[1]代承忠 彭礼清 余建群 刘静 蒲华霞.双源CT血管成像评价经导管主动脉瓣置入术术前患者颈动脉斑块[J].心血管病学进展,2019,(8):1182-1186.[doi:10.16806/j.cnki.issn.1004-3934.2019.08.028]
　DAI Chengzhong,PENG Liqing,YU Jianqun,et al.Evaluation of Carotid Arteries Plaques in Patients Referred for TAVI with Dual-source CT Angiography[J].Advances in Cardiovascular Diseases,2019,(8):1182-1186.[doi:10.16806/j.cnki.issn.1004-3934.2019.08.028]
点击复制

双源CT血管成像评价经导管主动脉瓣置入术术前患者颈动脉斑块()
分享到：

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2019年8期
页码:
1182-1186
栏目:
论著
出版日期:
2019-11-25

文章信息/Info

Title:
Evaluation of Carotid Arteries Plaques in Patients Referred for TAVI with Dual-source CT Angiography
作者:
代承忠 彭礼清 余建群 刘静 蒲华霞
(四川大学华西医院放射科,四川 成都 610041 )
Author(s):
DAI Chengzhong;  PENG Liqing;  YU Jianqun;  LIU Jing;  PU Huaxia
(Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China) (81601462)(2016FZ0107)(16ZD013)1.3.5(ZYGD18013)
关键词:
经导管主动脉瓣置入术; 动脉粥样硬化; 斑块; 双源CT血管成像
Keywords:
Transcatheter aortic valve implantation;  Atherosclerosis;  Plaque;  Dual-source computed tomography angiography
DOI:
10.16806/j.cnki.issn.1004-3934.2019.08.028
摘要:
目的 评价经导管主动脉瓣置入术前患者颈部大动脉的粥样硬化斑块影像学特征及锁骨下入路血管解剖。方法 2014年1月—2015年3月纳入80例经导管主动脉瓣置入术前行颈部双源CT血管成像患者的CT资料，回顾性分析颈部大动脉粥样硬化斑块发生率、分布及类型，并测量双侧锁骨下动脉直径。结果 77例患者（96.3%）检出动脉粥样硬化斑块，其中以钙化斑块最常见（52.5%，201/383），其次为混合斑块（32.4%，124/383），未钙化斑块比例发生率最低（15.1%，58/383），三种斑块发生率差异有统计学意义（P＜0.05）。在斑块分布方面，非钙化斑块主要分布于颈内动脉（29.3%），混合斑块（21.8%）及钙化斑块（22.3%）主要分布于主动脉弓，不同斑块分布发生率差异有统计学意义（P＜0.05）。斑块分布最常见的部位是颈内动脉（19.8%，76/383），其次是主动脉弓（18.8%，72/383）。在血管管腔狭窄方面，各类型斑块所致的非阻塞性狭窄明显多于阻塞性狭窄（90.3% vs 9.7%，P＜0.05）。结论 双源CT血管成像检出的经导管主动脉瓣置入术术前患者粥样硬化斑块发生率较高，以钙化斑块、非阻塞性狭窄为主。颈动脉粥样硬化斑块最常见于颈内动脉及主动脉弓。
Abstract:
Objective To evaluate the imaging features of atherosclerotic plaques of carotid arteries and anatomy of subclavian artery as access vessel in patients referred for transcatheter aortic valve implantation (TAVI) with dual-source computed tomography angiography (DSCTA). Method From January 2014 to March 2015, 80 cases referred for TAVI with carotid artery angiography by DSCTA were included, and retrospective analysis was performed for the prevalence, plaque distribution, types of atherosclerotic plaques of carotid arteries, and the measurement of subclavian artery diameter. Result Atherosclerotic plaques were detected in 77 patients (96.3%), among which calcified plaque was the most common (52.5%, 201/383), followed by mixed plaque (32.4%, 124/383) and uncalcified plaque was lowest (15.1%, 58/383). The prevalences of different plaques were statistically significant (P＜0.05). In addition, non-calcified plaques were mainly detected in internal carotid artery (29.3%), while mixed plaques (21.8%) and calcified plaques (22.3%) were mainly detected in the aortic arch, respectively ( P＜0.05). The difference was statistically significant (P＜0.05). The most common site for plaque was the internal carotid artery (19.8%, 76/383), followed by the aortic arch (18.8%, 72/383). Non-obstructive stenosis was significantly more common than obstructive stenosis in all types of plaque (90.3% vs 9.7%, P＜0.05). Conclusion DSCTA detects a high prevalence of atherosclerotic plaques in patients referred for TAVI, among which higher proportion of calcified plaques and non-obstructive stenosis were found. Plaques are mainly distributed in the internal carotid artery and aortic arch.

