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Caunite L, Myagmardorj R, Galloo X, Laenens D, Stassen J, Nabeta T, Yedidya I, Meucci MC, Kuneman JH, van den Hoogen IJ, van Rosendael SE, Wu HW, van den Brand VM, Giuca A, Trusinskis K, van der Bijl P, Bax JJ, Ajmone Marsan N. Prognostic Value of Follow-up Measures of Left Ventricular Global Longitudinal Strain in Patients With ST-Segment Elevation Myocardial Infarction. J Am Soc Echocardiogr 2024:S0894-7317(24)00114-7. [PMID: 38513963 DOI: 10.1016/j.echo.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/14/2024] [Accepted: 03/03/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION After ST-segment elevation myocardial infarction (STEMI), follow-up imaging is currently recommended only in patients with left ventricular ejection fraction (LVEF) <40%. Left ventricular global longitudinal strain (LVGLS) was shown to improve risk stratification over LVEF in these patients but has not been thoroughly studied during follow-up. The aim of this study was to explore the changes in LVGLS after STEMI and their potential prognostic value. MATERIALS AND METHODS Data were analyzed from an ongoing STEMI registry. Echocardiography was performed during the index hospitalization and 1 year after STEMI; LVGLS was expressed as an absolute value and the relative LVGLS change (ΔGLS) was calculated. The study end point was all-cause mortality. RESULTS A total of 1,409 STEMI patients (age 60 ± 11 years; 75% men) who survived at least 1 year after STEMI and underwent echocardiography at follow-up were included. At 1-year follow-up, LVEF improved from 50% ± 8% to 53% ± 8% (P < .001) and LVGLS from 14% ± 4% to 16% ± 3% (P < .001). Median ΔGLS was 14% (interquartile range, 0.5%-32%) relative improvement. Starting 1 year after STEMI, a total of 87 patients died after a median follow-up of 69 (interquartile range, 38-103) months. The optimal ΔGLS threshold associated with the end point (derived by spline curve analysis) was a relative decrease >7%. Cumulative 10-year survival was 91% in patients with ΔGLS improvement or a nonsignificant decrease, versus 85% in patients with ΔGLS decrease of >7% (P = .001). On multivariate Cox regression analysis, ΔGLS decrease >7% remained independently associated with the end point (hazard ratio, 2.5 [95% CI, 1.5-4.1]; P < .001) after adjustment for clinical and echocardiographic parameters. CONCLUSIONS A significant decrease in LVGLS 1 year after STEMI was independently associated with long-term all-cause mortality and might help further risk stratification and management of these patients during follow-up.
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Affiliation(s)
- Laima Caunite
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Latvian Cardiology Center, Pauls Stradins Clinical University Hospital, Riga, Latvia; Faculty of Residency, Riga Stradins University, Riga, Latvia
| | | | - Xavier Galloo
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Cardiology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Ixelles, Belgium
| | - Dorien Laenens
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan Stassen
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Cardiology, Jessa Hospital, Hasselt, Belgium
| | - Takeru Nabeta
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Idit Yedidya
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel; Faculty of Medicine, Tel-Aviv University, Tel Aviv-Jaffa, Israel
| | - Maria C Meucci
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Cardiovascular Science, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Jurrien H Kuneman
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Hoi Wai Wu
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Adrian Giuca
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Cardiology, "Prof. Dr. C.C. Iliescu" Emergency Institute for Cardiovascular Diseases, Fundeni Clinical Institute, Bucharest, Romania; Department of Research Methodology, Craiova University of Medicine and Pharmacy, Craiova, Romania
| | - Karlis Trusinskis
- Latvian Cardiology Center, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Pieter van der Bijl
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Heart Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Nina Ajmone Marsan
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
