多层螺旋CT评价冠状动脉周围脂肪与冠心病的相关性

Associations of Pericoronary Adipose Tissue Measuredby MSCT with Coronary Artery Disease

目的:采用多层螺旋CT评价冠状动脉周围脂肪体积(PCAT)与冠心病的关系。方法:临床疑诊冠心病患者138例为研究对象,男78例,女60例,平均年龄52.6±6.9岁。收集所有病例一般临床资料。所有病例均行多层螺旋CT冠状动脉造影(CCTA)检查,测量心外膜脂肪容积和厚度、LM-LAD、LCX、RCA周围脂肪体积,并对冠状动脉狭窄程度进行定量Gensini积分。结果:根据CCTA及冠状动脉造影结果分为冠心病组(n=82)及非冠心病组(n=56),两组EAT容积、LM-LAD、RCA冠周脂肪、三支血管冠周脂肪之和(Total PCAT)、Gensini积分、钙化积分差异均有统计学意义(P<0.05),以三支血管冠周脂肪之和(Total PCAT)、Gensini积分、钙化积分差异相对显著(P<0.01)。PCAT与Gensini积分、钙化积分、年龄、BMI、TG呈正相关;与Gensini积分、钙化积分相关性最为显著,P<0.01。与HDL-C呈负相关(P<0.05)。结论:PCAT体积与冠心病的存在及严重程度相关,可作为冠心病风险的预测因子。

Purpose： To evaluate the pericoronary adipose tissue （PCAT） volume associated with the presence and the severity of coronary artery disease （CAD）. Methods： MSCT was performed in 138 consecutive patients with suspected coronary artery disease （78 males and 60 females）. The age ranged from 35 to 79 years with a mean ~ standard deviation （SD） of （52.6±6.9） years. The clinical information of all the patients was collected. All the patents were performed coronary computed tomography angiography （CCTA）. The volume and thickness of epicardium adipose tissue （EAT）, PCAT of LM-LAD, LCX, RCA were measured with GE ADW Workstation 4.4. The severity of coronary artery stenosis （CAS） was quantitated with Gensini scoring system. Results： The subjects were divided into normal （n=56） and CAD groups （n=82） based on the CCTA and coronary angiography （CAG） results. There were significant differences in the volume of EAT, PCAT of LM-LAD and RCA, total PCAT, Gensini scores, calcification scores （P〈0.01）. The volume of PCAT was associated with Gensini scores, calcification scores, age, BMI and TG （P〈0.05）. And it was negatively associated with HDL-C （P〈0.05）. Conclusions： PCAT volume is associated with the presence and severity of CAD and may be used as a predictor of CAD risk.