Pericoronary Fat Attenuation: Diagnosis and Clinical Implications.

IF 5.7 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE
Current Atherosclerosis Reports Pub Date : 2024-12-01 Epub Date: 2024-10-10 DOI:10.1007/s11883-024-01245-z
Malek Nayfeh, Maria Alwan, Ahmed Sayed, Mouaz H Al-Mallah
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Abstract

Purpose of the review: The purpose of this review is to evaluate the current state of knowledge regarding the technical challenges associated with the Post-Acquisition Fat Attenuation Index (PFAI). By examining the limitations and gaps in the current methodologies, this review aims to provide a comprehensive understanding of how various factors impact the accuracy and reliability of PFAI measurements.

Recent findings: PFAI correlates with plaque instability, as inflammation in coronary plaque alters surrounding adipose tissue composition, increasing its water content and reducing lipid content, which is detectable via cardiac CT as increased attenuation. Recent studies have demonstrated PFA's prognostic value, with elevated levels linked to higher risks of cardiac events and plaque instability. A 2022 meta-analysis confirmed its association with major adverse cardiac events. Machine learning algorithms incorporating PFA and additional imaging features have further enhanced risk prediction beyond traditional metrics. Pericoronary fat attenuation is a promising marker for assessing coronary inflammation and could be useful in predicting plaque development, rupture, and monitoring treatment response, though further prospective studies and technical standardization are needed to fully establish its clinical benefits.

冠状动脉周围脂肪衰减:诊断与临床意义。
综述的目的:本综述旨在评估与采集后脂肪衰减指数(PFAI)相关的技术挑战的知识现状。通过研究当前方法的局限性和差距,本综述旨在全面了解各种因素如何影响 PFAI 测量的准确性和可靠性:PFAI 与斑块的不稳定性相关,因为冠状动脉斑块中的炎症会改变周围脂肪组织的组成,增加其含水量并减少脂质含量,这可通过心脏 CT 检测到衰减的增加。最近的研究表明,PFA 具有预后价值,其水平升高与较高的心脏事件风险和斑块不稳定性有关。2022 年的一项荟萃分析证实,PFA 与重大心脏不良事件有关。结合了冠状动脉脂肪衰减和其他成像特征的机器学习算法进一步增强了风险预测能力,超越了传统指标。冠状动脉周围脂肪衰减是一种很有前景的冠状动脉炎症评估标志物,可用于预测斑块的发展、破裂和监测治疗反应,但还需要进一步的前瞻性研究和技术标准化来充分确定其临床益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.00
自引率
3.40%
发文量
87
审稿时长
6-12 weeks
期刊介绍: The aim of this journal is to systematically provide expert views on current basic science and clinical advances in the field of atherosclerosis and highlight the most important developments likely to transform the field of cardiovascular prevention, diagnosis, and treatment. We accomplish this aim by appointing major authorities to serve as Section Editors who select leading experts from around the world to provide definitive reviews on key topics and papers published in the past year. We also provide supplementary reviews and commentaries from well-known figures in the field. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
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