Incremental diagnostic value of epicardial adipose tissue for the detection of functionally relevant coronary artery disease

Romijn, Marie-Louise; Danad, Ibrahim; Bakkum, Michiel J.; Stuijfzand, Wijnand J.; Tulevski, Igor I.; Somsen, G. Aernout; Lammertsma, Adriaan A.; Kuijk, Cornelis van; Ven, Peter M. van de; Min, James K.; Leipsic, Jonathon; Rossum, Albert C. van; Raijmakers, Pieter; Knaapen, Paul

doi:10.1016/j.atherosclerosis.2015.07.005

Cited by 25 publications

(21 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The significant correlations of the total EAT volume with functionally or anatomically significant CAD have been widely observed [2,3], although not reported in a recent study by Muthalaly et al with moderately severe CAD patients [18] or even in the prospective, large-scale CORE320 multicenter study [19]. Likewise, Romijn et al found an independent relation between EAT volume and myocardial ischemia, but the diagnostic performance for identifying hemodynamically significant CAD was not improved when considering coronary artery calcification [20]. A recent meta-analysis that included more than 40,000 subjects at low to intermediate risk of cardiovascular disorders showed that EAT volume was an independent predictor of obstructive stenosis, significant stenosis, myocardial ischemia, and MACE, irrespective of traditional cardiovascular risk factors [21].…”

Section: Discussionmentioning

confidence: 96%

Relation between quantity and quality of peri-coronary epicardial adipose tissue and its underlying hemodynamically significant coronary stenosis

Yang

Liu

et al. 2020

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background: We aimed to investigate the association of lesion-specific epicardial adipose tissue (EAT) volume and density with the presence of myocardial ischemia. Methods: We enrolled 45 patients (55 lesions) with known or suspected coronary artery disease who underwent coronary computed tomography angiography (CTA) followed by invasive fractional flow reserve (FFR) assessment within 30 days. EAT volume (index) and density in patient-, vessel-and lesion-level were measured on CTA images. Lesion-specific ischemia was defined as a lesion with stenosis diameter > 90% or FFR ≤0.80. Multivariate analysis determined the independent association of EAT parameters with lesion-specific ischemia. Results: Mean age of the patients was 60 years, and 75% were male. Overall, 55.6% of patients had ischemic lesions and a mean FFR baseline value of 0.82 ± 0.10. Total EAT volume index was significantly higher in patients with functionally or anatomically significant stenosis. Specifically, peri-lesion EAT volume index, not the density, was positively correlated with lesion-specific ischemia independent of luminal stenosis and plaque characteristics (hazard ratio 1.56, 95% confidence interval 1.04-2.33, P = 0.032; per 0.1 ml/m 2 increase). Moreover, peri-lesion EAT volume was negatively correlated with lesion FFR values, whereas total EAT volume was positively correlated with fat accumulation and glucose metabolism. In addition, there was no association of EAT volume or density with myocardial ischemia in vessel-level analysis. Conclusions: Lesion-specific EAT volume index, but not density, seems positively and independently associated with myocardial ischemia, while its incremental diagnostic value of lesion-specific ischemia should be further investigated.

show abstract

Section: Discussionmentioning

confidence: 96%

Relation between quantity and quality of peri-coronary epicardial adipose tissue and its underlying hemodynamically significant coronary stenosis

Yang

Liu

et al. 2020

BMC Cardiovasc Disord

View full text Add to dashboard Cite

show abstract

“…Because voluminous epicardial adipose tissue is a risk factor for coronary events [ 11 ], there is a possibility that the pericoronary adipose tissue (PCAT), which is a part of epicardial adipose tissue adjacent to the coronary artery, acts as a risk factor by supplying oxLDL to the adjacent coronary arterial wall. The PCAT releases a number of cytokines which influence coronary function [ 12 ] but it is not known whether or not it stores and releases oxLDL to the adjacent coronary arterial intima which is the site of atherosclerosis.…”

Section: Introductionmentioning

confidence: 99%

Pericoronary Adipose Tissue as Storage and Supply Site for Oxidized Low-Density Lipoprotein in Human Coronary Plaques

