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MDCT PWV - j-ca.org

Online publication May 27, 2010. 49 2 . MDCT PWV .. CT. MDCT .. MDCT . MDCT . PWV .. J Jpn Coll Angiol, 2010, 50: 163 167 . Key words: coronary artery disease, multi-detector row computed tomography, coronary calcification, pulse wave velocity 97 . PPV NPV . 87 . 99 1 .. arterial stiffness .. >50 .. 91 96 PPV 76 NPV. 99 2 NPV 100 .. MetS .. MDCT .. CT. MDCT . Fuster . ACS .. PWV . 3 .. MDCT . ACS . MDCT .. Fig. 1 .. 64 MDCT CT . Raff 94 Inoue ACS . 2009 3 27 . THE JOURNAL of JAPANESE COLLEGE of ANGIOLOGY Vol. 50, 2010 163. MDCT PWV . Figure 1 Volume rendering image and multi-planner reconstruction image were shown in A and B, respectively. Severe stenosis (A, B) and plaque with positive remodeling (B). was identified in the proximal left anterior descending coronary artery.

164 脈管学 vol. 50, 2010 mdct による冠動脈狭窄や石灰化スコアの評価とpwv の関連性 におけるプラークのct 値は50 hu以下で,acsと安定狭

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Transcription of MDCT PWV - j-ca.org

1 Online publication May 27, 2010. 49 2 . MDCT PWV .. CT. MDCT .. MDCT . MDCT . PWV .. J Jpn Coll Angiol, 2010, 50: 163 167 . Key words: coronary artery disease, multi-detector row computed tomography, coronary calcification, pulse wave velocity 97 . PPV NPV . 87 . 99 1 .. arterial stiffness .. >50 .. 91 96 PPV 76 NPV. 99 2 NPV 100 .. MetS .. MDCT .. CT. MDCT . Fuster . ACS .. PWV . 3 .. MDCT . ACS . MDCT .. Fig. 1 .. 64 MDCT CT . Raff 94 Inoue ACS . 2009 3 27 . THE JOURNAL of JAPANESE COLLEGE of ANGIOLOGY Vol. 50, 2010 163. MDCT PWV . Figure 1 Volume rendering image and multi-planner reconstruction image were shown in A and B, respectively. Severe stenosis (A, B) and plaque with positive remodeling (B). was identified in the proximal left anterior descending coronary artery.

2 CT 50 HU ACS . CT ACS .. 25 15 HU vs. 71 16 HU .. Fig. 2 . 4 . MDCT Mo- toyama ACS 30 HU . spotty . 5 . MDCT .. MDCT . Figure 2 Comparison of the CT density of plaques between . Fig. 3 . 2 . patients with acute coronary syndrome (ACS) and stable angi- MDCT na (SA). In the culprit lesions, the mean CT density of the plaque was 25 15 HU (from -12 to 48 HU) in patients with .. ACS and 71 16 HU (from 46 to 101 HU) in patients with SA. MDCT There was a statistically significant difference between the 2. groups (p < ).. MDCT . 3 . 0 12 10 .. 13 445 > 445 1,000 . 12 . 2 6 .. 3 .. Fig. 4 Budoff . 2 . MDCT . 164 Vol. 50, 2010. 2 . Figure 3. A: A case of non-calcified plaque (CAC score = 0) with significant coronary stenosis in LAD observed by MDCT. and CAG. B: A case of moderate calcification (CAC score =.)

3 245). Coronary stenosis was not diagnosed by MDCT. because of calcification and no significant coronary stenosis was confirmed by CAG. C: A case of severe calcification (CAC score = 3,809). Coronary stenosis was not diagnosed by MDCT because of severe calcification. Significant coronary stenosis in LAD was confirmed by CAG. CAC, coronary artery calcification; MDCT, multi-detector row computed tomography; CAG, coronary angiography;. LAD, left anterior descending coronary artery.. PWV .. PWV .. Moens-Korteweg .. 7 . vascular damage . Figure 4 Coronary artery calcification (CAC) score according to the number of significant stenosed vessels (VD) evaluated by invasive coronary angiography. The CAC score in 3VD was signifi- . cantly higher than in the other groups (0, 1VD and 2VD).

