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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Quantitative CT histogram indices for abdominal muscles are associated with coronary artery disease severity
1Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China; Department of Medical Imaging, Hebei Chest Hospital, Shijiazhuang, China.
Insights
Quantitative CT histogram indices of abdominal muscles, specifically psoas major and abdominal wall muscles, show associations with coronary artery disease (CAD) severity. These relationships differ between sexes, highlighting potential sex-specific indicators for CAD.
Area of Science:
- Radiology and Imaging
- Cardiovascular Disease Research
- Musculoskeletal Imaging
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Quantitative imaging biomarkers are increasingly important for disease assessment.
- Abdominal muscle composition may reflect systemic health and disease risk.
Purpose of the Study:
- To investigate the association between quantitative computed tomography (CT) histogram indices of abdominal muscles and the severity of coronary artery disease (CAD).
- To explore potential sex-specific relationships between abdominal muscle characteristics and CAD indicators.
Main Methods:
- Abdominal muscles (abdominal wall, psoas major, paraspinal) were segmented from CT scans at the L1-L2 level in CAD patients and controls.
- Six histogram indices of muscle attenuation were measured.
- Associations between histogram indices and coronary artery calcium score (CACS) and total coronary plaque burden were analyzed using multivariate regression, adjusting for confounders.
Main Results:
- In male CAD patients, standard deviation of psoas major muscle attenuation was positively associated with CACS after adjustment.
- In female CAD patients, kurtosis of abdominal wall muscle attenuation was positively associated with total plaque burden after adjustment.
- Abdominal muscle CT histogram indices showed distinct patterns in CAD patients compared to controls, with sex-specific differences observed.
Conclusions:
- Quantitative CT histogram indices of abdominal muscles are independently associated with CAD severity.
- The identified associations between abdominal muscle histogram indices and CAD severity differ between males and females.
- These findings suggest potential for using abdominal muscle imaging characteristics as novel biomarkers for CAD.
Aim:
To explore the relationship between quantitative CT histogram indices of abdominal muscles and coronary artery disease (CAD) severity.
Materials And Methods:
CAD patients and controls who received chest CT covering the L1-L2 intervertebral disc were enrolled. Abdominal muscles at the L1-L2 level, including the abdominal wall muscles, the psoas major muscles and the paraspinal muscles, were segmented. Six histogram indices, covering area, average and median attenuation, skewness, kurtosis and standard deviation (SD) of attenuation, were measured and compared with controls. Associations between histogram indices and coronary artery calcium score (CACS) and total coronary plaque burden were then assessed using multivariate regression analysis.
Results:
Two hundred ninety male and 165 female CAD patients were enrolled. Compared with controls, both sexes of CAD patients had a broader, platykurtic and right-skewed distribution in the psoas major muscles and female CAD patients had a leptokurtic and left-skewed distribution in the abdominal wall muscles additionally. After adjusting for cardiovascular risk factors, BMI, liver fat fraction, visceral adipose tissue and subcutaneous adipose tissue, the SD in the psoas major muscles was positively associated with CACS in male CAD patients (β=0.13; 95% CI: 0.02 to 0.23; P=0.02), and kurtosis in the abdominal wall muscles was positively associated with total plaque burden in female CAD patients (β=0.15; 95% CI, 0.01 to 0.29; P=0.03).
Conclusion:
The histogram indices for abdominal wall muscles were independently associated with CAD severity in CAD patients, and the relationships were different between the two sexes.
