Abstract
Aims
This study explored the coronary plaque volume change (PVC) according to the change of percent body mass index (BMI) and categorical BMI group using serial coronary computed tomography ...angiography (CCTA).
Methods and results
A total of 1568 subjects who underwent serial CCTA with available BMI at baseline (CCTA1) and follow-up (CCTA2) were included. Median inter-scan period was 3.3 (interquartile range: 2.6–4.6) years. Quantitative assessment of coronary plaque was performed at both scans. All participants were categorized into three BMI (kg/m2) groups: normal: <25.0; overweight: 25.0–29.9; and obesity: ≥30.0. During follow-up, there were no significant differences in annualized PVC according to the 5% change of BMI in all BMI groups. Among 1424 (90.8%) subjects in the same BMI group at CCTA1 and CCTA2, a significant difference in annualized (PVC) was observed among the three groups. In 144 (9.2%) subjects with the change in their BMI group at CCTA2 compared their results at CCTA1, annualized PVC was not different compared with subjects in the same BMI group during follow-up. The percent change of BMI was not significantly related to the annualized PVC after adjusting confounding factors. Male gender odds ratio (OR): 1.38; 95% confidence interval (CI): 1.05–1.81; P = 0.022, baseline plaque volume (OR: 1.07; 95% CI: 1.05–1.09; P < 0.001), and baseline overweight or obesity (OR: 1.35; 95% CI: 1.04–1.77; P = 0.027) were independently associated with coronary plaque progression.
Conclusion
Over the near term, longitudinal small changes in BMI were not associated with changes in coronary plaque volume although baseline BMI was.
Clinical trial registration
ClinicalTrials.gov NCT02803411.
To investigate potential differences in plaque progression (PP) between in East Asians and Caucasians as well as to determine clinical predictors of PP in East Asians.
Studies have demonstrated ...differences in cardiovascular risk factors as well as plaque burden and progression across different ethnic groups.
The study comprised 955 East Asians (age 60.4 ± 9.3 years, 50.9% males) and 279 Caucasians (age 60.4 ± 8.6 years, 74.5% males) who underwent two serial coronary computed tomography angiography (CCTA) studies over a period of at least 24 months. Patients were enrolled and analyzed from the PARADIGM (Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging) registry. After propensity-score matching, plaque composition and progression were compared between East Asian and Caucasian patients. Within East Asians, the plaque progression group (defined as plaque volume at follow-up CCTA minus plaque volume at baseline CCTA> 0) was compared to the no PP group to determine clinical predictors for PP in East Asians.
In the matched cohort, baseline volumes of total plaque as well as all plaque subtypes were comparable. There was a trend towards increased annualized plaque progression among East Asians compared to Caucasians (18.3 ± 24.7 mm3/year vs 16.6 mm3/year, p = 0.054). Among East Asians, 736 (77%) had PP. East Asians with PP had more clinical risk factors and higher plaque burden at baseline (normalized total plaque volume of144.9 ± 233.3 mm3 vs 36.6 ± 84.2 mm3 for PP and no PP, respectively, p < 0.001). Multivariate logistic regression analysis showed that baseline normalized plaque volume (OR: 1.10, CI: 1.10–1.30, p < 0.001), age (OR: 1.02, CI: 1.00–1.04, p = 0.023) and body mass index (OR: 2.24, CI: 1.01–1.13, p = 0.024) were all predictors of PP in East Asians. Clinical events, driven mainly by percutaneous coronary intervention, were higher among the PP group with a total of 124 (16.8%) events compared to 22 (10.0%) in the no PP group (p = 0.014).
East Asians and Caucasians had comparable plaque composition and progression. Among East Asians, the PP group had a higher baseline plaque burden which was associated with greater PP and increased clinical events.
The association of age with coronary plaque dynamics is not well characterized by coronary computed tomography angiography (CCTA).
From a multinational registry of patients who underwent serial CCTA, ...1153 subjects (61 ± 5 years old, 61.1% male) were analyzed. Annualized volume changes of total, fibrous, fibrofatty, necrotic core, and dense calcification plaque components of the whole heart were compared by age quartile groups. Clinical events, a composite of all-cause death, acute coronary syndrome, and any revascularization after 30 days of the initial CCTA, were also analyzed. Random forest analysis was used to define the relative importance of age on plaque progression.
With a 3.3-years’ median interval between the two CCTA, the median annual volume changes of total plaque in each age quartile group was 7.8, 10.5, 10.8, and 12.1 mm3/year and for dense calcification, 2.5, 4.6, 5.4, and 7.1 mm3/year, both of which demonstrated a tendency to increase by age (p-for-trend = 0.001 and < 0.001, respectively). However, this tendency was not observed in any other plaque components. The annual volume changes of total plaque and dense calcification were also significantly different in the propensity score-matched lowest age quartile group versus the other age groups as was the composite clinical event (log-rank p = 0.003). In random forest analysis, age had comparable importance in the total plaque volume progression as other traditional factors.
The rate of whole-heart plaque progression and dense calcification increases depending on age. Age is a significant factor in plaque growth, the importance of which is comparable to other traditional risk factors.
URL: http://www.clinicaltrials.gov. Unique identifiers: NCT02803411.
Despite a potential role of hemoglobin in atherosclerosis, data on coronary plaque volume changes (PVC) related to serum hemoglobin levels are limited.
The authors sought to evaluate coronary ...atherosclerotic plaque burden changes related to serum hemoglobin levels using serial coronary computed tomographic angiography (CCTA).
