演題

Assessment of Cardiovascular Atherosclerosis of Heterozygous Familial Hypercholesterolemia (hFH) Using 320-detector Row Coronary CT

[演者] 坂井 晶子:1
[共同演者] 佐藤 加代子:1, 関口 治樹:1, 福島 賢慈:2, 長尾 充展:2, 坂井 修二:2, 萩原 誠久:1
1:東京女子医科大学 循環器内科学, 2:東京女子医科大学 画像診断・核医学科

Introduction: Heterozygous familial hypercholesterolaemia(hFH) is most common genetic disease and cause of premature coronary artery disease. Non invasive cardiac CT has the ability of detect subclinical atherosclerosis. Hypothesis: We hypothesized that the patients with hFH developed the coronary atherosclerosis with complex plaque morphology more than the patients with LDL-C of hypercholesterolemia(DL). Methods: We enrolled 60 patients with hFH, diagnosed according to FH guidelines of Japanese Atherosclerosis Society (median age, 58.8±1.5 years; men 72%) and 27 patients with DL (median age, 65.4±2.2 years; men 49%). We evaluated all patients underwent 320-detector row coronary CT, ABI, PWV, and EndoPAT for the assessment of atherosclerosis. Carotid intima-media thickness and carotid artery plaque score(PS) were measured using carotid ultra sound.Results: The coronary plaque score (15.1±1.2 vs 6.4±1.9,p<0.01) and the segment involvement score (6.7±0.6 vs 3.2±0.8,p<0.01) were significantly higher in hFH. In addition, PS was significantly associated with the presence of coronary artery plaques (r=0.64,p<0.01). After multivariate analysis, age, max LDL-C and PS were associated with coronary plaque score (P<0.05, respectively), indicating that hFH had a high incidence of the significantly obstructive atherosclerosis and non-calcified plaque in their coronary arteries.Conclusion: The coronary atherosclerosis is developed in hFH patients, and the plaque morphology of coronary artery is related with carotid plaque. 320-detector row coronary CT has the ability of risk stratification of FH patients with PS.

[Keywords] lipids / plaque
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