Quantitative Plaque Analysis Of Coronary CTA In Predicting Myocardial Ischemia By MPI

Objective:Quantitative plaque Analysis of Coronary CTA in predicting Myocardial Ischemia by MPI.Methods:In this study,84 patients with suspected myocardial ischemia underwent coronary artery CTA,stress/rest myocardial perfusion imaging,and 59 patients with coronary artery plaques were quantitatively analyzed.The automatic software(Release5.6.5,Circle Cardiovascular Imaging,Canada)quantitative analysis of maximum diameter stenosis of coronary artery plaque.Quantitative coronary artery plaque measurements including total plaque volume,the volume of non-calcified plaque,calcified plaque volume,low-density non calcified plaque volume,total plaque burden,calcified plaque burden,non-calcified plaque burden,low-density non-calcified plaque burden,remodeling index,plaque length,maximum diameter stenosis.Univariate and multivariate logistic regression analysis was performed to assess the correlation between quantitative plaque characteristics and myocardial ischemia.Results:Total plaque volume[25.2mm~3(17.8-37.8)vs 15.6mm~3(10.3-24.9),p=0.000]、calcified plaque volume(1.6±7.1mm~3 vs 2.3±6.4mm~3,p=0.019)、non-calcified plaque volume[23.6mm~3(16.6-35.9)vs 14.6mm~3(10.3-22.8),p=0.000]、low-density non-calcified plaque volume[4.9mm~3(2.1-8.2)vs 2.2 mm~3(1.0-5.5),p=0.003]、total plaque burden(47.6±17.1%vs 36.2±17.3%,p=0.002)、calcified plaque burden(1.5±5.5%vs 2.9±6.9%,p=0.014)、non-calcified plaque burden(46.1±18.8%vs 33.3±16.4%,p=0.001)、low-density non-calcified plaque burden[12.3%(6.4-17.7)vs 3.3%(1.6-5.3)、p=0.000]、remodeling index[1.2(1.1-1.4)vs 1.2(1.1-1.2),p=0.033]、plaque length[4.0mm(3.2-6.1)vs3.3mm(2.8-3.8),p=0.009]、maximumdiameter stenosis[18.1%(10.0-52.9)vs 12.6%(6.5-18.5),p=0.011]were associated with myocardial ischemia.In multivariate analysis,low-density noncalcified plaque burden(OR 1.33,95%CI 1.16 to 1.53,p=0.000)remained a significant predictor of myocardial ischemia after adjusting for stenosis≥50%and gender.The AUC of the model containing low-density non-calcified plaque burden,stenosis≥50%and gender was 0.875(95%CI 0.812 to0.938),which was significantly better than the model with stenosis≥50%and gender(AUC 0.729,95%CI 0.633 to 0.825).Conclusion:We found that quantitative plaque characteristics were correlated with the incidence of myocardial ischemia in a group of suspected myocardial ischemia patients.Low-density non-calcified plaques burden in quantitative plaque characteristics independent of stenosis≥50%andgender is closely associated with myocardial ischemia and increases with both.