Balaji Tamarappoo1, Yuka Otaki2, Mhairi Doris2, Yoav Arnson2, Heidi Gransar2, Sean Hayes2, John Friedman2, Louise Thomson2, Frances Wang2, Alan Rozanski2, Piotr Slomka3, Damini Dey3, Daniel Berman4. 1. Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA; Department of Medicine and Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA; Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA. Electronic address: balaji.tamarappoo@cshs.org. 2. Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA. 3. Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA; Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA. 4. Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA; Department of Medicine and Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA; Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Abstract
BACKGROUND: Computed tomography coronary angiography (CTA) can be used for assessment of plaque characteristics; however, quantitative assessment of changes in plaque composition in response to LDL lowering has not been performed with CTA. We sought to assess the association between LDL reduction and changes in plaque composition with quantitative CTA. METHODS: Quantification of total, calcified, non-calcified and low-density non-calcified plaque volumes (TPV, CPV, NCPV and LD-NCPV) was performed using semi-automated software in 234 vessels from 116 consecutive patients (89 men, 60 ± 10 years) with baseline LDL>70 mg/dl. Significant reduction in LDL was defined as a decrease by >10% of baseline LDL. Changes (Δ) in plaque volumes between the second and baseline study were compared between patients with LDL reduction (n = 63) and those with no decrease in LDL (n = 53). RESULTS: Median LDL at baseline was 98 mg/dl [interquartile range (IQR) 83-119 mg/dl] and median ΔLDL was -14 mg/dl (IQR -38 to 3 mg/dl). Mean interval between sequential CTA was 3.5 ± 1.6 years. TPV, NCPV, and LD-NCPV decreased in patients with a reduction in LDL compared to baseline; whereas, patients without reduction in LDL experienced an increase in TPV, NCPV and LD-NCPV. After adjusting for age, statin use, diabetes, baseline LDL and baseline TPV, reduction in LDL was associated with a decrease in TPV (P = 0.005), NCPV (P = 0.002) and LD-NCPV (P = 0.011) compared to patients without a reduction in LDL. CONCLUSION: Reduction in LDL was associated with beneficial changes in the amount and composition of noncalcified plaque as measured using semi-automated quantitative software by CTA.
BACKGROUND: Computed tomography coronary angiography (CTA) can be used for assessment of plaque characteristics; however, quantitative assessment of changes in plaque composition in response to LDL lowering has not been performed with CTA. We sought to assess the association between LDL reduction and changes in plaque composition with quantitative CTA. METHODS: Quantification of total, calcified, non-calcified and low-density non-calcified plaque volumes (TPV, CPV, NCPV and LD-NCPV) was performed using semi-automated software in 234 vessels from 116 consecutive patients (89 men, 60 ± 10 years) with baseline LDL>70 mg/dl. Significant reduction in LDL was defined as a decrease by >10% of baseline LDL. Changes (Δ) in plaque volumes between the second and baseline study were compared between patients with LDL reduction (n = 63) and those with no decrease in LDL (n = 53). RESULTS: Median LDL at baseline was 98 mg/dl [interquartile range (IQR) 83-119 mg/dl] and median ΔLDL was -14 mg/dl (IQR -38 to 3 mg/dl). Mean interval between sequential CTA was 3.5 ± 1.6 years. TPV, NCPV, and LD-NCPV decreased in patients with a reduction in LDL compared to baseline; whereas, patients without reduction in LDL experienced an increase in TPV, NCPV and LD-NCPV. After adjusting for age, statin use, diabetes, baseline LDL and baseline TPV, reduction in LDL was associated with a decrease in TPV (P = 0.005), NCPV (P = 0.002) and LD-NCPV (P = 0.011) compared to patients without a reduction in LDL. CONCLUSION: Reduction in LDL was associated with beneficial changes in the amount and composition of noncalcified plaque as measured using semi-automated quantitative software by CTA.
Authors: Markus Goeller; Balaji K Tamarappoo; Alan C Kwan; Sebastien Cadet; Frederic Commandeur; Aryabod Razipour; Piotr J Slomka; Heidi Gransar; Xi Chen; Yuka Otaki; John D Friedman; J Jane Cao; Moritz H Albrecht; Daniel O Bittner; Mohamed Marwan; Stephan Achenbach; Daniel S Berman; Damini Dey Journal: Eur Heart J Cardiovasc Imaging Date: 2019-06-01 Impact factor: 6.875
Authors: Donghee Han; Daniel S Berman; Robert J H Miller; Daniele Andreini; Matthew J Budoff; Filippo Cademartiri; Kavitha Chinnaiyan; Jung Hyun Choi; Edoardo Conte; Hugo Marques; Pedro de Araújo Gonçalves; Ilan Gottlieb; Martin Hadamitzky; Jonathon Leipsic; Erica Maffei; Gianluca Pontone; Sangshoon Shin; Yong-Jin Kim; Byoung Kwon Lee; Eun Ju Chun; Ji Min Sung; Sang-Eun Lee; Renu Virmani; Habib Samady; Peter Stone; Jagat Narula; Jeroen J Bax; Leslee J Shaw; Fay Y Lin; James K Min; Hyuk-Jae Chang Journal: JAMA Netw Open Date: 2020-07-01
Authors: Frederic Commandeur; Markus Goeller; Aryabod Razipour; Sebastien Cadet; Michaela M Hell; Jacek Kwiecinski; Xi Chen; Hyuk-Jae Chang; Mohamed Marwan; Stephan Achenbach; Daniel S Berman; Piotr J Slomka; Balaji K Tamarappoo; Damini Dey Journal: Radiol Artif Intell Date: 2019-11-27