Relationship between changes in pericoronary adipose tissue attenuation and coronary plaque burden quantified from coronary computed tomography angiography

European Heart Journal Cardiovascular Imaging - Tập 20 Số 6 - Trang 636-643 - 2019
Markus Goeller1,2, Balaji Tamarappoo3, Alan C. Kwan3, Sebastien Cadet3, Frédéric Commandeur1, Aryabod Razipour1, Piotr J. Slomka3, Heidi Gransar3, Xi Chen3, Yuka Otaki3, John D. Friedman3, Jane Cao4, Moritz H. Albrecht5, Daniel O. Bittner2, Mohamed Marwan2, Stephan Achenbach2, Daniel S. Berman3, Damini Dey1
1Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, S. Mark Taper Building, Los Angeles, CA, USA
2Department of Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Faculty of Medicine, Erlangen, Germany
3Department of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
4Department of Cardiology, St Francis Hospital, New York, NY, USA
5Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany

Tóm tắt

Abstract Aims Increased attenuation of pericoronary adipose tissue (PCAT) around the proximal right coronary artery (RCA) from coronary computed tomography angiography (CTA) has been shown to be associated with coronary inflammation and improved prediction of cardiac death over plaque features. Our aim was to investigate whether PCAT CT attenuation is related to progression of coronary plaque burden. Methods and results We analysed CTA studies of 111 stable patients (age 59.2 ± 9.8 years, 77% male) who underwent sequential CTA (3.4 ± 1.6 years between scans) with identical acquisition protocols. Total plaque (TP), calcified plaque (CP), non-calcified plaque (NCP), and low-density non-calcified plaque (LD-NCP) volumes and corresponding burden (plaque volume × 100%/vessel volume) were quantified using semi-automated software. PCAT CT attenuation (HU) was measured around the proximal RCA, the most standardized method for PCAT analysis. Patients with an increase in NCP burden (n = 51) showed an increase in PCAT attenuation, whereas patients with a decrease in NCP burden (n = 60) showed a decrease {4.4 [95% confidence interval (CI) 2.6–6.2] vs. −2.78 (95% CI −4.6 to −1.0) HU, P < 0.0001}. Changes in PCAT attenuation correlated with changes in the burden of NCP (r = 0.55, P < 0.001) and LD-NCP (r = 0.24, P = 0.01); but not CP burden (P = 0.3). Increased baseline PCAT attenuation ≥−75 HU was independently associated with increase in NCP (odds ratio 3.07, 95% CI 1.4–7.0; P < 0.008) and TP burden on follow-up CTA. Conclusion PCAT attenuation measured from routine CTA is related to the progression of NCP and TP burden. This imaging biomarker may help to identify patients at increased risk of high-risk plaque progression and allow monitoring of beneficial changes from medical therapy.

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European Heart Journal Cardiovascular Imaging

Tập 20 Số 6

636-643

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