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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Calcified Carotid Plaques Show Double Symptomatic Peaks According to Agatston Calcium Score
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Calcified Carotid Plaques Show Double Symptomatic Peaks According to Agatston Calcium Score

机译：根据Agatston钙评分，钙化颈动脉斑块显示双症状峰

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Background: The precise mechanism of carotid calcification formation and its clinical significance including the difference in outcomes compared with coronary artery have not been clearly elucidated yet. We applied the calcium score for analyzing carotid plaque calcification in focus on its relationship with symptoms and discuss the difference in transitional patterns and the clinical outcome in comparison with calcified coronary plaques. Methods: Multidetector row computed tomography angiography was performed preoperatively to determine the Agatston calcium score, volume score, and Hounsfield values for a total of 330 carotid arteries from 194 patients. Analysis focused on the relation of "the symptomatic rate'' to calcium score, volume score, and Hounsfield value as well as the characteristics of calcified plaques and coexisting diseases. The symptomatic rate of carotid artery plaques in each range of the index was calculated as the percentage of the number of carotid arteries with plaques, which elicited symptoms of the contralateral limbs or the ipsilateral retina to the whole number of carotid arteries with plaques within the range. Results: Calcified carotids with low symptomatic rate (<40%) tended to have calcification with significantly high calcium scores, high volume scores and mean/maximum Hounsfield values, high circularities, outer positions, positive remodeling, and carotid bulb/common carotid locations by univariate analysis, whereas high maximum Hounsfield value, high circularity, and outer position of calcification were significant independent predictors of low-symptomatic calcified carotid plaques by multivariate logistic regression analysis. When analyzed by calcium score, the rates for symptomatic carotids showed double peaks at calcium scores around 200-400 and 600-800 with a dip at 400-600. Significant independent predictors of low symptomatic carotid artery were high maximum Hounsfield value (odds ratio [OR], 5.70; P = .005), calcification encircling the carotid perimeter (OR, 7.18; P = .005), and the calcium location in the common carotid artery (OR, 6.62; P = .006) in comparing groups with low (0-400) and medium (400-600) calcium scores, whereas a high volume score (OR, .01; P = .003) alone was a significant independent determinant in the comparison between groups with high (600-1000) and medium calcium scores. Conclusions: Symptomatic rates of carotid plaque calcification were demonstrated to show double peaks with increasing calcium score and represent different features. Assessment of the 2 calcium-score parts might be helpful for appropriate comprehension of symptomatology and the complex process of carotid plaque calcification. We report a hypothesis for the mechanisms of the 2 different sections.
机译：背景：颈动脉钙化形成的确切机制及其临床意义（包括与冠状动脉相比的结局差异）尚未明确。我们将钙值评分用于分析颈动脉斑块钙化，重点在于其与症状的关系，并讨论了与钙化冠状斑块相比的过渡方式和临床结局的差异。方法：术前进行多排行计算机断层血管造影术，以确定来自194例患者的总共330条颈动脉的Agatston钙评分，体积评分和Hounsfield值。分析的重点是“症状发生率”与钙评分，体积评分和Hounsfield值之间的关系，以及钙化斑块和并存疾病的特征，计算各指标范围内颈动脉斑块的症状发生率，如下引起对侧肢体或同侧视网膜症状的带斑块的颈动脉总数在该范围内的颈动脉总数中所占百分比的钙化结果：低症状率（<40％）的钙化颈动脉倾向于通过单变量分析发现钙化具有显着高的钙得分，高体积得分和均值/最大Hounsfield值，高圆形度，外部位置，正重塑以及颈动脉/颈总颈动脉位置，而最大Hounsfield最大值，高圆形度和外部位置钙化是低症状钙化颈动脉斑块的重要独立预测因素回归分析。当通过钙分数分析时，有症状的颈动脉的比率在200-400和600-800左右的钙分数处显示双峰，而在400-600处下降。有症状的低颈动脉的重要独立预测因子是最大Hounsfield值高（奇数比[OR]，5.70; P = .005），围绕颈周的钙化程度（OR，7.18; P = .005），以及钙在颈动脉中的位置钙分数低（0-400）和中度（400-600）的对照组的颈总动脉（OR，6.62; P = .006），而单独的体积分数高（OR，.01; P = .003）在钙得分高（600-1000）和中等的组之间进行比较时，它是一个重要的独立决定因素。结论：颈动脉斑块钙化的症状率显示为双峰，钙分数增加，并表现出不同的特征。评估2个钙分数部分可能有助于正确理解症状和颈动脉斑块钙化的复杂过程。我们报告了两个不同部分的机制的假设。

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