艾滋病人群心外膜及冠状动脉周围脂肪定量参数与CT-FFR的关系研究

Relation between Quantitative Parameters of Epicardial and Peri-Coronary Fat and CT-FFR in HIV Patients

目的探讨基于冠状动脉CT血管造影(CCTA)的艾滋病人群心外膜及冠状动脉周围脂肪定量参数与CT血流储备分数(CT-FFR)的关系。方法对112例艾滋病患者行CCTA检查,按将其按CT-FFR≤0.8和>0.8分为缺血组和非缺血组,并对CCTA图像行冠状动脉脂肪衰减指数(FAI)、心外膜脂肪组织(EAT)体积及密度、冠状动脉钙化积分(CACS)等定量分析,以分析和比较两组间以上参数的差异。绘制受试者工作特征(ROC)曲线,比较曲线下面积(AUC)以得出最佳诊断模型。结果缺血组的男性、吸烟史比例及肌酸激酶更高,三支冠状动脉主血管及整体平均FAI值、EAT密度及CACS较非缺血组更高,EAT体积在两组中无显著差异。Logistic分析中显示FAI是心肌缺血的独立预测因子。冠状动脉周围脂肪FAI、EAT密度及CACS的模型较单独冠状动脉周围脂肪FAI的模型诊断心肌缺血的效能高,但差异无统计学意义。结论在艾滋病人群中,冠状动脉周围脂肪FAI是心肌缺血的重要预测因子并且诊断效能较高。

Objective To investigate the relationship between quantitative parameters of epicardial and CT-FFR in HIV patients based on CT coronary angiography(CCTA).Methods A total of 112 HIV patients who underwent CCTA examination were retrospectively included.Divided into ischemic group and non-ischemic group according to CT-FFR≤0.8 and>0.8.Quantitative analysis of pericoronary FAI,EAT volume and density and CACS were performed on CCTA images to analyze and compare the differences of parameters between the two groups.Drew the ROC curve and compared the area under the curve(AUC)to get the best diagnostic model.Results Compared with the non-ischemic group,the proportion of males、smoking history and creatin kinase in the ischemia group was higher.The FAI value of the three main coronary arteries and overall average,EAT density and CACS in the ischemia group were higher.There was no significant difference in EAT volume between the two groups.The Logistic analysis showed that pericoronary FAI was an independent predictor of myocardial ischemia.The model based on pericoronary FAI,EAT density and CACS was more effective in the diagnosis of myocardial ischemia than the model based on pericoronary FAI,but the difference was not statistically significant.Conclusion In HIV patients,pericoronary FAI is an important predictor of myocardial ischemia and has high diagnostic efficacy.