Model development and validation of noninvasive parameters based on coronary computed tomography angiography to predict culprit lesions in acute coronary syndromes within 3 years: value of plaque characteristics, hemodynamics and pericoronary adipose tissue

Li, Na; Dong, Xiaolin; Zhu, Chentao; Shi, Ke; Si, Nuo; Shi, Zhenzhou; Peng, Hong; Wang, Zhen; Zhao, Min; Zhang, Tong

doi:10.21037/qims-22-1045

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…PCAT attenuation was calculated based on the average attenuation of the perivascular adipose tissue. Semiautomated software (CoronaryDoc, Shukun Technology, China) was used to perform PCAT attenuation analysis as previously described ( 11 ). The global FAI was defined as the lowest value among the three major coronary arteries, whereas the global PCAT volume was calculated as the average of the three arteries.…”

Section: Methodsmentioning

confidence: 99%

Relationship between peri-coronary inflammation and coronary vascular function in patients with suspected coronary artery disease

Chen,

Liu,

et al. 2024

Front. Cardiovasc. Med.

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BackgroundIn this study, we aim to investigate the relationship between the attenuation of peri-coronary adipose tissue (PCAT) in patients with suspected coronary artery disease (CAD) and the assessment of coronary vascular functions using coronary flow reserve (CFR).MethodsWe included 364 patients who underwent 13N-NH3 positron emission tomography/computed tomography and coronary computed tomography angiography (CCTA). We determined the relationship between fat attenuation index (FAI), PCAT volume, and other qualitative CT-derived anatomic parameters with CFR.ResultsWe detected a decrease in CFR (<2.5) in 206 (57%) patients. At the patient level, those with reduced CFR showed a significantly higher prevalence of diffused atherosclerosis (41% vs. 23%; P < 0.001) and higher FAI (−75.5 HU vs. −77.1 HU; P = 0.014). In patients without obstructive CAD, FAI was significantly higher in those with reduced CFR (−75.5 HU vs. −77.7 HU, P = 0.026). On the vessel level, 1,092 vessels were analyzed, and 642 (59%) exhibited reduced CFR. The vessels with reduced CFR presented a significantly higher prevalence of obstructive CAD (37% vs. 26%; P < 0.001), diffused atherosclerosis (22% vs. 11%; P < 0.001), low-attenuation plaque (6% vs. 3%; P = 0.030), and positive remodeling (7% vs. 2%; P = 0.001). FAI was higher in vessels with reduced CFR (−80.8 HU vs. −81.8 HU; P = 0.045) than in normal CFR. In the patient-level analysis, obstructive CAD, diffused atherosclerosis, and FAI were independently linked with CFR. FAI was still associated with global CFR after adjusting for traditional risk factors (age, hypertension, diabetes, hyperlipidemia, and smoking). FAI remained independently associated with reduced CFR in patients without obstructive CAD.ConclusionsCoronary perivascular inflammation evaluated by CCTA was independently associated with coronary vascular function. In patients without obstructive CAD, FAI was higher in the presence of reduced CFR. Altogether, FAI can help reveal microcirculatory damage in patients who do not exhibit epicardial artery stenosis.

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Section: Methodsmentioning

confidence: 99%

Relationship between peri-coronary inflammation and coronary vascular function in patients with suspected coronary artery disease

Chen,

Liu,

et al. 2024

Front. Cardiovasc. Med.

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“…Recent landmark studies of PCAT attenuation have demonstrated that PCAT attenuation can not only detect biopsy-proven vascular inflammation ( 9 ) but can also be used as a noninvasive biomarker of vascular inflammation to assess CHD ( 12 ), adverse cardiac events ( 13 ), left ventricular function ( 14 ), and microvascular complications in patients with diabetes ( 15 ). In addition, high PCAT attenuation values detected using coronary computed tomographic angiography (CCTA) are related to endothelial dysfunction ( 16 ), oxidized HDL levels ( 17 ), cardiovascular events in patients with nonalcoholic fatty liver disease ( 18 ), and the recurrence of atrial fibrillation after ablation ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

Relationship between different clinical characteristics and pericoronary adipose tissue attenuation values quantified from coronary computed tomographic angiography (CCTA) in patients without coronary heart disease (CHD)

Xu,

Jing,

Zhu

et al. 2024

Quant Imaging Med Surg

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Background Pericoronary adipose tissue (PCAT) is a sensor of vascular inflammation. Elevated PCAT attenuation values indicate the presence of coronary inflammation in patients. However, it is unclear which clinical characteristics are associated with increased PCAT attenuation values in patients without coronary heart disease (CHD). The study aims to investigate the relationship between increased PCAT attenuation values and clinical characteristics of patients without CHD. Methods We recruited 785 eligible patients without CHD who underwent coronary computed tomographic angiography (CCTA). Clinical data were recorded for each patient, and PCAT attenuation values for the left anterior descending branch (LAD PCAT ), left circumflex branch (LCX PCAT ), and right coronary artery (RCA PCAT ) were quantified by CCTA using fully automated software. Univariate and multivariate analyses were performed to identify the associations between different clinical characteristics and elevated LAD PCAT , LCX PCAT , and RCA PCAT . Results Univariate analysis showed body mass index (BMI) to be positively associated with LAD PCAT (rs=0.109), LCX PCAT (rs=0.076), and RCA PCAT (rs=0.083). Moreover, the duration of smoking, and drinking was positively associated with LAD PCAT (rs=0.099, 0.165). Hyperlipidemia was positively associated with LAD PCAT (rs=0.089) and RCA PCAT (rs=0.334), while statin use was negatively associated with RCA PCAT (rs=−0.145). Multivariate analysis showed that the significant determinants of LAD PCAT were BMI (β=0.359, P=0.001), duration of smoking (β=2.612, P=0.002), drinking (β=4.106, P<0.001), and hyperlipidemia (β=1.664, P=0.027). LCX PCAT was associated with BMI (β=0.218, P=0.024), while RCA PCAT was associated with hyperlipidemia (β=6.110, P<0.001) and statin use (β=−3.338, P<0.001). Conclusions In patients without CHD, the PCAT attenuation values measured using CCTA were associated with various clinical characteristics. LAD PCAT was associated with BMI, smoking duration, drinking, and hyperlipidemia. On the other hand, LCX PCAT was associated with BMI, while RCA PCAT was associated with hyperlipidemia and statin use.

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Quantitative plaque characteristics and pericoronary fat attenuation index enhance risk prediction of unstable angina in nonobstructive lesions

Li,

Wang

et al. 2025

Clinical Radiology

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Model development and validation of noninvasive parameters based on coronary computed tomography angiography to predict culprit lesions in acute coronary syndromes within 3 years: value of plaque characteristics, hemodynamics and pericoronary adipose tissue

Cited by 5 publications

References 26 publications

Relationship between peri-coronary inflammation and coronary vascular function in patients with suspected coronary artery disease

Relationship between peri-coronary inflammation and coronary vascular function in patients with suspected coronary artery disease

Relationship between different clinical characteristics and pericoronary adipose tissue attenuation values quantified from coronary computed tomographic angiography (CCTA) in patients without coronary heart disease (CHD)

Quantitative plaque characteristics and pericoronary fat attenuation index enhance risk prediction of unstable angina in nonobstructive lesions

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