Characterization of plaque phenotypes exhibiting an elevated pericoronary adipose tissue attenuation: insights from the REASSURE-NIRS registry.

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

International Journal of Cardiovascular Imaging Pub Date : 2023-10-01 Epub Date: 2023-06-29 DOI:10.1007/s10554-023-02907-w

Satoshi Kitahara, Yu Kataoka, Hiroyuki Miura, Tatsuya Nishii, Kunihiro Nishimura, Kota Murai, Takamasa Iwai, Hideo Matama, Satoshi Honda, Masashi Fujino, Shuichi Yoneda, Kensuke Takagi, Fumiyuki Otsuka, Yasuhide Asaumi, Yusuke Fujino, Kenichi Tsujita, Rishi Puri, Stephen J Nicholls, Teruo Noguchi

{"title":"Characterization of plaque phenotypes exhibiting an elevated pericoronary adipose tissue attenuation: insights from the REASSURE-NIRS registry.","authors":"Satoshi Kitahara, Yu Kataoka, Hiroyuki Miura, Tatsuya Nishii, Kunihiro Nishimura, Kota Murai, Takamasa Iwai, Hideo Matama, Satoshi Honda, Masashi Fujino, Shuichi Yoneda, Kensuke Takagi, Fumiyuki Otsuka, Yasuhide Asaumi, Yusuke Fujino, Kenichi Tsujita, Rishi Puri, Stephen J Nicholls, Teruo Noguchi","doi":"10.1007/s10554-023-02907-w","DOIUrl":null,"url":null,"abstract":"Inflammation has been considered to promote atheroma instability. Coronary computed tomography angiography (CCTA) visualizes pericoronary adipose tissue (PCAT) attenuation, which reflects coronary artery inflammation. While PCAT attenuation has been reported to predict future coronary events, plaque phenotypes exhibiting high PCAT attenuation remains to be fully elucidated. The current study aims to characterize coronary atheroma with a greater vascular inflammation. We retrospectively analyzed culprit lesions in 69 CAD patients receiving PCI from the REASSURE-NIRS registry (NCT04864171). Culprit lesions were evaluated by both CCTA and near-infrared spectroscopy/intravascular ultrasound (NIRS/IVUS) imaging prior to PCI. PCAT attenuation at proximal RCA (PCATRCA) and NIRS/IVUS-derived plaque measures were compared in patients with PCATRCA attenuation ≥ and < -78.3 HU (median). Lesions with PCATRCA attenuation ≥ -78.3 HU exhibited a greater frequency of maxLCBI4mm ≥ 400 (66% vs. 26%, p < 0.01), plaque burden ≥ 70% (94% vs. 74%, p = 0.02) and spotty calcification (49% vs. 6%, p < 0.01). Whereas positive remodeling (63% vs. 41%, p = 0.07) did not differ between two groups. On multivariable analysis, maxLCBI4mm ≥ 400 (OR = 4.07; 95%CI 1.12-14.74, p = 0.03), plaque burden ≥ 70% (OR = 7.87; 95%CI 1.01-61.26, p = 0.04), and spotty calcification (OR = 14.33; 95%CI 2.37-86.73, p < 0.01) independently predicted high PCATRCA attenuation. Of note, while the presence of only one plaque feature did not necessarily elevate PCATRCA attenuation (p = 0.22), lesions harboring two or more features were significantly associated with higher PCATRCA attenuation. More vulnerable plaque phenotypes were observed in patients with high PCATRCA attenuation. Our findings suggest PCATRCA attenuation as the presence of profound disease substrate, which potentially benefits from anti-inflammatory agents.","PeriodicalId":50332,"journal":{"name":"International Journal of Cardiovascular Imaging","volume":" ","pages":"1943-1952"},"PeriodicalIF":1.5000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10589176/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Cardiovascular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10554-023-02907-w","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/6/29 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Inflammation has been considered to promote atheroma instability. Coronary computed tomography angiography (CCTA) visualizes pericoronary adipose tissue (PCAT) attenuation, which reflects coronary artery inflammation. While PCAT attenuation has been reported to predict future coronary events, plaque phenotypes exhibiting high PCAT attenuation remains to be fully elucidated. The current study aims to characterize coronary atheroma with a greater vascular inflammation. We retrospectively analyzed culprit lesions in 69 CAD patients receiving PCI from the REASSURE-NIRS registry (NCT04864171). Culprit lesions were evaluated by both CCTA and near-infrared spectroscopy/intravascular ultrasound (NIRS/IVUS) imaging prior to PCI. PCAT attenuation at proximal RCA (PCAT_RCA) and NIRS/IVUS-derived plaque measures were compared in patients with PCAT_RCA attenuation ≥ and < -78.3 HU (median). Lesions with PCAT_RCA attenuation ≥ -78.3 HU exhibited a greater frequency of maxLCBI_4mm ≥ 400 (66% vs. 26%, p < 0.01), plaque burden ≥ 70% (94% vs. 74%, p = 0.02) and spotty calcification (49% vs. 6%, p < 0.01). Whereas positive remodeling (63% vs. 41%, p = 0.07) did not differ between two groups. On multivariable analysis, maxLCBI_4mm ≥ 400 (OR = 4.07; 95%CI 1.12-14.74, p = 0.03), plaque burden ≥ 70% (OR = 7.87; 95%CI 1.01-61.26, p = 0.04), and spotty calcification (OR = 14.33; 95%CI 2.37-86.73, p < 0.01) independently predicted high PCAT_RCA attenuation. Of note, while the presence of only one plaque feature did not necessarily elevate PCAT_RCA attenuation (p = 0.22), lesions harboring two or more features were significantly associated with higher PCAT_RCA attenuation. More vulnerable plaque phenotypes were observed in patients with high PCAT_RCA attenuation. Our findings suggest PCAT_RCA attenuation as the presence of profound disease substrate, which potentially benefits from anti-inflammatory agents.

