TY - JOUR
T1 - Percent atheroma volume
T2 - Optimal variable to report whole-heart atherosclerotic plaque burden with coronary CTA, the PARADIGM study
AU - van Rosendael, Alexander R.
AU - Lin, Fay Y.
AU - Ma, Xiaoyue
AU - van den Hoogen, Inge J.
AU - Gianni, Umberto
AU - Al Hussein, Omar
AU - Al'Aref, Subhi J.
AU - Peña, Jessica M.
AU - Andreini, Daniele
AU - Al-Mallah, Mouaz H.
AU - Budoff, Matthew J.
AU - Cademartiri, Filippo
AU - Chinnaiyan, Kavitha
AU - Choi, Jung Hyun
AU - Conte, Edoardo
AU - Marques, Hugo
AU - de Araújo Gonçalves, Pedro
AU - Gottlieb, Ilan
AU - Hadamitzky, Martin
AU - Leipsic, Jonathon A.
AU - Maffei, Erica
AU - Pontone, Gianluca
AU - Raff, Gilbert L.
AU - Shin, Sanghoon
AU - Kim, Yong Jin
AU - Lee, Byoung Kwon
AU - Chun, Eun Ju
AU - Sung, Ji Min
AU - Lee, Sang Eun
AU - Berman, Daniel S.
AU - Virmani, Renu
AU - Samady, Habib
AU - Stone, Peter H.
AU - Narula, Jagat
AU - Bax, Jeroen J.
AU - Shaw, Leslee J.
AU - Min, James K.
AU - Chang, Hyuk Jae
N1 - Publisher Copyright:
© 2020
PY - 2020/9/1
Y1 - 2020/9/1
N2 - 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.
AB - 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.
KW - Atherosclerosis
KW - Coronary CTA
KW - Imaging
KW - Percent atheroma volume
UR - http://www.scopus.com/inward/record.url?scp=85079527446&partnerID=8YFLogxK
U2 - 10.1016/j.jcct.2020.01.012
DO - 10.1016/j.jcct.2020.01.012
M3 - Article
C2 - 32063545
AN - SCOPUS:85079527446
SN - 1934-5925
VL - 14
SP - 400
EP - 406
JO - Journal of Cardiovascular Computed Tomography
JF - Journal of Cardiovascular Computed Tomography
IS - 5
ER -