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van Rosendael SE, Bax AM, Lin FY, Achenbach S, Andreini D, Budoff MJ, Cademartiri F, Callister TQ, Chinnaiyan K, Chow BJW, Cury RC, DeLago AJ, Feuchtner G, Hadamitzky M, Hausleiter J, Kaufmann PA, Kim YJ, Leipsic JA, Maffei E, Marques H, de Araújo Gonçalves P, Pontone G, Raff GL, Rubinshtein R, Villines TC, Chang HJ, Berman DS, Min JK, Bax JJ, Shaw LJ, van Rosendael AR. Sex and age-specific interactions of coronary atherosclerotic plaque onset and prognosis from coronary computed tomography. Eur Heart J Cardiovasc Imaging 2023; 24:1180-1189. [PMID: 37165981 PMCID: PMC10445263 DOI: 10.1093/ehjci/jead094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/21/2023] [Accepted: 04/05/2023] [Indexed: 05/12/2023] Open
Abstract
AIMS The totality of atherosclerotic plaque derived from coronary computed tomography angiography (CCTA) emerges as a comprehensive measure to assess the intensity of medical treatment that patients need. This study examines the differences in age onset and prognostic significance of atherosclerotic plaque burden between sexes. METHODS AND RESULTS From a large multi-center CCTA registry the Leiden CCTA score was calculated in 24 950 individuals. A total of 11 678 women (58.5 ± 12.4 years) and 13 272 men (55.6 ± 12.5 years) were followed for 3.7 years for major adverse cardiovascular events (MACE) (death or myocardial infarction). The age where the median risk score was above zero was 12 years higher in women vs. men (64-68 years vs. 52-56 years, respectively, P < 0.001). The Leiden CCTA risk score was independently associated with MACE: score 6-20: HR 2.29 (1.69-3.10); score > 20: HR 6.71 (4.36-10.32) in women, and score 6-20: HR 1.64 (1.29-2.08); score > 20: HR 2.38 (1.73-3.29) in men. The risk was significantly higher for women within the highest score group (adjusted P-interaction = 0.003). In pre-menopausal women, the risk score was equally predictive and comparable with men. In post-menopausal women, the prognostic value was higher for women [score 6-20: HR 2.21 (1.57-3.11); score > 20: HR 6.11 (3.84-9.70) in women; score 6-20: HR 1.57 (1.19-2.09); score > 20: HR 2.25 (1.58-3.22) in men], with a significant interaction for the highest risk group (adjusted P-interaction = 0.004). CONCLUSION Women developed coronary atherosclerosis approximately 12 years later than men. Post-menopausal women within the highest atherosclerotic burden group were at significantly higher risk for MACE than their male counterparts, which may have implications for the medical treatment intensity.
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Affiliation(s)
- Sophie E van Rosendael
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - A Maxim Bax
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Fay Y Lin
- Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, Zena and Michael A. Wiener Cardiovascular Institute, and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, New York, NY, USA
| | - Stephan Achenbach
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen Medizinische Klinik 2-Kardiologie und Angiologie, Ulmenweg 18, 91054 Erlangen, Germany
| | - Daniele Andreini
- Division of Cardiology and Cardiac Imaging, IRCCS Galeazzi Sant'Ambrogio, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Matthew J Budoff
- Department of Medicine, Los Angeles Biomedical Research Institute, Torrance, CA
| | | | - Tracy Q Callister
- Department of Cardiology, Tennessee Heart and Vascular Institute, 353 New Shackle Island Rd Hendersonville, TN 37075, USA
| | - Kavitha Chinnaiyan
- Department of Cardiology, William Beaumont Hospital, 3535 W 13 Mile Rd #742, Royal Oak, MI 48073, USA
| | - Benjamin J W Chow
- Department of Medicine and Radiology, University of Ottawa, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada
| | - Ricardo C Cury
- Department of Radiology, Miami Cardiac and Vascular Institute, 8900 N Kendall Dr, Miami, FL 33176, USA
| | - Augustin J DeLago
- Capitol Cardiology Associate, 7 Southwoods Blvd, Albany, NY 12211, USA
| | - Gudrun Feuchtner
- Department of Radiology, Medical University of Innsbruck, Christoph-Probst-Platz 1, Innrain 52 A, Fritz-Pregl-Straße 3, 6020 Innsbruck, Austria
| | - Martin Hadamitzky
- Department of Radiology and Nuclear Medicine, German Heart Center Munich, Lazarettstraße 36, 80636 München, Germany
| | - Joerg Hausleiter
- Department of Radiology, Medizinische Klinik I der Ludwig-Maximilians-Universität München, Ziemssenstraße 1, 80336 München, Germany
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, University Hospital of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Yong-Jin Kim
