Quantitative plaque analysis with A.I.-augmented CCTA in end-stage renal disease and complex CAD.

Autor: Cho GW; Division of Cardiology, David Geffen School of Medicine UCLA, Los Angeles, CA, USA. Electronic address: gcho@mednet.ucla.edu., Ghanem AK; Lundquist Institute of Biomedical Innovation, Harbor-UCLA, Torrance, CA, USA., Quesada CG; Cardiovascular Research Foundation of Southern California, Beverly Hills, CA, USA., Crabtree TR; Cleerly Inc, New York, NY, USA., Jennings RS; Cleerly Inc, New York, NY, USA., Budoff MJ; Lundquist Institute of Biomedical Innovation, Harbor-UCLA, Torrance, CA, USA., Choi AD; George Washington University, Washington, DC, USA., Min JK; Cleerly Inc, New York, NY, USA., Karlsberg RP; Cedars-Sinai Smidt Heart Institute, Cardiovascular Research Foundation of Southern California, Beverly Hills, CA, USA., Earls JP; George Washington University, Washington, DC, USA.
Jazyk: angličtina
Zdroj: Clinical imaging [Clin Imaging] 2022 Sep; Vol. 89, pp. 155-161. Date of Electronic Publication: 2022 Jul 06.
DOI: 10.1016/j.clinimag.2022.06.012
Abstrakt: Background: Adverse cardiovascular events are a significant cause of mortality in end-stage renal disease (ESRD) patients. High-risk plaque anatomy may be a significant contributor. However, their atherosclerotic phenotypes have not been described. We sought to define atherosclerotic plaque characteristics (APC) in dialysis patients using artificial-intelligence augmented CCTA.
Methods: We retrospectively analyzed ESRD patients referred for CCTA using an FDA approved artificial-intelligence augmented-CCTA program (Cleerly). Coronary lesions were evaluated for APCs by CCTA. APCs included percent atheroma volume(PAV), low-density non-calcified-plaque (LD-NCP), non-calcified-plaque (NCP), calcified-plaque (CP), length, and high-risk-plaque (HRP), defined by LD-NCP and positive arterial remodeling >1.10 (PR).
Results: 79 ESRD patients were enrolled, mean age 65.3 years, 32.9% female. Disease distribution was non-obstructive (65.8%), 1-vessel disease (21.5%), 2-vessel disease (7.6%), and 3-vessel disease (5.1%). Mean total plaque volume (TPV) was 810.0 mm 3 , LD-NCP 16.8 mm 3 , NCP 403.1 mm 3 , and CP 390.1 mm 3 . HRP was present in 81.0% patients. Patients with at least one >50% stenosis, or obstructive lesions, had significantly higher TPV, LD-NCP, NCP, and CP. Patients >65 years had more CP and higher PAV.
Conclusion: Our study provides novel insight into ESRD plaque phenotypes and demonstrates that artificial-intelligence augmented CCTA analysis is feasible for CAD characterization despite severe calcification. We demonstrate elevated plaque burden and stenosis caused by predominantly non-calcified-plaque. Furthermore, the quantity of calcified-plaques increased with age, with men exhibiting increased number of 2-feature plaques and higher plaque volumes. Artificial-intelligence augmented CCTA analysis of APCs may be a promising metric for cardiac risk stratification and warrants further prospective investigation.
(Copyright © 2022. Published by Elsevier Inc.)
Databáze: MEDLINE
Externí odkaz: