研究人群包括145名前瞻性招募的冠状动脉CT血管造影(CCTA)和眼底镜检查患者。这项研究首先检查了CCTA评估的视网膜血管变化与冠状动脉疾病报告和数据系统(CAD-RADS)之间的关联。然后,我们开发了一种图形神经网络(GNN)模型,用于预测CAD-RADS作为冠状动脉疾病的替代指标.CCTA扫描由专家读者通过CAD-RADS评分进行分层,并从眼底图像中提取血管生物标志物。CAD-RADS评分与患者特征进行关联分析,视网膜疾病,和定量血管生物标志物。最后,与传统机器学习(ML)模型相比,构建GNN模型用于预测CAD-RADS评分.实验结果表明,一些视网膜血管生物标志物与不良的CAD-RADS评分显著相关,主要与动脉宽度有关,动脉角,静脉角,和分形维数。此外,GNN模型实现了灵敏度,特异性,精度和曲线下面积分别为0.711、0.697、0.704和0.739。该性能优于从传统ML模型获得的相同评估指标(p<0.05)。数据表明,视网膜脉管系统可能是冠状动脉动脉粥样硬化的潜在生物标志物,并且GNN模型可用于准确预测。
The study population contains 145 patients who were prospectively recruited for coronary CT angiography (CCTA) and
fundoscopy. This study first examined the association between retinal vascular changes and the Coronary Artery Disease Reporting and Data System (CAD-RADS) as assessed on CCTA. Then, we developed a graph neural network (GNN) model for predicting the CAD-RADS as a proxy for coronary artery disease. The CCTA scans were stratified by CAD-RADS scores by expert readers, and the vascular biomarkers were extracted from their fundus images. Association analyses of CAD-RADS scores were performed with patient characteristics, retinal diseases, and quantitative vascular biomarkers. Finally, a GNN model was constructed for the task of predicting the CAD-RADS score compared to traditional machine learning (ML) models. The experimental results showed that a few retinal vascular biomarkers were significantly associated with adverse CAD-RADS scores, which were mainly pertaining to arterial width, arterial angle, venous angle, and fractal dimensions. Additionally, the GNN model achieved a sensitivity, specificity, accuracy and area under the curve of 0.711, 0.697, 0.704 and 0.739, respectively. This performance outperformed the same evaluation metrics obtained from the traditional ML models (p < 0.05). The data suggested that retinal vasculature could be a potential biomarker for atherosclerosis in the coronary artery and that the GNN model could be utilized for accurate prediction.