Header

UZH-Logo

Maintenance Infos

Quantitative plaque features from coronary computed tomography angiography to identify regional ischemia by myocardial perfusion imaging


Diaz-Zamudio, Mariana; Fuchs, Tobias A; Slomka, Piotr; Otaki, Yuka; Arsanjani, Reza; Gransar, Heidi; Germano, Guido; Berman, Daniel S; Kaufmann, Philipp A; Dey, Damini (2017). Quantitative plaque features from coronary computed tomography angiography to identify regional ischemia by myocardial perfusion imaging. European Heart Journal. Cardiovascular Imaging, 18(5):499-507.

Abstract

AIMS We aimed to investigate whether quantitative plaque features measured from coronary CT angiography (CCTA) predict ischemia by myocardial perfusion SPECT imaging (MPI).
METHODS AND RESULTS Hundred and eighty-four consecutive patients (63% males) with suspected-coronary artery disease, undergoing hybrid CCTA, and attenuation corrected solid state (99m)Tc stress/rest MPI and single vessel ischemia were considered. Quantitative analysis of CCTA derived non-calcified plaque (NCP), low-density NCP [< 30 Hounsfield Units (HU)] (LDNCP), calcified and total plaque burdens (%, normalized to vessel volume), maximum diameter stenosis and contrast density difference (CD, maximum difference in HU/lumen area within lesion). Normal thresholds for plaque features were defined as 95th percentile thresholds, from 40% of vessels with non-ischemic MPI regions. These vessels were excluded from further analysis. Regional ischemia (≥ 2%) was quantified from MPI. All plaque features were higher in arteries corresponding to ischemia (P < 0.003 for all). In multi-variable analysis, abnormal NCP burden [odds ratio (OR) 2.6], LDNCP burden (OR 3.9), and CD (OR 2.7) were significantly associated with ischemia, whereas stenosis ≥ 50% was not (P = 0.14). In a subset of vessels with ≥ 50% stenosis, LDNCP burden (OR 4.3, P = 0.008) and CD (OR 3.7, P = 0.029) were associated with ischemia. In subsets of vessels with stenosis 30-69% and ≥ 70%, abnormal LDNCP burden (OR 6.4, P = 0.006) and CD (OR 7.3, P = 0.02) were associated with ischemia.
CONCLUSIONS Quantitative plaque features obtained from CCTA, LDNCP, and CD, are associated with ischemia by MPI independent of stenosis. LDNCP burden and CD are associated with ischemia in stenosis 30-69% and ≥ 70%, respectively.

Abstract

AIMS We aimed to investigate whether quantitative plaque features measured from coronary CT angiography (CCTA) predict ischemia by myocardial perfusion SPECT imaging (MPI).
METHODS AND RESULTS Hundred and eighty-four consecutive patients (63% males) with suspected-coronary artery disease, undergoing hybrid CCTA, and attenuation corrected solid state (99m)Tc stress/rest MPI and single vessel ischemia were considered. Quantitative analysis of CCTA derived non-calcified plaque (NCP), low-density NCP [< 30 Hounsfield Units (HU)] (LDNCP), calcified and total plaque burdens (%, normalized to vessel volume), maximum diameter stenosis and contrast density difference (CD, maximum difference in HU/lumen area within lesion). Normal thresholds for plaque features were defined as 95th percentile thresholds, from 40% of vessels with non-ischemic MPI regions. These vessels were excluded from further analysis. Regional ischemia (≥ 2%) was quantified from MPI. All plaque features were higher in arteries corresponding to ischemia (P < 0.003 for all). In multi-variable analysis, abnormal NCP burden [odds ratio (OR) 2.6], LDNCP burden (OR 3.9), and CD (OR 2.7) were significantly associated with ischemia, whereas stenosis ≥ 50% was not (P = 0.14). In a subset of vessels with ≥ 50% stenosis, LDNCP burden (OR 4.3, P = 0.008) and CD (OR 3.7, P = 0.029) were associated with ischemia. In subsets of vessels with stenosis 30-69% and ≥ 70%, abnormal LDNCP burden (OR 6.4, P = 0.006) and CD (OR 7.3, P = 0.02) were associated with ischemia.
CONCLUSIONS Quantitative plaque features obtained from CCTA, LDNCP, and CD, are associated with ischemia by MPI independent of stenosis. LDNCP burden and CD are associated with ischemia in stenosis 30-69% and ≥ 70%, respectively.

Statistics

Altmetrics

Downloads

0 downloads since deposited on 03 Feb 2017
0 downloads since 12 months

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 May 2017
Deposited On:03 Feb 2017 13:07
Last Modified:07 Jun 2017 01:02
Publisher:Oxford University Press
ISSN:2047-2404
Publisher DOI:https://doi.org/10.1093/ehjci/jew274
PubMed ID:28025263

Download

Preview Icon on Download
Content: Published Version
Filetype: PDF - Registered users only
Size: 776kB
View at publisher