斑块定量参数及冠周脂肪衰减指数对FFR-CT进展的影响

目的 探讨基于冠状动脉CT血管成像(CCTA)的基线斑块定量参数和冠脉周围脂肪衰减指数(FAI)对CT血流储备分数(FFR-CT)进展的影响.方法 回顾性分析行两次CCTA检查的259例患者资料.分析斑块的定量参数,并测量冠周FAI和FFR-CT.第一次CCTA选定斑块远段FFR-CT≥0.8,第二次FFR-CT<0....

Effects of plaque quantitative parameters and pericoronary fat attenuation index on progression of coronary blood flow reserve fraction

Objective To investigate the effects of baseline plaque quantitative analysis and pericoronary fat attenuation index(pFAI)on the progress of CT flow reserve fraction(FFR-CT)based on coronary CT angiography(CCTA).Methods 259 consecutive patients underwent two CCTA examinations.Plaque quantitative parameters,FAI and machine learning-based FFR-CT were retrospectively measured.Baseline FFR-CT≥0.8 with follow-up FFR-CT<0.8 was classified as the FFR-CT progression whereas follow-up FFR-CT>0.8 was classified as the FFR-CT non-progression.The parameters between the two groups were compared.The influence of these parameters on FFR-CT progression was analyzed by univariate and multivariate binary logistic regression as well as receiver operating characteristic(ROC)curve.The area under the ROC curve(AUC)was used to determine the predictive performance of different CCTA parameters.Results pFAI,traditional plaque parameters and plaque component parameters had statistically significant differences(P<0.05).Multivariate logistic regression analysis showed that pFAI(OR=1.042,95%CI=1.002-1.083),plaque length(OR=1.138,95%CI=1.069-1.211),high-risk plaque(OR=2.433,95%CI=1.275-4.643),total plaque burden(OR=1.261,95%CI=1.127-1.410),and non-calcified plaque volume(OR=0.984,95%CI=0.976-0.992)were independent predictors of plaque progression.The model based on pFAI with traditional plaque parameters and plaque composition parameters(AUC=0.738,P<0.001)on CCTA was significantly better.Conclusion pFAI,plaque length,high-risk plaque,total plaque load and non-calcified plaque volume are all influential factors for FFR-CT progression.The model combining multiple parameters has the highest efficacy in predicting hemodynamic progression.