Lesion-Specific Peri-Coronary Fat Attenuation Index Is Associated With Functional Myocardial Ischemia Defined by Abnormal Fractional Flow Reserve

Frontiers in Cardiovascular Medicine

Shaowei Ma¹  Lei Xu²  Hui Liu³  Yining Wang⁴  Yue Ma⁵  Xujiao Chen⁵  Yang Hou⁵  Ting Liu⁶  Kunhua Wang⁷  Jiayin Zhang⁸  Jinzhu Yang⁹ 

[1] Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China;Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;Department of Radiology, Guangdong General Hospital, Guangzhou, China;Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China;Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China;Department of Radiology, The People's Hospital of Liaoning Province, Shenyang, China;Institute of Diagnostic and Interventional Radiology and Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China;Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, China;

关键词: computed tomography angiography;    coronary artery disease;    adipose tissue;    fractional flow reserve (FFR);    functional ischemia;   

DOI  :  10.3389/fcvm.2021.755295

来源: DOAJ

【 摘 要 】

Background: The association between abnormal invasive fractional flow reserve (FFR) and the fat attenuation index (FAI) of lesion-specific peri-coronary adipose tissue (PCAT) is unclear.Method: Data of patients who underwent coronary computed tomography angiography (CTA) and subsequent invasive coronary angiography (ICA) and FFR measurement within 1 week were retrospectively included. Lesion-specific FAI (FAIlesion), lesion-free FAI (FAInormal), epicardial adipose tissue (EAT) volume and attenuation was collected, along with stenosis severity and plaque characteristics. Lesions with FFR <0.8 were considered functionally significant. The association between FFR and each parameter was analyzed by logistic regression or receiver operating characteristic curve.Result: A total of 227 patients from seven centers were included. EAT volume or attenuation, traditional risk factors, and FAInormal (with vs. without ischemia: −82 ± 11 HU vs. −81 ± 11 HU, p = 0.65) were not significantly different in patients with or without abnormal FFR. In contrast, lesions causing functional ischemia presented more severe stenosis, greater plaque volume, and higher FAIlesion (with vs. without ischemia: −71 ± 8 HU vs. −76 ± 9 HU, p < 0.01). Additionally, the CTA-assessed stenosis severity (OR 1.06, 95%CI 1.04–1.08, p < 0.01) and FAIlesion (OR 1.08, 95%CI 1.04–1.12, p < 0.01) were determined to be independent factors that could predict ischemia. The combination model of these two CTA parameters exhibited a diagnostic value similar to the invasive coronary angiography (ICA)-assessed stenosis severity (AUC: 0.820 vs. 0.839, p = 0.39).Conclusion: It was FAIlesion, not general EAT parameters, that was independently associated with abnormal FFR and the diagnostic performance of CTA-assessed stenosis severity for functional ischemia was significantly improved in combination with FAIlesion.

【 授权许可】

Unknown