Perivascular fat attenuation index and high-risk plaque features evaluated by coronary CT angiography: relationship with serum inflammatory marker level

Xu, Da-Zhong; Deng, Jianhong; Yu, Meijuan; Lu, Zhigang; Shen, Chengxing; Zhang, Jiayin

doi:10.1007/s10554-019-01758-8

Cited by 31 publications

(25 citation statements)

References 20 publications

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“…These findings go in line with previous cross-sectional reports of a consistent association of higher epicardial fat volume and underlying myocardial or coronary artery disease [5,8,13,14]. Results on the perivascular fat attenuation are not so unanimous [13,15,16]. While Dai and colleagues did not find a significant correlation of attenuation index and higher plaque load, the largest and probably most profound cohort determined an optimal cut off at 70.1 HU.…”

Section: Discussionsupporting

confidence: 88%

Reciprocal communication of pericoronary adipose tissue and coronary atherogenesis

Honold

Wildauer

Beyer

et al. 2021

European Journal of Radiology

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Pericoronary adipose tissue (PCAT) has been linked to underlying coronary artery disease (CAD) and proposed to modulate adjacent atherosclerotic plaque formation over pro-inflammatory pathways. In vitro and ex vivo studies support the bilateral communication of adipose tissue and vessel wall. We quantified PCAT and its dynamics in a low coronary risk cohort with a semi-automated software in serial coronary computed tomography angiography (CTA). Methods: We retrospectively included patients from a tertiary care hospital who underwent serial coronary CTA with a low cardiovascular risk profile. All examinations were evaluated in a standardized approach: epicardial adipose tissue (EAT) volume and attenuation was quantified in total, in the atrioventricular (RCA, LCX) or interventricular (LAD) sulcus and within a 5 mm radius for each coronary artery (PCAT). Coronary plaques were quantified using a semi-automated software and compared for progression, stability or regression. Results: Of 120 patients (27% females), 59.2% showed atherosclerotic plaques. After 36 months mean follow-up, 22 (18.3%) showed plaque regression, 39 (32.5%) were stable and 49 (40.8%) were progressive. Total EAT volume decreased by -15.6 ± 37.2 mm 3 in the regressive group, increased by 2.7 ± 30.6 mm 3 in the stable group and by 24.3 ± 37.1 mm 3 in the progressive group (p = 0.003). Per-vessel analysis showed a significant decrease of PCAT attenuation in patients with CAD regression (− 3.8 ± 7.6HU) compared to the stable (1.2 ± 9.1HU) and progressive group (3.5 ± 8.2HU, p < 0.0001). Mean sulcus EAT attenuation did not show a significant change (p = 0.135). Conclusion: Epicardial adipose tissue volume is mutually changing with the progression or regression of coronary artery disease. Perivascular but not epicardial attenuation levels correlate to adjacent plaque and support a direct bilateral influence.

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Section: Discussionsupporting

confidence: 88%

Reciprocal communication of pericoronary adipose tissue and coronary atherogenesis

Honold

Wildauer

Beyer

et al. 2021

European Journal of Radiology

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“…Other high-risk features, however, and calcified plaque did not associate with FAI. Another study by the same group [ 60 ] evaluated the relationship between high-risk plaque (HRP), CRP and FAI in a cohort of stable CAD patients. Analysis of FAI was performed around every coronary plaque in each of the three epicardial vessels; it was found that while HRP features were associated with increased CRP, FAI was not able to distinguish between patients with elevated compared to nominal CRP levels.…”

Section: Coronary Computed Tomography Angiography (Cta) Assessment Ofmentioning

confidence: 99%

The Emerging Role of CT-Based Imaging in Adipose Tissue and Coronary Inflammation

Yuvaraj

Cheng

Lin

et al. 2021

Cells

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A large body of evidence arising from recent randomized clinical trials demonstrate the association of vascular inflammatory mediators with coronary artery disease (CAD). Vascular inflammation localized in the coronary arteries leads to an increased risk of CAD-related events, and produces unique biological alterations to local cardiac adipose tissue depots. Coronary computed tomography angiography (CTA) provides a means of mapping inflammatory changes to both epicardial adipose tissue (EAT) and pericoronary adipose tissue (PCAT) as independent markers of coronary risk. Radiodensity or attenuation of PCAT on coronary CTA, notably, provides indirect quantification of coronary inflammation and is emerging as a promising non-invasive imaging implement. An increasing number of observational studies have shown robust associations between PCAT attenuation and major coronary events, including acute coronary syndrome, and ‘vulnerable’ atherosclerotic plaque phenotypes that are associated with an increased risk of the said events. This review outlines the biological characteristics of both EAT and PCAT and provides an overview of the current literature on PCAT attenuation as a surrogate marker of coronary inflammation.

