冠状动脉周围脂肪组织脂肪衰减指数与冠状动脉慢血流的关系

The relationship between fat attenuation index of pericoronary adipose tissue and coronary slow flow

摘要:

目的]探讨冠状动脉周围脂肪组织脂肪衰减指数(FAI)与冠状动脉慢血流(CSF)的关系。 [方法]回顾性收集2023年11月—2024年7月期间因胸闷、胸痛等症状接受冠状动脉造影(CAG)检查的135例住院患者的临床资料,按血流分级标准分为CSF组(n＝61)和血流正常组(n＝74)。收集患者的基本信息、入院当日的实验室检测结果以及冠状动脉CT血管成像(CCTA)检查资料,并采用多因素Logistic回归分析CSF危险因素,采用受试者工作特征(ROC)曲线评估FAI预测CSF的效能。 [结果]CSF组白细胞计数(WBC)、空腹血糖、高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、右冠状动脉(RCA)-FAI分别为血流正常组的1.23、1.10、1.33、1.53、1.13倍(均P＜0.05),CSF组左心室射血分数(LVEF)为血流正常组的94.78%(P＜0.05)。多因素Logistic回归分析结果显示,WBC升高(OR＝1.891)、空腹血糖升高(OR＝1.774)、LVEF降低(OR＝0.094)、hs-CRP升高(OR＝1.124)、RCA-FAI增加(OR＝1.077)是CSF的独立危险因素(P＜0.05)。ROC曲线分析结果显示,RCA-FAI预测CSF的曲线下面积(AUC)为0.715(95%CI:0.627~0.802),最佳截断值为－81.5 HU,灵敏度为0.803,特异度为0.581。 [结论]WBC升高、空腹血糖升高、LVEF降低、hs-CRP升高、RCA-FAI增加是CSF的危险因素,其中RCA-FAI对于预测CSF的发生具有良好的效能,可用以尽早识别高危CSF患者,降低CSF发生率。

Abstract:

Aim To investigate the relationship between fat attenuation index (FAI) of pericoronary adipose tissue and coronary slow flow (CSF). Methods The clinical data of 135 hospitalized patients who underwent coronary angiography (CAG) due to chest tightness, chest pain and other similar symptoms from November 2023 to July 2024 were retrospectively collected. According to the blood flow grading criteria, the patients were divided into CSF group (n＝61) and normal blood flow group (n＝74). The basic information of the patients, the laboratory test results on the day of admission and the data of coronary CT angiography (CCTA) were also collected. Multivariate Logistic regression was used to analyze the risk factors for CSF. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of FAI in predicting CSF. Results The white blood cell count (WBC), fasting blood glucose (FBG), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and right coronary artery (RCA) FAI in the CSF group were 1.3,1.0,1.33 1.53 and 1.13 times that of those in the normal blood flow group, respectively (P＜0.05). The left ventricular ejection fraction (LVEF) in the CSF group was 94.78% of the normal blood flow group (P＜0.05). Multivariate Logistic regression analysis showed that elevated WBC (OR＝1.891), elevated FBG (OR＝1.774), decreased LVEF (OR＝0.094), elevated hs-CRP increased (OR＝1.124), increased RCA-FAI (OR＝1.077) were independent risk factors for CSF (P＜0.05). The results of ROC curve analysis showed that the area under the curve (AUC) of RCA-FAI in predicting CSF was 0.715 (95%CI:0.627～0.802), the optimal cut-off value was －81.5 HU, the sensitivity was 0.803, and the specificity was 0.581. Conclusion Elevated WBC, elevated FBG, decreased LVEF, increased hs-CRP, and increased RCA-FAI are risk factors for CSF. Among them, RCA-FAI has a good efficacy in predicting the occurrence of CSF, which can be used to identify high-risk CSF patients as early as possible and reduce the incidence of CSF.