Introduction: We aimed to evaluate the relationship between quantitative plaque metrics derived from coronary CT angiography (CTA) and segmental myocardial ischemia using dynamic perfusion CT (DPCT).
Methods: In a prospective single-center study, patients with > 30% stenosis on rest CTA underwent regadenoson stress DPCT. 480 myocardium segments of 30 patients were analyzed. Quantitative plaque assessment included total plaque volume (PV), area stenosis, and remodeling index (RI). High-risk plaque (HRP) was defined as low-attenuation plaque burden > 4% or RI > 1.1. Absolute myocardial blood flow (MBF) and relative MBF (MBFi: MBF/75th percentile of all MBF values) were quantified. Linear and logistic mixed models correcting for intra-patient clustering and clinical factors were used to evaluate the association between total PV, area stenosis, HRP and MBF or myocardial ischemia (MBF < 101 ml/100 g/min).
Results: Median MBF and MBFi were 111 ml/100 g/min and 0.94, respectively. The number of ischemic segments were 164/480 (34.2%). Total PV of all feeding vessels of a given myocardial territory differed significantly between ischemic and non-ischemic myocardial segments ( = 0.001). Area stenosis and HRP features were not linked to MBF or MBFi (all > 0.05). Increase in PV led to reduced MBF and MBFi after adjusting for risk factors including hypertension, diabetes, and statin use (per 10 mm; β = -0.035, < 0.01 for MBF; β = -0.0002, < 0.01 for MBFi). Similarly, using multivariate logistic regression total PV was associated with ischemia (OR = 1.01, = 0.033; per 10 mm) after adjustments for clinical risk factors, area stenosis and HRP.
Conclusion: Total PV was independently associated with myocardial ischemia based on MBF, while area stenosis and HRP were not.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498180 | PMC |
| http://dx.doi.org/10.3389/fcvm.2022.974805 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Cerebrovascular risk in rheumatoid arthritis patients: insights from carotid artery atherosclerosis in the Paracelsus 10,000 study.
Rheumatol Int
January 2025
Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University, Salzburg, Austria.
Rheumatoid arthritis (RA) is a chronic autoimmune disease marked by systemic inflammation. While RA primarily affects the joints, its systemic effects may lead to an increased cerebro- and cardiovascular risk. Atherosclerosis of the carotid arteries is a significant risk factor for cerebrovascular events and serves as a surrogate marker for cardiovascular risk.
View Article and Find Full Text PDFRisk factors and predictive model for moderate to severe perivalvular leakage following transcatheter aortic valve replacement.
Am J Transl Res
December 2024
Department of Cardiac Surgery, The Second Hospital of Hebei Medical University Shijiazhuang 050000, Hebei, China.
Objective: To identify the risk factors associated with moderate to severe perivalvular leakage (PVL) after transcatheter aortic valve replacement (TAVR) and to construct a prediction model for this risk.
Methods: A retrospective analysis was conducted on 128 patients with severe aortic stenosis who had received TAVR in The Second Hospital of Hebei Medical University from January 2019 to January 2024. The length of the aortic regurgitation bundle and annular circumference ratio were measured by transesophageal echocardiography immediately after the valve implantation.
Background: Intracranial atherosclerotic stenosis is a leading cause of ischemic stroke and recurrent events due to plaque instability. High-resolution magnetic resonance imaging identifies plaque enhancement as a key marker of instability. This study evaluated the efficacy of combined high-intensity statins and proprotein convertase subtilisin/kexin type 9 inhibitors in plaque stabilization.
View Article and Find Full Text PDFPerioperative management of a patient with severe aortic stenosis and chronic obstructive pulmonary disease undergoing abdominal aortic aneurysm repair: A case report.
Int J Surg Case Rep
January 2025
Al-Neelain University, Faculty of Medicine, Khartoum, Sudan.
Introduction And Importance: Severe aortic stenosis (AS) and chronic obstructive pulmonary disease (COPD) significantly increase perioperative morbidity and mortality. This case report discusses the challenges of managing a 75-year-old male patient with severe AS and advanced COPD undergoing elective abdominal aortic aneurysm (AAA) repair.
Case Presentation: The patient presented with a 6.
Hemodynamic Valve Deterioration After Transcatheter Aortic Valve Replacement: Incidence, Predictors, and Clinical Outcomes.
JACC Cardiovasc Interv
January 2025
Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address:
Background: Reports on the durability of transcatheter aortic valve replacement (TAVR) prostheses are scarce and confounded by varying definitions and competing risks of death.
Objectives: The authors sought to determine the incidence, predictors, and clinical outcomes of hemodynamic valve deterioration (HVD) according to the Valve Academic Research Consortium 3 definition after TAVR.
Methods: We analyzed consecutive patients undergoing TAVR in the prospective Bern TAVI (Transcatheter Aortic Valve Implantation) registry between August 2007 and June 2022 for the incidence and predictors of HVD and performed case control-matching to compare outcomes according to HVD.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!