Journal of Shandong University (Health Sciences) ›› 2024, Vol. 62 ›› Issue (10): 98-105.doi: 10.6040/j.issn.1671-7554.0.2024.0492

• Clinical Medicine • Previous Articles    

Predictive value of perivascular fat attenuation index based on CCTA for revascularization in chronic total occlusion of coronary artery

YANG Baozhu1, HUANG Shuyuan1, YU Xinxin1, DENG Yan2, HAN Pengxi3, LIU Xiaolong4, WANG Ximing1   

  1. 1. Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China;
    2. Department of Radiology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    3. Department of Radiology, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong, China;
    4. Department of Medical Imaging, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong, China
  • Published:2024-10-12

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Abstract: Objective To evaluate the predictive value of the perivascular fat attenuation index(FAI)based on coronary computed tomography angiography(CCTA)for revascularization in chronic total occlusion(CTO)of coronary artery. Methods A total of 204 patients with coronary artery total occlusion and treated with percutaneous coronary intervention(PCI)between November 2012 and June 2023 were retrospectively analyzed and divided into the successful group(n=144)and the unsuccessful group(n=60)according to the outcome of the procedure. The general clinical data, FAI of the occluded segment, and the morphological characteristics of CCTA of CTO lesions, including lesion site ［right coronary artery(RCA), left anterior descending artery(LAD), left circumflex artery(LCX)］, lesion length, lesion CT value, the volume of calcified plaques in the lesion, the stump morphology of the lesion entrance, whether the angle of curvature of the lesion was >45°, and whether the lesion was negatively remodeled, were analyzed and compared between the two groups. Independent factors affecting the revascularization of CTO lesion were screened by binary Logistic regression analysis, and a conventional model of morphological characteristics and a combined model of morphological characteristics and FAI were established. The predictive performance of each model was evaluated by the receiver operating characteristic(ROC)curve. Results The differences in FAI ［(-82.33±10.61)HU vs.(-71.70±10.91)HU, P<0.001］, CT value［69.85(55.95, 86.25)HU vs. 58.25(47.00, 72.83)HU, P<0.001］, calcified volume［20.92(2.25, 52.80)mm3 vs. 5.69(0.00, 25.75)mm3, P<0.001］, and length［23.60(13.90, 34.50)mm vs. 14.65(9.43, 19.60)mm, P<0.001］of the occluded segment were all statistically significant. The occluded segment length >23.05 mm, FAI of the occluded segment <-77.50 HU, CT value of the occluded segment >58.15 HU, and negative remodeling of the occluded vessel were identified as independent predictors of failure of CTO lesion revascularization. A conventional morphological characteristics model was established by combining the three morphological characteristics factors, and another model was established by combining the conventional morphological characteristics model with FAI. The combined model demonstrated superior predictive performance for the outcome of revascularization compared to the conventional morphological characteristics model, with AUC being 0.857 and 0.787, respectively, P<0.001. Conclusion The FAI may serve as a novel predictor of the outcomes of PCI surgery for CTO of the coronary artery. Based on the conventional morphological characteristics, FAI provides a novel approach to predicting the surgical outcomes of CTO patients.

Key words: Coronary computed tomography angiography, Pericoronary adipose tissue, Fat attenuation index, Chronic total occlusion, Percutaneous coronary intervention

CLC Number: 

  • R543
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