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“…Compared to proximal PCAT MA , there may be a stronger relation of lesionspecific PCAT MA with plaque considering a hypothesized local effect of coronary inflammation. Three PCAT MA s t u d i e s ( 3 5 -1 9 9 p a t i e n t s ) u s e d a l e s i o n -b a s e d measurement method considering all three main coronary arteries [9,15,16]. One study showed that lesion-specific PCAT MA was higher around culprit lesions in acute coronary syndrome (ACS) patients compared to non-culprit lesions in ACS and CAD patients [15].…”

Section: Introductionmentioning

confidence: 99%

Focal pericoronary adipose tissue attenuation is related to plaque presence, plaque type, and stenosis severity in coronary CTA

Assen

Ties

et al. 2021

Eur Radiol

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Objectives To investigate the association of pericoronary adipose tissue mean attenuation (PCATMA) with coronary artery disease (CAD) characteristics on coronary computed tomography angiography (CCTA). Methods We retrospectively investigated 165 symptomatic patients who underwent third-generation dual-source CCTA at 70kVp: 93 with and 72 without CAD (204 arteries with plaque, 291 without plaque). CCTA was evaluated for presence and characteristics of CAD per artery. PCATMA was measured proximally and across the most severe stenosis. Patient-level, proximal PCATMA was defined as the mean of the proximal PCATMA of the three main coronary arteries. Analyses were performed on patient and vessel level. Results Mean proximal PCATMA was −96.2 ± 7.1 HU and −95.6 ± 7.8HU for patients with and without CAD (p = 0.644). In arteries with plaque, proximal and lesion-specific PCATMA was similar (−96.1 ± 9.6 HU, −95.9 ± 11.2 HU, p = 0.608). Lesion-specific PCATMA of arteries with plaque (−94.7 HU) differed from proximal PCATMA of arteries without plaque (−97.2 HU, p = 0.015). Minimal stenosis showed higher lesion-specific PCATMA (−94.0 HU) than severe stenosis (−98.5 HU, p = 0.030). Lesion-specific PCATMA of non-calcified, mixed, and calcified plaque was −96.5 HU, −94.6 HU, and −89.9 HU (p = 0.004). Vessel-based total plaque, lipid-rich necrotic core, and calcified plaque burden showed a very weak to moderate correlation with proximal PCATMA. Conclusions Lesion-specific PCATMA was higher in arteries with plaque than proximal PCATMA in arteries without plaque. Lesion-specific PCATMA was higher in non-calcified and mixed plaques compared to calcified plaques, and in minimal stenosis compared to severe; proximal PCATMA did not show these relationships. This suggests that lesion-specific PCATMA is related to plaque development and vulnerability. Key Points • In symptomatic patients undergoing CCTA at 70 kVp, PCATMAwas higher in coronary arteries with plaque than those without plaque. • PCATMAwas higher for non-calcified and mixed plaques compared to calcified plaques, and for minimal stenosis compared to severe stenosis. • In contrast to PCATMAmeasurement of the proximal vessels, lesion-specific PCATMAshowed clear relationships with plaque presence and stenosis degree.

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Perivascular fat attenuation index and high-risk plaque features evaluated by coronary CT angiography: relationship with serum inflammatory marker level

Cited by 31 publications

References 20 publications

Reciprocal communication of pericoronary adipose tissue and coronary atherogenesis

Reciprocal communication of pericoronary adipose tissue and coronary atherogenesis

The Emerging Role of CT-Based Imaging in Adipose Tissue and Coronary Inflammation

Focal pericoronary adipose tissue attenuation is related to plaque presence, plaque type, and stenosis severity in coronary CTA

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