参考文献/References:

[1].Rahimtoola SH. The year in valvular heart disease[J]. J Am Coll Cardiol,2007,49(3):361.
[2].Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: a population-based study[J]. Lancet,2006,368(9540):1005-1011.
[3].Urena M, Hayek S, Cheema AN, et al. Arrhythmia burden in elderly patients with severe aortic stenosis as determined by continuous electrocardiographic recording: toward a better understanding of arrhythmic events after transcatheter aortic valve replacement[J]. Circulation,2015,131(5):469-477.
[4].Biancari F, Rosato S, D’Errigo P, et al. Immediate and intermediate outcome after transapical versus transfemoral transcatheter aortic valve replacement[J]. Am J Cardiol,2016,117(2):245-251.
[5].Barnett HJM, Taylor DW, Haynes RB, et al. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis[J]. N Engl J Med,1991,325(7):445-453.
[6].Ballotta E, Da Giau G, Renon L. Carotid plaque gross morphology and clinical presentation: a prospective study of 457 carotid artery specimens[J]. J Surg Res,2000,89(1):78-84.
[7].贾圣琪,裴汉军.经导管主动脉瓣植入术的研究进展[J].心血管病学进展,2018,39(5):746-750.
[8].Schaff HV. Transcatheter aortic-valve implantation—at what price?[J].N Engl J Med,2011,364(23):2256-2258.
[9].Li GW, Zheng GY, Li JG, et al. Relationship between?carotid atherosclerosis?and?cerebral infarction[J].Chin Med Sci,2010,25(1):32-37.
[10].Li P, Xu L, Yang L, et al. Blooming?artifact?reduction in coronary artery calcification by a new de-blooming?algorithm:initial study[J].Sci Rep,2018,8(1):6945.
[11].Gupta A, Baradaran H, Schweitzer AD, et al. Carotid plaque MRI and stroke risk: a systematic review and meta-analysis[J]. Stroke,2013,44(11):3071-3077.
[12].Rozie S, de Weert TT, de Monyé C, et al. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography: relationship with severity of stenosis and cardiovascular risk factors[J]. Eur Radi ol,2009,19(9):2294-2301.
[13].陈文强.不稳定性斑块的研究进展[J].心血管病学进展,2003,24(6):439-443.
[14].Fr?hlich GM, Baxter PD, Malkin CJ, et al. Comparative?survivalafter?transapical, directand?subclavian?transcatheter aortic valve implantation (data from the UK TAVI registry)[J]. Am J Cardiol,2015,116(10):1555-1559.
[15].Muensterer A, Mazzitelli D, Ruge H, et al. Safety and efficacy of the subclavian access route for TAVI in cases of missing transfemoral access[J]. Clin Res Cardiol,2013,102(9):627-636.
[16].Achenbach S, Delgado V, Hausleiter J, et al. SCCT expert consensus document on computed tomography imaging before transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR)[J]. J Cardiovasc Comput Tomogr,2012,6(6):366-380.
[17].Blanke P, Weir-McCall JR, Achenbach S, et al. Computed tomography imaging in the context of transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR):an expert consensus document of the Society of Cardiovascular Computed Tomography[J]. J Cardiovasc Comput Tomogr,2019,13(1):1-20.
[18].Li JJ, Chen JL. Inflammation may be a bridge connecting hypertension and atherosclerosis[J]. Med Hypotheses,2005,64(5):925-929.