Uchida

Shimoyama

et al. 2016

PLoS ONE

View full text Add to dashboard Cite

ObjectivesIt is generally believed that low-density lipoprotein enters the vascular wall from its lumen and oxidized (oxLDL), after which it plays an important role in atherosclerosis. Because voluminous epicardial adipose tissue is a risk factor for coronary events, there is a possibility that the pericoronary adipose tissue (PCAT), which is a part of epicardial adipose tissue, acts as a risk factor by supplying oxLDL to the coronary arterial wall. The present study was performed whether PCAT stores and supplies oxLDL to the coronary wall.MethodsLocalization of oxLDL in PCAT and its relation to plaque morphology were examined by immunohistochemical techniques in 27 epicardial coronary arteries excised from 9 human autopsy cases.ResultsOxLDL deposited in all PCAT of the studied cases. The percent (%) incidence of oxLDL in the intima of 25 normal segment, 19 white plaques, 15 yellow plaques without necrotic core (NC) and 10 yellow plaques with NC, was 32, 84, 93 (p<0.05 vs normal segments and yellow plaques with NC), and 30, respectively. OxLDL deposited either in dotted or diffuse pattern. Double immunohistochemical staining revealed that the dotted oxLDL was that contained in CD68(+)-macrophages. The oxLDL-containing macrophages were observed in the interstitial space but not inside of the vasa vasorum, and they traversed PCAT, adventitia, external and internal elastic laminae, suggesting their migration towards the intima. Diffuse oxLDL deposits were observed in 17 preparations, the majority of which were co-localized with the vasa vasorum in outer or in both inner and outer halves of intima, and rarely in the inner half alone.ConclusionsThe results suggested that PCAT is a supply source of oxLDL to coronary intima and acts as a risk factor for coronary events, that oxLDL increasingly deposits in the intima with plaque growth and decreases after plaque maturation, and therefore molecular therapies targeting the PCAT before plaque growth could be effective in preventing human coronary atherosclerosis.

show abstract

“…At present, the volume of epicardial fat may be determined by a variety of imaging techniques, including echocardiography, CT and cardiovascular magnetic resonance ( 31 , 32 ). Due to its non-invasiveness, reliable results and capacity to provide abundant information, CT imaging technology is widely used in the detection of CAD and EAT ( 33 , 34 ).…”

Section: Discussionmentioning

confidence: 99%

Cardiac CT scanning in coronary artery disease: Epicardial fat volume and its correlation with coronary artery lesions and left ventricular function

et al. 2020

View full text Add to dashboard Cite

Coronary artery disease (CAD) is a major and common disease that poses a threat to human health. Recent studies suggested that epicardial fat may have an important role in the pathogenesis of CAD. Therefore, the association between epicardial fat volume (EFV) and left ventricular function with CAD was investigated in the present study. A total of 61 patients with suspected CAD who underwent CT scanning were enrolled. Baseline data, parameters of left heart function and EFV of the subjects were collected and analyzed. The degree of coronary artery lesions was assessed using the Gensini score. Pearson's correlation analysis and a logistic regression model were applied to assess the association between EFV and risk factors for CAD, the Gensini score and left ventricular function index. A total of 29 female and 32 male subjects with a median age of 63 years were enrolled. The median body mass index (BMI) of the subjects was 23.37 kg/m 2 and the median EFV was 86.41 cm 3. It was revealed that risk factors of CAD, specially hypertension, diabetes mellitus, dyslipidemia, history of myocardial infarction and smoking, had no significant association with the EFV (P>0.05); however, the EFV was significantly positively correlated with the BMI (r=0.479, P<0.0001), interventricular septal thickness (r=0.436, P=0.004), left ventricular posterior wall thickness (r=0.350, P=0.0058), left ventricular end diastolic diameter (r=0.265, P=0.0388), left ventricular mass (r=0.445, P=0.0003) and left ventricular mass index (r=0.371, P=0.0035). However, no correlation was identified between the EFV and the Gensini score (r=0.131, P=0.3137). In conclusion, the EFV measured by cardiac CT scanning was positively correlated with the BMI and left ventricular function, but was not associated with the presence of CAD according to the Gensini scores.

show abstract

Incremental diagnostic value of epicardial adipose tissue for the detection of functionally relevant coronary artery disease

Cited by 25 publications

References 35 publications

Relation between quantity and quality of peri-coronary epicardial adipose tissue and its underlying hemodynamically significant coronary stenosis

Relation between quantity and quality of peri-coronary epicardial adipose tissue and its underlying hemodynamically significant coronary stenosis

Pericoronary Adipose Tissue as Storage and Supply Site for Oxidized Low-Density Lipoprotein in Human Coronary Plaques

Cardiac CT scanning in coronary artery disease: Epicardial fat volume and its correlation with coronary artery lesions and left ventricular function

Contact Info

Product

Resources

About