were classified into two groups according to presence of significant coronary artery stenosis. Among 1920 patients with VA, 189 patients were classified in the “significant stenosis” group. The one-year composite clinical events rate was significantly higher in the significant stenosis group than in the “no significant stenosis” group (5.8% vs. 1.4%, respectively; p < 0.001). Additionally, the prevalence of ACS was significantly greater in the "significant stenosis" group (4.8% vs. 0.9%, respectively; p < 0.001). After propensity score matching, the adverse effects of significant stenosis remained. In addition, significant stenosis was independently associated with a 6.67-fold increased risk of ACS in VA patients. In conclusion, significant coronary artery stenosis can increase the adverse clinical outcomes in VA patients at long-term follow-up. Clinicians should manage traditional risk factors associated with atherosclerosis and control vasospasm as well as reduce the burden of atherosclerosis.

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