- Department of Medicine, Seoul National University Hospital, Jongno-gu, Seoul 03080, South Korea
| | - Jonathon A Leipsic
- Department of Medicine and Radiology, University of British Columbia, 1081 Burrard Street Vancouver, BC V6Z 1Y6, Canada
| | - Erica Maffei
- Department of Radiology, Fondazione Monasterio (FTGM)-CNR, Pisa, Italy
| | - Hugo Marques
- UNICA, Cardiovascular Imaging Unit, Hospital da Luz Lisboa, Av. Lusíada 100, 1500-650 Lisboa, Portugal
- Católica Medical School, Estr. Octávio Pato, 2635-631 Rio de Mouro, Portugal
- Católica Biomedical Research Center, R. Q.ta Grande 6 2780, 2780-156 Oeiras, Portugal
| | - Pedro de Araújo Gonçalves
- UNICA, Cardiovascular Imaging Unit, Hospital da Luz Lisboa, Av. Lusíada 100, 1500-650 Lisboa, Portugal
- Nova Medical School, Campo dos Mártires da Pátria 130, 1169-056 Lisboa, Portugal
| | - Gianluca Pontone
- Division of Cardiology and Cardiac Imaging, IRCCS Galeazzi Sant'Ambrogio, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Gilbert L Raff
- Department of Cardiology, William Beaumont Hospital, 3535 W 13 Mile Rd #742, Royal Oak, MI 48073, USA
| | - Ronen Rubinshtein
- Department of Cardiology at the Lady Davis Carmel Medical Center, The Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Todd C Villines
- Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Hyuk-Jae Chang
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea
| | - Daniel S Berman
- Department of Imaging, Cedars Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, USA
| | | | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Leslee J Shaw
- Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, Zena and Michael A. Wiener Cardiovascular Institute, and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, New York, NY, USA
| | - Alexander R van Rosendael
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
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van Rosendael SE, van Rosendael AR, Kuneman JH, Patel MR, Nørgaard BL, Fairbairn TA, Nieman K, Akasaka T, Berman DS, Koweek LMH, Pontone G, Kawasaki T, Sand NPR, Jensen JM, Amano T, Poon M, Øvrehus KA, Sonck J, Rabbat MG, Rogers C, Matsuo H, Leipsic JA, Marsan NA, Jukema JW, Bax JJ, Saraste A, Knuuti J. Coronary Volume to Left Ventricular Mass Ratio in Patients With Hypertension. Am J Cardiol 2023; 199:100-109. [PMID: 37198076 DOI: 10.1016/j.amjcard.2023.04.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/22/2023] [Accepted: 04/17/2023] [Indexed: 05/19/2023]
Abstract
The coronary vascular volume to left ventricular mass (V/M) ratio assessed by coronary computed tomography angiography (CCTA) is a promising new parameter to investigate the relation of coronary vasculature to the myocardium supplied. It is hypothesized that hypertension decreases the ratio between coronary volume and myocardial mass by way of myocardial hypertrophy, which could explain the detected abnormal myocardial perfusion reserve reported in patients with hypertension. Individuals enrolled in the multicenter ADVANCE (Assessing Diagnostic Value of Noninvasive FFRCT in Coronary Care) registry who underwent clinically indicated CCTA for analysis of suspected coronary artery disease with known hypertension status were included in current analysis. The V/M ratio was calculated from CCTA by segmenting the coronary artery luminal volume and left ventricular myocardial mass. In total, 2,378 subjects were included in this study, of whom 1,346 (56%) had hypertension. Left ventricular myocardial mass and coronary volume were higher in subjects with hypertension than normotensive patients (122.7 ± 32.8 g vs 120.0 ± 30.5 g, p = 0.039, and 3,105.0 ± 992.0 mm3 vs 2,965.6 ± 943.7 mm3, p <0.001, respectively). Subsequently, the V/M ratio was higher in patients with hypertension than those without (26.0 ± 7.6 mm3/g vs 25.3 ± 7.3 mm3/g, p = 0.024). After correcting for potential confounding factors, the coronary volume and ventricular mass remained higher in patients with hypertension (least square) mean difference estimate: 196.3 (95% confidence intervals [CI] 119.9 to 272.7) mm3, p <0.001, and 5.60 (95% CI 3.42 to 7.78) g, p <0.001, respectively), but the V/M ratio was not significantly different (least square mean difference estimate: 0.48 (95% CI -0.12 to 1.08) mm3/g, p = 0.116). In conclusion, our findings do not support the hypothesis that the abnormal perfusion reserve would be caused by reduced V/M ratio in patients with hypertension.
