Pericoronary adipose tissue computed tomography attenuation distinguishes different stages of coronary artery disease: a cross-sectional study

European Heart Journal Cardiovascular Imaging - Tập 22 Số 3 - Trang 298-306 - 2021
Andrew Lin1,2,3, Nitesh Nerlekar2,3, Joshua Yuvaraj2,3, K. Fernandes3, Canchen Jiang3, Stephen J. Nicholls2,3, Damini Dey1, Dennis T. L. Wong2,3
1Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
2Department of Medicine, Monash University, Clayton, Victoria, Australia
3Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, 246 Clayton Road, Clayton, Victoria 3168, Australia

Tóm tắt

Abstract Aims  Vascular inflammation inhibits local adipogenesis in pericoronary adipose tissue (PCAT) and this can be detected on coronary computed tomography angiography (CCTA) as an increase in CT attenuation of PCAT surrounding the proximal right coronary artery (RCA). In this cross-sectional study, we assessed the utility of PCAT CT attenuation as an imaging biomarker of coronary inflammation in distinguishing different stages of coronary artery disease (CAD). Methods and results Sixty patients with acute myocardial infarction (MI) were prospectively recruited to undergo CCTA within 48 h of admission, prior to invasive angiography. These participants were matched to patients with stable CAD (n = 60) and controls with no CAD (n = 60) by age, gender, BMI, risk factors, medications, and CT tube voltage. PCAT attenuation around the proximal RCA was quantified per-patient using semi-automated software. Patients with MI had a higher PCAT attenuation (−82.3 ± 5.5 HU) compared with patients with stable CAD (−90.6 ± 5.7 HU, P < 0.001) and controls (−95.8 ± 6.2 HU, P < 0.001). PCAT attenuation was significantly increased in stable CAD patients over controls (P = 0.01). The association of PCAT attenuation with stage of CAD was independent of age, gender, cardiovascular risk factors, epicardial adipose tissue volume, and CCTA-derived quantitative plaque burden. No interaction was observed for clinical presentation (MI vs. stable CAD) and plaque burden on PCAT attenuation. Conclusion PCAT CT attenuation as a quantitative measure of global coronary inflammation independently distinguishes patients with MI vs. stable CAD vs. no CAD. Future studies should assess whether this imaging biomarker can track patient responses to therapies in different stages of CAD.

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European Heart Journal Cardiovascular Imaging

Tập 22 Số 3

298-306

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