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Percent atheroma volume: Optimal variable to report whole-heart atherosclerotic plaque burden with coronary CTA, the PARADIGM study

Authors
 Alexander R van Rosendael  ;  Fay Y Lin  ;  Xiaoyue Ma  ;  Inge J van den Hoogen  ;  Umberto Gianni  ;  Omar Al Hussein  ;  Subhi J Al'Aref  ;  Jessica M Peña  ;  Daniele Andreini  ;  Mouaz H Al-Mallah  ;  Matthew J Budoff  ;  Filippo Cademartiri  ;  Kavitha Chinnaiyan  ;  Jung Hyun Choi  ;  Edoardo Conte  ;  Hugo Marques  ;  Pedro de Araújo Gonçalves  ;  Ilan Gottlieb  ;  Martin Hadamitzky  ;  Jonathon A Leipsic  ;  Erica Maffei  ;  Gianluca Pontone 5  ;  Gilbert L Raff  ;  Sanghoon Shin  ;  Yong-Jin Kim  ;  Byoung Kwon Lee  ;  Eun Ju Chun  ;  Ji Min Sung  ;  Sang-Eun Lee  ;  Daniel S Berman  ;  Renu Virmani  ;  Habib Samady  ;  Peter H Stone  ;  Jagat Narula  ;  Jeroen J Bax  ;  Leslee J Shaw  ;  James K Min  ;  Hyuk-Jae Chang 
Citation
 JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY, Vol.14(5) : 400-406, 2020-09 
Journal Title
 JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY 
ISSN
 1934-5925 
Issue Date
2020-09
MeSH
Aged ; Body Surface Area ; Computed Tomography Angiography* ; Coronary Angiography* ; Coronary Artery Disease / diagnostic imaging* ; Coronary Vessels / diagnostic imaging* ; Disease Progression ; Female ; Humans ; Male ; Middle Aged ; Plaque, Atherosclerotic* ; Predictive Value of Tests ; Prospective Studies ; Registries ; Severity of Illness Index ; Sex Factors ; Time Factors
Keywords
Atherosclerosis ; Coronary CTA ; Imaging ; Percent atheroma volume
Abstract
Background and aims: Different methodologies to report whole-heart atherosclerotic plaque on coronary computed tomography angiography (CCTA) have been utilized. We examined which of the three commonly used plaque burden definitions was least affected by differences in body surface area (BSA) and sex. Methods: The PARADIGM study includes symptomatic patients with suspected coronary atherosclerosis who underwent serial CCTA >2 years apart. Coronary lumen, vessel, and plaque were quantified from the coronary tree on a 0.5 mm cross-sectional basis by a core-lab, and summed to per-patient. Three quantitative methods of plaque burden were employed: (1) total plaque volume (PV) in mm3, (2) percent atheroma volume (PAV) in % [which equaled: PV/vessel volume * 100%], and (3) normalized total atheroma volume (TAVnorm) in mm3 [which equaled: PV/vessel length * mean population vessel length]. Only data from the baseline CCTA were used. PV, PAV, and TAVnorm were compared between patients in the top quartile of BSA vs the remaining, and between sexes. Associations between vessel volume, BSA, and the three plaque burden methodologies were assessed. Results: The study population comprised 1479 patients (age 60.7 ± 9.3 years, 58.4% male) who underwent CCTA. A total of 17,649 coronary artery segments were evaluated with a median of 12 (IQR 11-13) segments per-patient (from a 16-segment coronary tree). Patients with a large BSA (top quartile), compared with the remaining patients, had a larger PV and TAVnorm, but similar PAV. The relation between larger BSA and larger absolute plaque volume (PV and TAVnorm) was mediated by the coronary vessel volume. Independent from the atherosclerotic cardiovascular disease risk (ASCVD) score, vessel volume correlated with PV (P < 0.001), and TAVnorm (P = 0.003), but not with PAV (P = 0.201). The three plaque burden methods were equally affected by sex. Conclusions: PAV was less affected by patient's body surface area then PV and TAVnorm and may be the preferred method to report coronary atherosclerotic burden.
Full Text
https://www.sciencedirect.com/science/article/pii/S1934592519304599
DOI
10.1016/j.jcct.2020.01.012
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Byoung Kwon(이병권) ORCID logo https://orcid.org/0000-0001-9259-2776
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180487
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