4 PWV 8, 9 PWV * p < vs. 0, 1 and 2. Vol. 50, 2010 165. MDCT PWV . Table 1 Contributor of CAC score groups as assessed by logistic regression analysis Variable p value Upstroke time (mean) < Sex Age PWV (mean) HDL-C Hypertension %MAP (mean) CCB Systolic blood pressure ARB Figure 5 Correlations between brachial-ankle pulse wave velocity (baPWV) and length of abdominal aortic calcification Uric acid (AAC). The length of AAC was measured on X-ray films, and Diabetes mellitus this has been reported to correlate significantly with cardiovas- PWV, pulse wave velocity; MAP, mean arterial pressure; CCB, cular morbidity and mortality. baPWV was significantly corre- calcium channel blocker; ABI, ankle/brachial pressure index; PWV, lated with AAC length. pulse wave velocity; ARB, angiotensin II receptor blocker.

5 Based on reference 12.. Fig. 5 . 10 . IMT . 11 .. PWV 1 Leschka S, Alkadhi H, Plass A et al: Accuracy of MSCT. coronary angiography with 64-slice technology: rst expe- MDCT rience. Eur Heart J, 2005, 26: 1482 1487. PWV 2 Mitsutake R, Niimura H, Miura S et al: Clinical signi cance PWV of the coronary calci cation score by multidetector row com- PWV puted tomography for the evaluation of coronary stenosis in Japanese patients. Circ J, 2006, 70: 1122 1127.. up- 3 Fuster V, Badimon L, Badimon JJ et al: The pathogenesis of . stroke time, UT . coronary artery disease and the acute coronary syndromes.. Table 1 . 12 . N Engl J Med, 1992, 326: 310 318. PWV 4 Inoue F, Sato Y, Matsumoto N et al: Evaluation of plaque texture by means of multislice computed tomography in pa- MDCT tients with acute coronary syndrome and stable angina.

6 Circ PWV J, 2004, 68: 840 844. UT 5 Motoyama S, Kondo T, Sarai M et al: Multislice computed tomographic characteristics of coronary lesions in acute coronary syndromes. J Am Coll Cardiol, 2007, 50: 319 326. 6 Budoff MJ, Shaw LJ, Liu ST et al: Long-term prognosis associated with coronary calcification: observations from MDCT . a registry of 25,253 patients. J Am Coll Cardiol, 2007, 49: MDCT 1860 1870. 7 Yamashina A, Tomiyama H, Takeda K et al: Validity, repro- PWV ducibility, and clinical signi cance of noninvasive brachial- MDCT ankle pulse wave velocity measurement. Hypertens Res, 2002, 25: 359 364. 166 Vol. 50, 2010. 2 . 8 Lehmann ED, Riley WA, Clarkson P et al: Non-invasive abdominal aortic calcification. Hypertens Res, 2003, 26: assessment of cardiovascular disease in diabetes mellitus.

7 163 167. Lancet, 1997, 350 Suppl 1: SI14 SI19. 11 Matsumoto M, Inoue K, Moriki A: Associations of brachial- 9 Cruickshank K, Riste L, Anderson SG et al: Aortic pulse-wave ankle pulse wave velocity and carotid atherosclerotic lesions velocity and its relationship to mortality in diabetes and with silent cerebral lesions. Hypertens Res, 2007, 30: 767 773. glucose intolerance: an integrated index of vascular function? 12 Mitsutake R, Miura S, Saku K: Association between coronary Circulation, 2002, 106: 2085 2090. artery calci cation score as assessed by multi-detector row com- 10 Nakamura U, Iwase M, Nohara S et al: Usefulness of brachial- puted tomography and upstroke time of pulse wave. Inernt ankle pulse wave velocity measurement: correlation with Med, 2007, 46: 1833 1836.

8 Association between Coronary Stenosis or Calcification Score on MDCT and PWV. Ryoko Mitsutake, Shin-ichiro Miura, and Keijiro Saku Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan Key words: coronary artery disease, multi-detector row computed tomography, coronary calcification, pulse wave velocity Multi-detector row computed tomography (MDCT) has become more widely available in many general hospitals, as it enables the accurate non-invasive assessment of coronary artery stenosis, plaque imaging and calcium scoring. However, it is very difficult to detect coronary stenosis on MDCT in a lesion with advanced calcification. We analyzed the association between coronary stenosis or calcification score on MDCT and pulse wave velocity, and found additional information for diagnosis of coronary artery disease.

9 (J Jpn Coll Angiol, 2010, 50: 163 167). Online publication May 27, 2010. Vol. 50, 2010 167.