M. Rațiu, N. Raț, Tiberiu Nyulas, Geanina Moldovan, V. Rus, T. Benedek, I. Benedek
{"title":"急性胸痛患者冠状动脉斑块几何形状和胸部脂肪分布的CT血管造影研究","authors":"M. Rațiu, N. Raț, Tiberiu Nyulas, Geanina Moldovan, V. Rus, T. Benedek, I. Benedek","doi":"10.2478/jce-2019-0001","DOIUrl":null,"url":null,"abstract":"Abstract The aim of our study was to investigate the correlation between volumes of thoracic fat distributed in different compartments and the geometry of vulnerable coronary plaques assessed by coronary computed tomography angiography (CCTA), in patients with acute chest pain. Methods: This was a non-randomized, observational, single-center study, including 50 patients who presented in the emergency department with acute chest pain who underwent 128-slice single-source CCTA. Plaque geometry was evaluated in transversal and longitudinal planes, and the assessment of adipose tissue was performed using the Syngo.via Frontier (Siemens AG, Healthcare Sector, Forchheim, Germany) research platform. Results: Eccentric plaques presented a significantly higher incidence of spotty calcification (40% vs. 22%, p = 0.018), whereas positive remodeling, volume of low attenuation plaque, and incidence of napkin-ring sign were not significantly different between the study groups or in ascending versus descending plaques. The volume of pericoronary fat around the plaque was significantly larger near eccentric lesions (707.68 ± 454.08 mm3 vs. 483.25 ± 306.98 mm3, p = 0.046) and descendent plaques (778.26 ± 479.37 mm3 vs. 473.60 ± 285.27 mm3, p = 0.016). Compared to ascending lesions, descendent ones presented a significantly larger volume of thoracic fat (1,599.25 ± 589.12 mL vs. 1,240.71 ± 291.50 mL), while there was no significant correlation between thoracic fat and cross-sectional eccentricity. Conclusions: The phenotype of plaque distribution and geometry seems to be associated with a higher vulnerability of coronary lesions and may be influenced by the local accumulation of inflammatory mediators released by the pericoronary epicardial adipose tissue.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"36 1","pages":"18 - 24"},"PeriodicalIF":0.6000,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"4","resultStr":"{\"title\":\"Coronary Plaque Geometry and Thoracic Fat Distribution in Patients with Acute Chest Pain – a CT Angiography Study\",\"authors\":\"M. Rațiu, N. Raț, Tiberiu Nyulas, Geanina Moldovan, V. Rus, T. Benedek, I. Benedek\",\"doi\":\"10.2478/jce-2019-0001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Abstract The aim of our study was to investigate the correlation between volumes of thoracic fat distributed in different compartments and the geometry of vulnerable coronary plaques assessed by coronary computed tomography angiography (CCTA), in patients with acute chest pain. Methods: This was a non-randomized, observational, single-center study, including 50 patients who presented in the emergency department with acute chest pain who underwent 128-slice single-source CCTA. Plaque geometry was evaluated in transversal and longitudinal planes, and the assessment of adipose tissue was performed using the Syngo.via Frontier (Siemens AG, Healthcare Sector, Forchheim, Germany) research platform. Results: Eccentric plaques presented a significantly higher incidence of spotty calcification (40% vs. 22%, p = 0.018), whereas positive remodeling, volume of low attenuation plaque, and incidence of napkin-ring sign were not significantly different between the study groups or in ascending versus descending plaques. The volume of pericoronary fat around the plaque was significantly larger near eccentric lesions (707.68 ± 454.08 mm3 vs. 483.25 ± 306.98 mm3, p = 0.046) and descendent plaques (778.26 ± 479.37 mm3 vs. 473.60 ± 285.27 mm3, p = 0.016). Compared to ascending lesions, descendent ones presented a significantly larger volume of thoracic fat (1,599.25 ± 589.12 mL vs. 1,240.71 ± 291.50 mL), while there was no significant correlation between thoracic fat and cross-sectional eccentricity. Conclusions: The phenotype of plaque distribution and geometry seems to be associated with a higher vulnerability of coronary lesions and may be influenced by the local accumulation of inflammatory mediators released by the pericoronary epicardial adipose tissue.\",\"PeriodicalId\":15210,\"journal\":{\"name\":\"Journal Of Cardiovascular Emergencies\",\"volume\":\"36 1\",\"pages\":\"18 - 24\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2019-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"4\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal Of Cardiovascular Emergencies\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2478/jce-2019-0001\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal Of Cardiovascular Emergencies","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2478/jce-2019-0001","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 4
摘要
摘要:本研究旨在探讨急性胸痛患者不同腔室的胸廓脂肪体积与冠状动脉ct血管造影(CCTA)评估的易损斑块几何形状之间的相关性。方法:这是一项非随机、观察性、单中心研究,包括50例急诊科急性胸痛患者,他们接受了128层单源CCTA。在横向和纵向平面上评估斑块的几何形状,并使用Syngo评估脂肪组织。通过Frontier (Siemens AG,医疗保健部门,德国福尔海姆)研究平台。结果:偏心斑块的点状钙化发生率明显较高(40%比22%,p = 0.018),而正重构、低衰减斑块的体积和餐巾环征象的发生率在研究组之间或上升斑块与下降斑块之间无显著差异。斑块周围的冠状动脉脂肪体积在偏心病变附近(707.68±454.08 mm3 vs. 483.25±306.98 mm3, p = 0.046)和下降斑块附近(778.26±479.37 mm3 vs. 473.60±285.27 mm3, p = 0.016)明显较大。与上升病变相比,下降病变的胸部脂肪量明显增加(1,599.25±589.12 mL vs 1,240.71±291.50 mL),而胸部脂肪与横截面偏心率无显著相关性。结论:斑块分布的表型和几何形状似乎与冠状动脉病变的易感性有关,并可能受到冠状动脉周围心外膜脂肪组织释放的炎症介质的局部积累的影响。
Coronary Plaque Geometry and Thoracic Fat Distribution in Patients with Acute Chest Pain – a CT Angiography Study
Abstract The aim of our study was to investigate the correlation between volumes of thoracic fat distributed in different compartments and the geometry of vulnerable coronary plaques assessed by coronary computed tomography angiography (CCTA), in patients with acute chest pain. Methods: This was a non-randomized, observational, single-center study, including 50 patients who presented in the emergency department with acute chest pain who underwent 128-slice single-source CCTA. Plaque geometry was evaluated in transversal and longitudinal planes, and the assessment of adipose tissue was performed using the Syngo.via Frontier (Siemens AG, Healthcare Sector, Forchheim, Germany) research platform. Results: Eccentric plaques presented a significantly higher incidence of spotty calcification (40% vs. 22%, p = 0.018), whereas positive remodeling, volume of low attenuation plaque, and incidence of napkin-ring sign were not significantly different between the study groups or in ascending versus descending plaques. The volume of pericoronary fat around the plaque was significantly larger near eccentric lesions (707.68 ± 454.08 mm3 vs. 483.25 ± 306.98 mm3, p = 0.046) and descendent plaques (778.26 ± 479.37 mm3 vs. 473.60 ± 285.27 mm3, p = 0.016). Compared to ascending lesions, descendent ones presented a significantly larger volume of thoracic fat (1,599.25 ± 589.12 mL vs. 1,240.71 ± 291.50 mL), while there was no significant correlation between thoracic fat and cross-sectional eccentricity. Conclusions: The phenotype of plaque distribution and geometry seems to be associated with a higher vulnerability of coronary lesions and may be influenced by the local accumulation of inflammatory mediators released by the pericoronary epicardial adipose tissue.