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Affiliation(s)
| | | | - Jurrien H Kuneman
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Manesh R Patel
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | | | - Timothy A Fairbairn
- Department of Cardiology, University of Liverpool, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - Koen Nieman
- Department of Cardiovascular Medicine, Stanford University, Stanford, California; Department of Radiology, Stanford University, Stanford, California
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Daniel S Berman
- Division of Nuclear Imaging, Department of Imaging, Cedars-Sinai Heart Institute, Los Angeles, California
| | - Lynne M Hurwitz Koweek
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | | | | | - Niels Peter Rønnow Sand
- Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark; Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - Jesper M Jensen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Tetsuya Amano
- Department of Cardiology, Aichi Medical University, Aichi, Japan
| | - Michael Poon
- Department of Noninvasive Cardiac Imaging, Northwell Health, New York, New York
| | | | - Jeroen Sonck
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium
| | - Mark G Rabbat
- Division of Cardiology, Loyola University Chicago, Chicago, Illinois
| | | | - Hitoshi Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - Jonathon A Leipsic
- Department of Radiology, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Nina Ajmone Marsan
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Netherlands Heart Institute, Utrecht, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Antti Saraste
- Netherlands Heart Institute, Utrecht, The Netherlands; Turku PET Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Juhani Knuuti
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Turku PET Center, Turku University Hospital and University of Turku, Turku, Finland.
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Kuneman JH, van Rosendael SE, van der Bijl P, van Rosendael AR, Kitslaar PH, Reiber JH, Jukema JW, Leon MB, Ajmone Marsan N, Knuuti J, Bax JJ. Pericoronary Adipose Tissue Attenuation in Patients With Acute Coronary Syndrome Versus Stable Coronary Artery Disease. Circ Cardiovasc Imaging 2023; 16:e014672. [PMID: 36802444 PMCID: PMC9946175 DOI: 10.1161/circimaging.122.014672] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Pericoronary adipose tissue (PCAT) attenuation has been associated with coronary inflammation and can be evaluated with coronary computed tomography angiography. The aims of this study were to compare the PCAT attenuation across precursors of culprit and nonculprit lesions of patients with acute coronary syndrome versus stable coronary artery disease (CAD). METHODS In this case-control study, patients with suspected CAD who underwent coronary computed tomography angiography were included. Patients who developed an acute coronary syndrome within 2 years after the coronary computed tomography angiography scan were identified, and patients with stable CAD (defined as any coronary plaque ≥30% luminal diameter stenosis) were 1:2 propensity score matched for age, sex, and cardiac risk factors. The mean PCAT attenuation was analyzed at lesion level and compared between precursors of culprit lesions, nonculprit lesions, and stable coronary plaques. RESULTS In total, 198 patients (age 62±10 years, 65% male) were selected, including 66 patients who developed an acute coronary syndrome and 132 propensity matched patients with stable CAD. Overall, 765 coronary lesions were analyzed (culprit lesion precursors: n=66; nonculprit lesion precursors: n=207; and stable lesions: n=492). Culprit lesion precursors had larger total plaque volume, fibro-fatty plaque volume, and low-attenuation plaque volume compared to nonculprit and stable lesions. The mean PCAT attenuation was significantly higher across culprit lesion precursors compared to nonculprit and stable lesions (-63.8±9.7 Hounsfield units versus -68.8±10.6 Hounsfield units versus -69.6±10.6 Hounsfield units, respectively; P<0.001), whereas the mean PCAT attenuation around nonculprit and stable lesions was not significantly different (P=0.99). CONCLUSIONS The mean PCAT attenuation is significantly increased across culprit lesion precursors in patients with acute coronary syndrome, compared to nonculprit lesions of these patients and to lesions of patients with stable CAD, which may suggest a higher intensity of inflammation. PCAT attenuation on coronary computed tomography angiography may be a novel marker to identify high-risk plaques.
