Objective To explore the correlation between coronary atherosclerosis related indicators and the overall bur-den of small cerebral vascular disease(CSVD).Methods Collect CSVD patients who underwent coronary CTA,head MRI and carotid ultrasound examination,and divide the subjects into groups0,1,2 and3-4 according to the overall burden score of CSVD.Based on the CCTA image,the coronary atherosclerosis related indicators were obtained,including Gensini score,coronary artery calcification score(CACS),the degree of stenosis and CT blood flow reserve score(FFRCT)at the most obvious stenosis of the three main coronary branches,and the fat attenuation index(FAI)around the proximal end of the three coronary arteries.Analyzed the correlation between the indicators and the overall burden of CSVD.All subjects were further divided into high group(3-4 points)and low group(0-2 points)to analyze and determine the effective pre-dictors of the high overall burden score of CSVD,and evaluate the predictive effectiveness of each model on the high overall burden score of CSVD.Results 1.169 patients with CSVD were finally included,including 45 patients with CSVD score 0,43 patients with CSVD score1,41 patients with CSVD score2,and40 patients with CSVD score3-4.Spearman correla-tion analysis showed that age,hypertension grade,total plaque number,maximum stenosis degree,Gensini score,CACS were positive correlated with CSVD burden score(rs =0.406,0.529,0.350,0.380,0.395,0.358,all P<0.05),and and FFR-minimum was negative correlated with CSVD burden score(rs =-0.464,P<0.05).2.According to the overall burden score of CSVD,the subjects were divided into high group(3-4 points)and low group(0-2 points),with40 cases in high group and 129 cases in low group.Binary logistic regression analysis showed that hypertension grade(OR =2.367,95%CI:1.440-3.892,P =0.001)and FFR-minimum(OR =0.916,95%CI:0.845-0.993,P =0.033)were effective pre-dictors of the overall high burden score of CSVD.ROC analysis showed that the area under the curve(AUC)of the com-bined model of hypertension classification and FFR-minimum was the highest(AUC =0.811,95%CI:0.745-0.868,P<0.05)for the risk prediction effectiveness of the overall high burden score of CSVD,followed by hypertension classification(AUC =0.759,95%CI:0.688-0.822,P<0.05),and FFR-minimum(AUC =0.752,95%CI:0.680-0.815,P<0.05).Conclusion In patients with CSVD,there is a certain correlation between coronary atherosclerosis and the overall burden of CSVD:the number of total coronary artery plaque,the degree of maximum stenosis,the Gensini score,CACS and the overall burden of CSVD have a moderate positive correlation,while FFR-minimum and the overall burden of CSVD have a moderate negative correlation;Hypertension grade and FFR-minimum are effective predictors of the overall high burden score of CSVD patients,which can be helpful for early intervention of high-risk patients with CSVD.
Cerebral small vessel diseaseCoronary atherosclerosisCoronary artery CTA
NETL
NSTL
万方数据
