Human coronary inflammation by computed tomography: Relationship with coronary microvascular dysfunction

被引:20
|
作者
Pasqualetto, Maria Cristina [1 ]
Tuttolomondo, Domenico [2 ]
Cutruzzola, Antonio [3 ]
Niccoli, Giampaolo [1 ]
Dey, Damini [4 ]
Greco, Alessandro [2 ]
Martini, Chiara [5 ]
Irace, Concetta [3 ]
Rigo, Fausto [6 ]
Gaibazzi, Nicola [2 ]
机构
[1] Dolo Hosp, Div Cardiol, Venice, Italy
[2] Parma Univ Hosp, Cardiol Dept, Parma, Italy
[3] Magna Graecia Univ Catanzaro, Dept Hlth Sci Clin & Expt Med, Catanzaro, Italy
[4] Cedars Sinai Med Ctr, Biomed Imaging Res Inst, Dept Biomed Sci, Los Angeles, CA 90048 USA
[5] Parma Univ Hosp, Radiol Dept, Parma, Italy
[6] Hosp Venice, Cardiol Dept, Venice, Italy
关键词
Peri-coronary adipose tissue attenuation; Computed tomography; Stress-echocardiography; Microcirculation; Doppler coronary flow velocity reserve; FAT ATTENUATION INDEX; FLOW RESERVE; PROGNOSTIC VALUE; RISK-FACTORS; ARTERY; HEART;
D O I
10.1016/j.ijcard.2021.05.040
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background A new imaging metric using coronary computed tomography angiography (CCTA), addressing the peri-coronary adipose tissue (PCAT) computed tomography (CT) attenuation, has been clinically validated. This method provides information regarding coronary inflammation. It is unclear how coronary inflammation affects microvascular function. The non-invasive evaluation of coronary flow velocity reserve is widely used in clinical practice using Doppler measurement on the left anterior descending coronary artery (CFVR-lad) during stress-echocardiography (SE). We hypothesize that coronary inflammation affects CFVR-lad and, in the absence of overt CAD, they are significantly correlated. Methods We evaluated the relationship between coronary inflammation (by PCAT CT attenuation) and coronary microvascular function (by CFVR-lad) in subjects with no or non-obstructive (diameter stenosis <70%) coronary artery disease (CAD). Results Two-hundred and two subjects were enrolled in the study. The relationship between PCAT CT attenuation and CFVR-lad show a significant inverse relationship in the entire group of subjects enrolled in the study (r = -0.32, p < 0.001). Correlation between PCAT CT attenuation and CFVR-lad was significant in subjects with no or mild CAD-lad, while this was not the case in subjects with intermediate CAD-lad. The R and R-2 were respectively -0.40, -0.16 in subjects without CAD (p < 0.001) and - 0.35 and - 0.12 in subjects with mild CAD lad (p = 0.001). Conclusions The main finding of the current study is the independent relationship between coronary microvascular function, by Doppler CFVR-lad during SE, in subjects without severely obstructive CAD in the left anterior descending coronary artery, and the level of local coronary inflammation, by PCAT attenuation measurement on CCTA. (C) 2021 Elsevier B.V. All rights reserved.
引用
收藏
页码:8 / 13
页数:6
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