Study on the Correlation Between Coronary Plaque Quantification Characteristics and High-risk Plaque Morphological Characteristics and CT-FFR in HIV + Population
Objective To explore the correlation between coronary plaque quantification characteristics and high-risk plaque morphological characteristics and coronary computed tomography angiography(CTA)-derived fractional flow reserve(CT-FFR)measurements in HIV-infected patients.Methods The clinical and imaging data of 167vessels in 121 patients with HIV infection who underwent coronary CTA examination were analyzed retrospectively.All patients were examined by CCTA.The CT-FFRvalue of coronary artery was measured and calculated,and the coronary ischemic change was defined as CT-FFR≤0.80.according to the CT-FFRvalue,the patients were divided into two groups:CT-FFR>0.8 group(n = 103)and CT-FFR≤0.80 group(n = 64).The plaques characteristic parameters are measured by semi-automatic software:plaque length,total plaque volume,calcification volume,non-calculated plaque volume,lipid plaque volume,fiber plaque volume,minimum lumen area;high-risk plaque morphology characteristics:low-density plaque,positive remodeling,spotty calcification,napkin-ring sign.The coronary computed tomography angiography(CTA)-derived fractional flow reserve(CT-FFR)was measured.CT-FFR≤0.80 was defined as coronary artery ischemia.The differences of coronary plaque charac-teristic parameters and high-risk plaque morphological characteristics between the two groups were analyzed and compared.The related risk factors of CT-FFR≤0.80 were analyzed by univariate and multivariate logistic regression.Results Com-pared with the CT-FFR>0.80 group,the CT-FFR≤0.80 group had longer plaque length[13.2(8.5,24.6)vs.7.3(5.2,10.5)mm,P<0.001],larger total plaque volume[122.8(63.32,72.9)vs.64.9(41.9,103.9)mm3,P<0.001],and larger non-calcified plaque volume[80.0(36.7,154.6)vs.37.5(21.5,63.5)mm3,P<0.001],the vol-ume of lipid plaque was larger[6.2(1.6,15.8)vs.2.2(0.9,5.3)mm3,P<0.001],the volume of fibrous plaque was lar-ger[60.5(34.6,133.6)vs.32.9(20.5)mm3,P<0.001],and the minimum lumen area was smaller[4.7(3.0,6.7)vs.5.9(3.9,9.1)mm3,P =0.008].The proportion of napkin-ring sign was larger(χ2 = 8.132,P<0.050).Among them,coronary plaque length(OR =1.097,95%CI 1.018-1.182,P =0.015),lipid plaque volume(OR =1.015,95%CI0.996-1.019,P =0.048),minimum lumen area(OR =0.895,95%CI0.790-1.013,P =0.008)and napkin-ring sign(OR =26.237,95%CI 5.008-119.166,P<0.001)were correlated with CT-FFR≤0.80 respectively.Plaque length,lipid plaque volume and napkin-ring sign were the risk factors of CT-FFR≤0.80.Conclusion Among the quanti-tative parameters of coronary artery plaque,the plaque length,the volume of lipid plaque,the degree of stenosis and the characteristics of high-risk plaque,the napkin ring sign is related to the risk of myocardial ischemic change.plaque length,lipid plaque volume and napkin ring sign are independent risk factors for myocardial ischemic changes.
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