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Affiliation(s)
- Jurrien H. Kuneman
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.H.K., S.E.v.R., P.v.d.R., A.R.v.R., J.W.J., N.A.M., J.K., J.J.B.)
| | - Sophie E. van Rosendael
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.H.K., S.E.v.R., P.v.d.R., A.R.v.R., J.W.J., N.A.M., J.K., J.J.B.)
| | - Pieter van der Bijl
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.H.K., S.E.v.R., P.v.d.R., A.R.v.R., J.W.J., N.A.M., J.K., J.J.B.)
| | - Alexander R. van Rosendael
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.H.K., S.E.v.R., P.v.d.R., A.R.v.R., J.W.J., N.A.M., J.K., J.J.B.)
| | - Pieter H. Kitslaar
- Division of Image Processing, Department of Radiology, Leiden University Medical Centre, The Netherlands (P.H.K.).,Medis Medical Imaging, Leiden, The Netherlands (P.H.K.)
| | - Johan H.C. Reiber
- Department of Radiology, Leiden University Medical Center, The Netherlands (J.H.C.R.)
| | - J. Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.H.K., S.E.v.R., P.v.d.R., A.R.v.R., J.W.J., N.A.M., J.K., J.J.B.).,Netherlands Heart Institute, Utrecht, The Netherlands (J.W.J.)
| | - Martin B. Leon
- Department of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital and Cardiovascular Research Foundation, NY (M.B.L.)
| | - Nina Ajmone Marsan
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.H.K., S.E.v.R., P.v.d.R., A.R.v.R., J.W.J., N.A.M., J.K., J.J.B.)
| | - Juhani Knuuti
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.H.K., S.E.v.R., P.v.d.R., A.R.v.R., J.W.J., N.A.M., J.K., J.J.B.).,Turku PET Centre, Turku University Hospital and University of Turku, Finland (J.K.)
| | - Jeroen J. Bax
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.H.K., S.E.v.R., P.v.d.R., A.R.v.R., J.W.J., N.A.M., J.K., J.J.B.).,Heart Center, Turku University Hospital and University of Turku, Finland (J.J.B.)
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5
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van Rosendael SE, Kuneman JH, van den Hoogen IJ, Kitslaar PH, van Rosendael AR, van der Bijl P, Reiber JHC, Ajmone Marsan N, Jukema JW, Knuuti J, Bax JJ. Vessel and sex differences in pericoronary adipose tissue attenuation obtained with coronary CT in individuals without coronary atherosclerosis. Int J Cardiovasc Imaging 2022; 38:2781-2789. [DOI: 10.1007/s10554-022-02716-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/09/2022] [Indexed: 11/05/2022]
Abstract
AbstractPericoronary adipose tissue (PCAT) attenuation, derived from coronary computed tomography angiography (CCTA), is associated with coronary artery inflammation. Values for PCAT attenuation in men and women without atherosclerosis on CCTA are lacking. The aim of the current study was to assess the mean PCAT attenuation in individuals without coronary artery atherosclerosis on CCTA. Data on PCAT attenuation in men and women without coronary artery atherosclerosis on CCTA were included in this retrospective analysis. The PCAT attenuation was analyzed from the proximal part of the right coronary artery (RCA), the left anterior descending artery (LAD), and the left circumflex artery (LCx). For patient level analyses the mean PCAT attenuation was defined as the mean of the three coronary arteries. In 109 individuals (mean age 45 ± 13 years; 44% men), 320 coronary arteries were analyzed. The mean PCAT attenuation of the overall population was − 64.4 ± 8.0 HU. The mean PCAT attenuation was significantly lower in the LAD compared with the LCx and RCA (− 67.8 ± 7.8 HU vs − 62.6 ± 6.8 HU vs − 63.6 ± 7.9 HU, respectively, p < 0.001). In addition, the mean PCAT attenuation was significantly higher in men vs. women in all three coronary arteries (LAD: − 65.7 ± 7.6 HU vs − 69.4 ± 7.6 HU, p = 0.014; LCx: − 60.6 ± 7.4 HU vs − 64.3 ± 5.9 HU, p = 0.008; RCA: -61.7 ± 7.9 HU vs − 65.0 ± 7.7 HU, p = 0.029, respectively). The current study provides mean PCAT attenuation values, derived from individuals without CAD. Moreover, the mean PCAT attenuation is lower in women vs. men. Furthermore, the mean PCAT attenuation is significantly lower in the LAD vs LCx and RCA.
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