A total of 830 subjects (age 61 ± 10 years, 51.9% male) who underwent serial CCTA were analyzed. The median interscan period was 3.2 (IQR: 2.5-4.4) years. Quantitative assessment of coronary plaques was performed at both scans. All participants were stratified into 4 groups based on the quartile of baseline hemoglobin levels. Annualized total PVC (mm3/year) was defined as total PVC divided by the interscan period.
Baseline total plaque volume (mm3) was not different among all groups (group I lowest: 34.1 IQR: 0.0-127.4 vs group II: 28.8 IQR: 0.0-123.0 vs group III: 49.9 IQR: 5.6-135.0 vs group IV highest: 34.3 IQR: 0.0-130.7; P = 0.235). During follow-up, serum hemoglobin level changes (Δ hemoglobin; per 1 g/dL) was related to annualized total PVC (β = −0.114) in overall participants (P < 0.05). After adjusting for age, sex, traditional risk factors, baseline hemoglobin and creatinine levels, baseline total plaque volume, and the use of aspirin, beta-blocker, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and statin, Δ hemoglobin significantly affected annualized total PVC in only the composite of groups I and II (β = −2.401; P = 0.004).
Serial CCTA findings suggest that Δ hemoglobin has an independent effect on coronary atherosclerosis. This effect might be influenced by baseline hemoglobin levels. (Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging PARADIGM; NCT02803411)
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The aim of the study is examine the impact of non-obstructive (<50%stenosis) left main (LM) disease on the natural history of coronary artery disease using serial coronary computed tomography ...angiography (CTA).
CTAs from the PARADIGM (Progression of atherosclerotic plaque determined by computed tomographic angiography imaging) study, a prospective multinational registry of patients who underwent serial CTA at a ≥2 year interval were analyzed. Those without evidence of CAD on their baseline scan were excluded, as were those with obstructive left main disease. Coronary artery vessels and their branches underwent quantification of: plaque volume and composition; diameter stenosis; presence of high-risk plaque.
Of 944 (62 ± 9 years, 60% male) who had evidence of CAD at baseline, 444 (47%) had LM disease. Those with LM disease had a higher baseline plaque volume (194.8 ± 221mm3 versus 72.9 ± 84.3mm3, p < 0.001) and a higher prevalence of high-risk plaque (17.5% versus 13%, p < 0.001) than those without LM disease. On multivariable general linear model, patients with LM disease had greater annual rates of progression of total (26.5 ± 31.4mm3/yr versus 14.9 ± 20.1mm3/yr, p < 0.001) and calcified plaque volume (17 ± 24mm3/yr versus 7 ± 11mm3/yr, p < 0.001), with no difference in fibrous, fibrofatty or necrotic core plaque components.
The presence of non-obstructive LM disease is associated with greater rates of plaque progression and a higher prevalence of high-risk plaque throughout the entire coronary artery tree compared to CAD without LM involvement. Our data suggests that non-obstructive LM disease may be a marker for an aggressive phenotype of CAD that may benefit from more intensive treatment strategies.
Following the recent development of quantum machine learning techniques, the literature has reported several quantum machine learning algorithms for disease detection. This study explores the ...application of a hybrid quantum-classical algorithm for classifying region-of-interest time-series data obtained from resting-state functional magnetic resonance imaging in patients with early-stage cognitive impairment based on the importance of cognitive decline for dementia or aging. Classical one-dimensional convolutional layers are used together with quantum convolutional neural networks in our hybrid algorithm. In the classical simulation, the proposed hybrid algorithms showed higher balanced accuracies than classical convolutional neural networks under the similar training conditions. Moreover, a total of nine brain regions (left precentral gyrus, right superior temporal gyrus, left rolandic operculum, right rolandic operculum, left parahippocampus, right hippocampus, left medial frontal gyrus, right cerebellum crus, and cerebellar vermis) among 116 brain regions were found to be relatively effective brain regions for the classification based on the model performances. The associations of the selected nine regions with cognitive decline, as found in previous studies, were additionally validated through seed-based functional connectivity analysis. We confirmed both the improvement of model performance with the quantum convolutional neural network and neuroscientific validities of brain regions from our hybrid quantum-classical model.
IntroductionDespite recently reinforced guidelines for hypertension, little is known regarding the association between blood pressure and coronary plaque volume change (PVC) in individuals with low ...cardiovascular risk.HypothesisThis study sought to assess the predictors of coronary plaque progression (PP) using serial coronary computed tomographic angiography (CCTA) in individuals without traditional cardiovascular risk factors (CVRFs).MethodsWe analyzed 103 participants (age 56.6 ± 8.6 y; 40.8% men; inter-scan period 3.5 ± 1.4 years) without previous medical history from the Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (PARADIGM) trial. Annualized PVC was defined as total PVC divided by inter-scan period. PP was defined as plaque volume at follow-up minus plaque volume at index being >0.ResultsCoronary PP was observed in 42.7% of cases; an increase of annualized PVC was significant in fibrous and dense calcium plaques. After index CCTA, systolic blood pressure (SBP) (β = 0.165), high-density lipoprotein cholesterol (β = -0.227), and baseline plaque volume (β = 0.521) were independently associated with annualized PVC (p <0.05). The optimal cut-off SBP for predicting PP was 118.5 mmHg, with 78.2% sensitivity and 62.5% specificity (area under curve0.700; 95% confidence interval CI0.590-0.811; p = 0.001). In multivariate analysis, SBP ≥118.5 mmHg (odds ratio OR4.026; 95% CI1.508–10.753) and baseline plaque volume (OR1.029; 95% CI1.002-1.056) influenced coronary PP (p <0.05).ConclusionBased on serial CCTA findings, strict SBP control is necessary to prevent coronary PP in individuals without CVRFs.
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