相似文献/References:

[1]李乐亮,综述,李萍,等.炎症标志物与颈动脉粥样斑块的稳定性[J].心血管病学进展,2016,(3):219.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.001]
　LI Leliang,LI Ping.Stability of Inflammatory Markers and Carotid Artery Plaque[J].Advances in Cardiovascular Diseases,2016,(8):219.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.001]
[2]耿春晖 关秀茹.MicroRNA作为动脉粥样硬化的诊断生物标志物的研究进展[J].心血管病学进展,2019,(7):996.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.008]
　GENG Chunhui,GUAN Xiuru.microRNA as a Diagnostic Biomarker for Atherosclerosis[J].Advances in Cardiovascular Diseases,2019,(8):996.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.008]
[3]乐健 何胜虎.前蛋白转化酶枯草溶菌素9致动脉粥样硬化的机制研究进展[J].心血管病学进展,2019,(7):1000.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.009]
　YUE Jian,HE Shenghu.Advances in the mechanism of PCSK9-induced atherosclerosis[J].Advances in Cardiovascular Diseases,2019,(8):1000.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.009]
[4]武亚琳,梁斌,杨志明.NLRP3/IL-1β途径的促动脉粥样硬化作用及临床应用[J].心血管病学进展,2019,(6):943.[doi:10.16806/j.cnki.issn.1004-3934.2016.06.026]
　WU Yalin,LIANG Bin,YANG Zhiming.The Role of NLRP3/IL-1in Atherosclerosis and Clinical Application[J].Advances in Cardiovascular Diseases,2019,(8):943.[doi:10.16806/j.cnki.issn.1004-3934.2016.06.026]
[5]李琦玉 ?张宁 陈婧 黄浙勇.动脉粥样硬化的抗血小板分子靶向治疗[J].心血管病学进展,2019,(5):701.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.010]
　LI Qiyu,ZHANG Ning,CHEN Jing,et al.Anti-Platelet Molecular Targeted Therapy or Atherosclerosis[J].Advances in Cardiovascular Diseases,2019,(8):701.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.010]
[6]侯冬华 郝丽荣.长正五聚蛋白3在动脉粥样硬化和心血管疾病中作用研究的新进展[J].心血管病学进展,2019,(5):805.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.035]
　HOU Donghua H AO Lirong.The Study of Atherosclerosis and Cardiovascular Diseases with Pentapycin 3[J].Advances in Cardiovascular Diseases,2019,(8):805.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.035]
[7]焦新峰 刘正霞 鲁翔.白介素-8在冠心病中的研究进展[J].心血管病学进展,2019,(8):1126.[doi:10.16806/j.cnki.issn.1004-3934.2019.08.014]
　JIAO Xinfeng,LIU Zhengxia,LU Xiang.Research Progress of Interleukin-8 in Coronary Heart Disease[J].Advances in Cardiovascular Diseases,2019,(8):1126.[doi:10.16806/j.cnki.issn.1004-3934.2019.08.014]
[8]徐侨 刘正霞 鲁翔.白介素22在动脉粥样硬化和2型糖尿病中的作用[J].心血管病学进展,2019,(9):1260.[doi:10.16806/j.cnki.issn.1004-3934.2019.09.019]
　XU Qiao,LIU Zhengxia,LU Xiang.IL-22 in Atherosclerosis and Type 2 Diabetes Mellitus[J].Advances in Cardiovascular Diseases,2019,(8):1260.[doi:10.16806/j.cnki.issn.1004-3934.2019.09.019]
[9]石文坚 花蕾 孟祥光 袁义强.环状RNA在冠状动脉粥样硬化性心脏病中的研究进展[J].心血管病学进展,2019,(9):1286.[doi:10.16806/j.cnki.issn.1004-3934.2019.09.026]
　SHI Wenjian,HUA Lei,MENG Xiangguang,et al.CircRNA in Coronary Atherosclerotic Heart Disease[J].Advances in Cardiovascular Diseases,2019,(8):1286.[doi:10.16806/j.cnki.issn.1004-3934.2019.09.026]
[10]林春尧 刘晓辉.IL-33/ST2在冠心病中的研究进展[J].心血管病学进展,2020,(2):128.[doi:10.16806/j.cnki.issn.1004-3934.2020.02.007]
　LIN Chunyao LIU Xiaohui.IL-33/ST2 in Coronary Heart Disease[J].Advances in Cardiovascular Diseases,2020,(8):128.[doi:10.16806/j.cnki.issn.1004-3934.2020.02.007]

备注/Memo

备注/Memo:
基金项目：国家自然科学基金资助项目（81601462）；四川省科技厅支撑计划项目（2016FZ0107）；四川省卫生和计划生育委员会科研课题（16ZD013）；四川大学华西医院学科卓越发展1.3.5工程项目(ZYGD18013）
更新日期/Last Update: 2020-03-02