心包内脂肪与冠状动脉CTA非钙化斑块的相关性

目的 探讨心包内脂肪容积与冠状动脉CTA非钙化斑块的关系。方法 连续收集冠状动脉钙化零评分而冠状动脉CTA提示非钙化斑块的患者31例,选取冠状动脉CTA检查正常的患者93例。应用多因素条件Logistic回归分析心包内脂肪容积与非钙化斑块的相关性;采用ROC曲线评估Framingham评分结合心包内脂肪容积对非钙化斑块的预测价值。结果 采用多因素条件Logistic回归调整年龄、体质量指数(BMI)、糖尿病、高血压、高脂血症史、吸烟、冠心病家族史影响因子后,心包内脂肪容积与冠状动脉CTA非钙化斑块异常相关(OR=1.23,95%CI 1.09~1.40,P=0.01)。Framingham评分结合心包内脂肪容积较单纯应用Framingham评分对非钙化斑块的预测能力明显提高(Z=2.08,P<0.05)。结论 心包内脂肪容积与非钙化斑块密切相关。Framingham评分结合心包内脂肪容积有助于改善对冠状动脉钙化零评分患者非钙化斑块的预测。

Association of pericardial fat and noncalcified coronary plaques determined by CTA

Objective To evaluate the relationship between pericardial fat volume (PFV) and noncalcified coronary plaques determined by coronary CTA. Methods Totally 31 cases of zero calcium score and noncalcified coronary plaques diagnosied by CTA, as well as 93 cases with normal coronary CTA results were enrolled. The correlation between PFV and noncalcified coronary plaques was assessed by multivariate conditional Logistic regression analysis. ROC curve was used to evaluate the ability of Framingham score combined with PFV in predicting noncalcified coronary plaques. Results Multivariate conditional Logistic regression analysis showed that after adjustment for factors including age, body mass index, hypertension, hyperlipidemia, diabetes, smoking and coronary artery disease family history, PFV was significantly associated with patients with noncalcified coronary plaques (OR=1.23, 95.0%CI 1.09-1.40, P=0.01). ROC curve analysis showed that compared with simple Framingham score, the ability of PFV combined with Framingham score in predicting noncalcified coronary plaques was significantly improved (Z=2.08, P<0.05). Conclusion PFV is significantly related to noncalcified coronary plaques on coronary CTA. Framingham score combined with PFV can improve the prediction of noncalcified coronary plaques in zero calcium score patient.