Abstract Image

查看原文本刊更多论文

冠状动脉周围脂肪组织衰减增加的斑块表型特征：来自REASURE-NIRS登记的见解。

炎症被认为会促进动脉粥样硬化的不稳定性。冠状动脉计算机断层扫描血管造影术（CCTA）显示冠状动脉周围脂肪组织（PCAT）的衰减，反映冠状动脉炎症。虽然PCAT衰减已被报道可以预测未来的冠状动脉事件，但表现出高PCAT衰减的斑块表型仍有待完全阐明。目前的研究旨在描述冠状动脉粥样硬化具有更大的血管炎症。我们回顾性分析了69例接受REASURE-NIRS登记（NCT04864171）PCI的CAD患者的罪魁祸首病变。在PCI之前，通过CCTA和近红外光谱/血管内超声（NIRS/IVUS）成像评估朊病毒病变。比较近端RCA的PCAT衰减（PCATRCA）和NIRS/IVUS衍生的斑块测量在PCATRCA衰减的患者中的作用 ≥ 和 RCA衰减 ≥ -78.3 HU表现出更高的最大LCBI4mm频率 ≥ 400（66%对26%，p 4毫米 ≥ 400（或 = 4.07；95%置信区间1.12-14.74，p = 0.03），斑块负荷 ≥ 70%（或 = 7.87；95%置信区间1.01-61.26，p = 0.04）和点状钙化（OR = 14.33；95%置信区间2.37-86.73，p RCA衰减。值得注意的是，虽然只有一个斑块特征的存在并不一定会提高PCATRCA的衰减（p = 0.22），具有两个或更多特征的病变与较高的PCATRCA衰减显著相关。在PCATRCA衰减较高的患者中观察到更易受感染的斑块表型。我们的研究结果表明，PCATRCA的衰减是由于存在深层疾病基质，这可能受益于抗炎药。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Cardiovascular Imaging 医学-核医学

CiteScore

4.00

自引率

9.50%

发文量

审稿时长

1 months

期刊介绍： The International Journal of Cardiovascular Imaging publishes technical and clinical communications (original articles, review articles and editorial comments) associated with cardiovascular diseases. The technical communications include the research, development and evaluation of novel imaging methods in the various imaging domains. These domains include magnetic resonance imaging, computed tomography, X-ray imaging, intravascular imaging, and applications in nuclear cardiology and echocardiography, and any combination of these techniques. Of particular interest are topics in medical image processing and image-guided interventions. Clinical applications of such imaging techniques include improved diagnostic approaches, treatment , prognosis and follow-up of cardiovascular patients. Topics include: multi-center or larger individual studies dealing with risk stratification and imaging utilization, applications for better characterization of cardiovascular diseases, and assessment of the efficacy of new drugs and interventional devices.