{"title":"MAFLD 对冠状动脉斑块特征和生理状态的影响：冠状动脉 CT 血管造影研究。","authors":"Qian Liu, Xin-De Zheng, Yu-Yao Xiao, Zhi-Han Xu, Meng-Meng Yu, Meng-Su Zeng","doi":"10.1016/j.acra.2024.10.027","DOIUrl":null,"url":null,"abstract":"<p><strong>Rationale and objectives: </strong>Metabolic dysfunction-associated fatty liver disease (MAFLD) is linked to an increased risk of cardiovascular events. Our study sought to determine the impact of MAFLD on both the anatomy and function of coronary plaques.</p><p><strong>Materials and methods: </strong>A total of 203 participants (including 728 plaques) with suspected coronary artery disease (CAD) who underwent coronary CT angiography (CCTA) and abdominal ultrasound were prospectively enrolled. Participants were divided into MAFLD and non-MAFLD groups. For each plaque, necrotic core plaque volume and fractional flow reserve derived from CT (FFR<sub>CT</sub>) were measured. Obstructive CAD, segment involvement score (SIS) >4, high-risk plaque (HRP) and FFR<sub>CT</sub> ≤ 0.8 were assessed.</p><p><strong>Results: </strong>Compared to non-MAFLD, necrotic core plaque volume was higher in MAFLD at both participant level (p < 0.001) and plaque level (p = 0.001). MAFLD had a higher prevalence of obstructive CAD, SIS >4, HRP and FFR<sub>CT</sub> ≤ 0.8 at participant level (obstructive CAD: 35.9% vs 21.6%, p = 0.026; SIS >4: 39.7% vs 17.6%, p < 0.001; HRP: 55.1% vs 29.6%, p < 0.001; FFR<sub>CT</sub> ≤0.8: 33.3% vs 15.2%, p = 0.002). In addition, MAFLD predicted the presence of obstructive CAD (adjusted OR: 2.44; 95% CI: 1.22-4.87; p = 0.011), SIS >4 (adjusted OR: 3.64; 95% CI: 1.78-7.46; p < 0.001), HRP (adjusted OR: 2.52; 95% CI: 1.37-4.63; p = 0.003) and FFR<sub>CT</sub> ≤ 0.8 (adjusted OR: 3.53; 95% CI: 1.65-7.57; p = 0.001) independent of traditional cardiovascular risk factors.</p><p><strong>Conclusion: </strong>MAFLD is associated with CCTA derived plaque characteristics, including the severity and extent of CAD, HRP, as well as physiologic status, independent of traditional risk factors.</p>","PeriodicalId":50928,"journal":{"name":"Academic Radiology","volume":" ","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The impact of MAFLD on coronary plaque characteristics and physiologic status: a coronary CT angiography study.\",\"authors\":\"Qian Liu, Xin-De Zheng, Yu-Yao Xiao, Zhi-Han Xu, Meng-Meng Yu, Meng-Su Zeng\",\"doi\":\"10.1016/j.acra.2024.10.027\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Rationale and objectives: </strong>Metabolic dysfunction-associated fatty liver disease (MAFLD) is linked to an increased risk of cardiovascular events. Our study sought to determine the impact of MAFLD on both the anatomy and function of coronary plaques.</p><p><strong>Materials and methods: </strong>A total of 203 participants (including 728 plaques) with suspected coronary artery disease (CAD) who underwent coronary CT angiography (CCTA) and abdominal ultrasound were prospectively enrolled. Participants were divided into MAFLD and non-MAFLD groups. For each plaque, necrotic core plaque volume and fractional flow reserve derived from CT (FFR<sub>CT</sub>) were measured. Obstructive CAD, segment involvement score (SIS) >4, high-risk plaque (HRP) and FFR<sub>CT</sub> ≤ 0.8 were assessed.</p><p><strong>Results: </strong>Compared to non-MAFLD, necrotic core plaque volume was higher in MAFLD at both participant level (p < 0.001) and plaque level (p = 0.001). MAFLD had a higher prevalence of obstructive CAD, SIS >4, HRP and FFR<sub>CT</sub> ≤ 0.8 at participant level (obstructive CAD: 35.9% vs 21.6%, p = 0.026; SIS >4: 39.7% vs 17.6%, p < 0.001; HRP: 55.1% vs 29.6%, p < 0.001; FFR<sub>CT</sub> ≤0.8: 33.3% vs 15.2%, p = 0.002). In addition, MAFLD predicted the presence of obstructive CAD (adjusted OR: 2.44; 95% CI: 1.22-4.87; p = 0.011), SIS >4 (adjusted OR: 3.64; 95% CI: 1.78-7.46; p < 0.001), HRP (adjusted OR: 2.52; 95% CI: 1.37-4.63; p = 0.003) and FFR<sub>CT</sub> ≤ 0.8 (adjusted OR: 3.53; 95% CI: 1.65-7.57; p = 0.001) independent of traditional cardiovascular risk factors.</p><p><strong>Conclusion: </strong>MAFLD is associated with CCTA derived plaque characteristics, including the severity and extent of CAD, HRP, as well as physiologic status, independent of traditional risk factors.</p>\",\"PeriodicalId\":50928,\"journal\":{\"name\":\"Academic Radiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-11-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Academic Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.acra.2024.10.027\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.acra.2024.10.027","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
The impact of MAFLD on coronary plaque characteristics and physiologic status: a coronary CT angiography study.
Rationale and objectives: Metabolic dysfunction-associated fatty liver disease (MAFLD) is linked to an increased risk of cardiovascular events. Our study sought to determine the impact of MAFLD on both the anatomy and function of coronary plaques.
Materials and methods: A total of 203 participants (including 728 plaques) with suspected coronary artery disease (CAD) who underwent coronary CT angiography (CCTA) and abdominal ultrasound were prospectively enrolled. Participants were divided into MAFLD and non-MAFLD groups. For each plaque, necrotic core plaque volume and fractional flow reserve derived from CT (FFRCT) were measured. Obstructive CAD, segment involvement score (SIS) >4, high-risk plaque (HRP) and FFRCT ≤ 0.8 were assessed.
Results: Compared to non-MAFLD, necrotic core plaque volume was higher in MAFLD at both participant level (p < 0.001) and plaque level (p = 0.001). MAFLD had a higher prevalence of obstructive CAD, SIS >4, HRP and FFRCT ≤ 0.8 at participant level (obstructive CAD: 35.9% vs 21.6%, p = 0.026; SIS >4: 39.7% vs 17.6%, p < 0.001; HRP: 55.1% vs 29.6%, p < 0.001; FFRCT ≤0.8: 33.3% vs 15.2%, p = 0.002). In addition, MAFLD predicted the presence of obstructive CAD (adjusted OR: 2.44; 95% CI: 1.22-4.87; p = 0.011), SIS >4 (adjusted OR: 3.64; 95% CI: 1.78-7.46; p < 0.001), HRP (adjusted OR: 2.52; 95% CI: 1.37-4.63; p = 0.003) and FFRCT ≤ 0.8 (adjusted OR: 3.53; 95% CI: 1.65-7.57; p = 0.001) independent of traditional cardiovascular risk factors.
Conclusion: MAFLD is associated with CCTA derived plaque characteristics, including the severity and extent of CAD, HRP, as well as physiologic status, independent of traditional risk factors.
期刊介绍：
Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.
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