Prognostic utility of the pericoronary fat attenuation index in patients with takotsubo cardiomyopathy.
Adipose tissue
Coronary computed tomography angiography
Fat attenuation index
Prognostication
Takotsubo cardiomyopathy
Journal
Journal of cardiovascular computed tomography
ISSN: 1876-861X
Titre abrégé: J Cardiovasc Comput Tomogr
Pays: United States
ID NLM: 101308347
Informations de publication
Date de publication:
22 Sep 2023
22 Sep 2023
Historique:
received:
02
05
2023
revised:
31
08
2023
accepted:
14
09
2023
medline:
25
9
2023
pubmed:
25
9
2023
entrez:
24
9
2023
Statut:
aheadofprint
Résumé
The etiology of takotsubo cardiomyopathy (TCM) remains poorly understood and no optimal management strategy has been established. Identification of features associated with poor outcomes may improve the prognosis of patients with TCM. We aimed to identify the predictors of poor prognosis in patients with TCM using coronary computed tomography angiography (CCTA). We enrolled consecutive patients with TCM who underwent CCTA during the acute disease phase. The pericoronary fat attenuation index (FAI) of adipose tissue was obtained from CCTA images. Major adverse cardiac and cerebrovascular events (MACCE) were defined as all-cause death, non-fatal myocardial infarction, stroke, rehospitalization due to congestive heart failure, and TCM recurrence. The relationships between patient characteristics and CCTA findings were compared between patients with and without MACCE. A total of 52 patients were included (10 men [19.2%]; mean age, 71 years). After a median follow-up of 23 months, MACCE had developed in 10 patients (19.2%). There were significant differences in clinical characteristics [including the three-vessel mean FAI (FAI-mean)] between patients with and without MACCE. Univariate Cox regression analyses showed that FAI-mean ≥ -68.94 Hounsfield units (cut-off value derived from receiver operating characteristic curve analysis) (hazard ratio [HR], 13.52; 95% confidence interval [CI], 1.705-107.2; p = 0.014) and NT-proBNP (HR, 1.000; 95% CI, 1.000-1.000; p = 0.022) were significant predictors of MACCE. FAI-mean ≥ -68.94 HU was significantly associated with MACCE (chi-squared statistic = 10.3, p = 0.001). In patients with TCM, a higher FAI-mean was significantly associated with poorer outcomes independent of the conventional risk factors.
Sections du résumé
BACKGROUND
BACKGROUND
The etiology of takotsubo cardiomyopathy (TCM) remains poorly understood and no optimal management strategy has been established. Identification of features associated with poor outcomes may improve the prognosis of patients with TCM. We aimed to identify the predictors of poor prognosis in patients with TCM using coronary computed tomography angiography (CCTA).
METHODS
METHODS
We enrolled consecutive patients with TCM who underwent CCTA during the acute disease phase. The pericoronary fat attenuation index (FAI) of adipose tissue was obtained from CCTA images. Major adverse cardiac and cerebrovascular events (MACCE) were defined as all-cause death, non-fatal myocardial infarction, stroke, rehospitalization due to congestive heart failure, and TCM recurrence. The relationships between patient characteristics and CCTA findings were compared between patients with and without MACCE.
RESULTS
RESULTS
A total of 52 patients were included (10 men [19.2%]; mean age, 71 years). After a median follow-up of 23 months, MACCE had developed in 10 patients (19.2%). There were significant differences in clinical characteristics [including the three-vessel mean FAI (FAI-mean)] between patients with and without MACCE. Univariate Cox regression analyses showed that FAI-mean ≥ -68.94 Hounsfield units (cut-off value derived from receiver operating characteristic curve analysis) (hazard ratio [HR], 13.52; 95% confidence interval [CI], 1.705-107.2; p = 0.014) and NT-proBNP (HR, 1.000; 95% CI, 1.000-1.000; p = 0.022) were significant predictors of MACCE. FAI-mean ≥ -68.94 HU was significantly associated with MACCE (chi-squared statistic = 10.3, p = 0.001).
CONCLUSION
CONCLUSIONS
In patients with TCM, a higher FAI-mean was significantly associated with poorer outcomes independent of the conventional risk factors.
Identifiants
pubmed: 37743156
pii: S1934-5925(23)00429-X
doi: 10.1016/j.jcct.2023.09.001
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.