| Objective The adipose tissue around the coronary artery produces a variety of bioactive substances,which act on the blood vessels in a paracrine manner to cause inflammation.Coronary artery inflammation is the initiating factor of atherosclerosis and plaque instability.Pericoronary fat attenuation index is an imaging index that can accurately,conveniently and non-invasively evaluate and quantify coronary artery inflammation.Therefore,the main purpose of this study is to explore the relationship between fat attenuation index around coronary artery and plaque characteristics(plaque nature,plaque range,plaque number and plaque distribution vessels)based on coronary computed tomography angiography.Materials and Methods The images and medical records of patients who underwent CCTA examination in our hospital from May 2021 to August 2022 were retrospectively collected.According to the exclusion criteria:(1)The CCTA image quality has pulsating artifacts that do not meet the diagnostic requirements and affect the FAI measurement.The intelligent analysis system cannot recognize the person.(2)Abnormal origin and/or termination of coronary artery,coronary artery fistula and other coronary artery diseases;(3)There is a history of coronary artery bypass grafting and coronary artery stent implantation.A total of 181patients(120 patients in plaque group and 61 patients without plaque group)were finally included in the study.Query and record the general clinical data of patients, including age,gender,coronary heart disease risk factors(hypertension,hyperlipidemia,diabetes)and laboratory indicators(total cholesterol,low-density lipoprotein,high-density lipoprotein and triglyceride).The AI-assisted diagnostic system(Coronary Doc)was used to automatically analyze the patient’s CCTA image and measure the perivascular fat attenuation index of the three major branches of coronary artery(left anterior descending branch,left circumflex branch and right coronary artery)at the proximal 40 mm segment.Then analyze the plaque in this segment.The indicators to be recorded include the nature of plaque(calcified plaque,non-calcified plaque and mixed plaque),the number of plaque(single and multiple)and the distribution of plaque(localization,segmental and diffuse).Multiple linear regression analysis was used to analyze the correlation between the fat attenuation index around coronary artery and the characteristics of plaque.Results385 vessels(202 vessels in plaque group and 183 vessels in non-plaque group)of 181 patients were included in the analysis.The FAI around the coronary artery(-85.43 ± 7.59 HU)was higher than that without plaque(-88.71±7.08 HU)when there was plaque at the proximal end of the coronary artery.The difference was statistically significant.The FAI of three coronary arteries in plaque group,including left anterior descending branch,left circumflex branch and right coronary artery,was higher than that of three coronary arteries in without plaque group,and all the difference was statistically significant.There was statistically significant difference in the FAI around the vessels with different plaque properties.The non-calcified plaque(-82.69 ±7.03 HU)was higher than the calcified plaque(-86.74 ± 7.84 HU,P=0.002)and the mixed plaque(-87.76 ± 6.87 HU,P<0.001).The value of FAI around the coronary artery was correlated with the nature of plaque,the distribution of blood vessels and the distribution of plaque,after multiple linear regression analysis.Conclusion For coronary artery which the peripheral FAI of coronary artery with plaque in the proximal 40 mm is higher than that of non-plaque.The peripheral FAI of coronary artery will be affected by the nature of plaque,and the FAI of non-calcified plaque is higher than that of calcified plaque and mixed plaque.The plaque nature,plaque distribution range and plaque distribution vessels were significantly correlated with the increase of FAI around coronary artery. |
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