在接受TAVR的患者中,基于计算机断层扫描的冠状周周脂肪组织衰减:一种用于风险评估的新方法
Alexandra Steyer1,2, Silvia Mas-Peiro3,4,5, David M Leistner3
1Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany.
Frontiers in cardiovascular medicine
|June 8, 2023
概括
围绕右冠状动脉 (RCA) 周围的冠状动脉周围脂肪组织 (PCAT) 衰减是一种新的标志物,用于预测经过透气管大动脉置换 (TAVR) 的患者的主要不良心血管事件 (MACE). 较高的RCA PCAT衰减表明TAVR后MACE的风险增加.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 生物医学工程 生物医学工程
背景情况:
- 冠状动脉疾病 (CAD) 常见于患有大动脉狭窄症 (AS) 的患者,这些患者接受过导管大动脉置换术 (TAVR).
- 需要TAVR后不良结果的预测标记,因为目前的查和治疗方法仍在争论中.
- 周冠状动脉脂肪组织 (PCAT) 衰减,特别是在靠近右冠状动脉 (RCA) 周围,是冠状动脉炎症的新兴基于计算机断层扫描 (CT) 的标志物.
研究的目的:
- 评估RCA PCAT减弱对主要心血管不良事件 (MACE) 的预测价值,在接受TAVR的AS患者中.
- 为了比较RCA PCAT减弱与传统CAD诊断工具在识别高风险患者中的有效性.
主要方法:
- 一个单一中心的回顾性研究包括62名接受TAVR的患者.
- 使用CT扫描测量了传统的CAD诊断工具 (冠状动脉分数,狭窄评估) 和RCA PCAT衰减.
- 在24个月的随访期间,RCA PCAT减弱和MACE之间的关联被使用多变量考克斯回归分析.
主要成果:
- 15名患者 (24.2%) 经历了MACE,其中包括10例心血管死亡.
- 与没有MACE的患者相比,RCA PCAT衰减的平均值显著高于没有MACE的患者 (-69.8 ± 7.5对-74.6 ± 6.2,P=0.02).
- 高RCAPCAT衰减 (> -70.5HU) 确定了患有MACE显著更高风险的患者 (HR:3.82,P=0.011) 并是多变量分析中唯一的显著预测因素.
结论:
- RCA PCAT减弱是一种有价值的基于CT的标记,用于预测TAVR接受TAVR的AS患者的MACE.
- 这种标志物在识别高风险个体方面表现出比传统CAD诊断工具更高的可靠性.
- RCA PCAT减弱具有显著的预测价值,即使在同时存在AS.
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