Assessing Cardiovascular Risk by Using the Fat Attenuation Index in Coronary CT Angiography

Klüner, Laura V; Oikonomou, Evangelos; Antoniades, Charalambos

doi:10.1148/ryct.2021200563

Cited by 36 publications

(34 citation statements)

References 49 publications

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“…The results of our study are comparable with previous reports that age and male gender are independently associated with coronary calcium levels. The correlation between coronary calcification and endothelial dysfunction has also been demonstrated, as well as with impaired myocardial perfusion in patients with angiographic intact coronary arteries [15][16][17]. Therefore, altered coronary blood flow in the presence of coronary calcification affects the development and formation of atherosclerotic plaques, which are the main determinants of the development of severe forms of coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

The role and diagnostic value of assessing the degree of coronary arteries calcification for predicting the severity of coronary heart disease

Nykonenko¹,

Makarenkov²,

Pidluzhnyi³

et al. 2021

Patologìâ

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Coronary heart disease (CHD) is one of the leading mortality causes. According to the latest guidelines, coronary computed tomography angiography (CCTA) is one of the main non-invasive methods for diagnosis of CHD, which allows for quantification of stenosis severity and the characterization of stenotic lesions. Aim of the study. It is to study the role, diagnostic value and dependence of coronary artery calcification on the degree of stenotic lesion of the coronary arteries and anthropometric parameters in patients with coronary artery disease examined by computed tomography. Materials and methods. According to the purpose of the study, 46 patients were included: 32 (69.6 %) males and 14 (30.4 %) females. The average age of the patients was 59.0 ± 9.8 years, height – 172 ± 9 cm, weight – 85.6 ± 12.9 kg, body mass index (BMI) – 28.6 ± 4.13, body surface area (BSA) – 1.98 ± 0.17 m2. Demographic and clinical variables were analyzed using descriptive statistics. Independent t-tests were conducted between two groups of patients (Agatston index ≥400 and <400), using P < 0.05 as a significant value. Pearson correlation coefficient was employed to determine independent coronary calcium predictors using P < 0.05 as a significant value. Results. According to the results of the age analysis, significant differences were found among both groups of patients (P = 0.02). Notable differences in the number of affected coronary arteries between Groups 1 and 2 with an Agatston index ≥400 and <400 (P < 0.01) were found. During the correlation analysis, a significant moderate positive correlation of the SYNTAX score level with Agatston index (r = 0.69, P < 0.01) was revealed. Conclusions. The degree of coronary arteries calcification with Agatston score ≥400 is an independent predictor of severe coronary heart disease with multivessel lesion of the coronary arteries. The degree of calcification of coronary arteries with Agatston score ≥400 is more common in males. Height, weight, BMI and BSA do not influence the degree of coronary calcification arteries and Agatston score level.

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Section: Discussionmentioning

confidence: 99%

The role and diagnostic value of assessing the degree of coronary arteries calcification for predicting the severity of coronary heart disease

Nykonenko¹,

Makarenkov²,

Pidluzhnyi³

et al. 2021

Patologìâ

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“…cardiac mortality [2,5], and recent studies suggest a relationship between elevated FAI and hemodynamically relevant coronary stenosis [10,11].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Noninvasive evaluation of CAD by CT is well-established and focuses on the detection of coronary artery atherosclerosis and the identification of vessel stenosis. [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…Vascular inflammation is thought to play a key role in the pathogenesis and progression of CAD. The appearance of the epicardial adipose tissue (EAT) on CT has recently been identified as a noninvasive marker of vascular inflammation, as cytokines released from the inflamed vessel segment may affect the composition of EAT through paracrine effects [2,[5][6][7][8][9]. The fat attenuation index (FAI) is a CTA-derived metric of fat attenuation determined for predefined segments of the coronary artery tree, facilitating the detection of coronary inflammation.…”

Section: Introductionmentioning

confidence: 99%

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Epicardial Adipose Tissue Attenuation and Fat Attenuation Index: Phantom Study and In Vivo Measurements With Photon-Counting Detector CT

Mergen

Ried

Allmendinger

et al. 2022

American Journal of Roentgenology

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The publication of this Accepted Manuscript is provided to give early visibility to the contents of the article, which will undergo additional copyediting, typesetting, and review before it is published in its final form. During the production process, errors may be discovered that could affect the content of the Accepted Manuscript. All legal disclaimers that apply to the journal pertain. The reader is cautioned to consult the definitive version of record before relying on the contents of this document.

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“…The EAT/PAT thickness and volume have been associated with presence of coronary artery disease, atrial fibrillation, HFpEF and adverse outcomes in the general population [8,16‐18]. In addition, CT‐derived peri‐coronary fat attenuation carries prognostic value in both primary and secondary prevention and offers a significant improvement in CV risk stratification beyond traditional risk factors [19,20]. The advantages and disadvantages of the screening modalities in imaging cardiac adiposity are summarized in Table 1.…”

Section: Introductionmentioning

confidence: 99%

Cardiac adiposity as a modulator of cardiovascular disease in HIV

et al. 2021

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Background With the number of people living with human immunodeficiency virus (HIV) steadily increasing, cardiovascular disease has emerged as a leading cause of non‐HIV related mortality. People living with HIV (PLWH) appear to be at increased risk of coronary artery disease and heart failure (HF), while the underlying mechanism appears to be multifactorial. In the general population, ectopic cardiac adiposity has been highlighted as an important modulator of accelerated coronary artery atherosclerosis, arrhythmogenesis and HF with preserved ejection fraction (HFpEF). Cardiac adiposity is also strongly linked with obesity, especially with visceral adipose tissue accumulation. Aims This review aims to summarize the possible role of cardiac fat depositions, assessed by imaging modalities,as potential contributors to the increased cardiac morbidity and mortality seen in PLWH, as well as therapeutic targets in the current ART era. Materials & Methods Review of contemporary literature on this topic. Discussion Despite antiretroviral therapy (ART), PLWH have evidence of persistent, HIV‐related systemic inflammation and body fat alterations. Cardiac adiposity can play an additional role in the pathogenesis of cardiovascular disease in the HIV setting. Imaging modalities such as echocardiography, cardiac multidetector computed tomography and cardiac magnetic resonance have demonstrated increased adipose tissue. Studies show that high cardiac fat depots play an additive role in promoting coronary artery atherosclerosis and HFpEF in PLWH. Systemic inflammation due to HIV infection, metabolic adverse effects of ART, adipose alterations in the ageing HIV population, inflammation and immune activation are likely important mechanisms for adipose dysfunction and disproportionately occurrence of ectopic fat depots in the heart among PLWH. Conclusions High cardiac adiposity seems to plays an additive role in promoting coronary artery atherosclerosis and HFpEF in PLWH. The underlying mechanisms are multiple and warrant further investigation. Improved understanding of the regulating mechanisms that increase cardiovascular risk in HIV infection may give rise to more tailored therapeutic strategies targeting cardiac fat depots.

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Assessing Cardiovascular Risk by Using the Fat Attenuation Index in Coronary CT Angiography

Cited by 36 publications

References 49 publications

The role and diagnostic value of assessing the degree of coronary arteries calcification for predicting the severity of coronary heart disease

The role and diagnostic value of assessing the degree of coronary arteries calcification for predicting the severity of coronary heart disease

Epicardial Adipose Tissue Attenuation and Fat Attenuation Index: Phantom Study and In Vivo Measurements With Photon-Counting Detector CT

Cardiac adiposity as a modulator of cardiovascular disease in HIV

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