Pericoronary adipose tissue attenuation predicts compositional plaque changes: a 12-month longitudinal study in individuals with type 2 diabetes without symptoms or known coronary artery disease

Cardiovascular Diabetology, Journal Year: 2025, Volume and Issue: 24(1)

Published: March 28, 2025

Abstract Background Pericoronary adipose tissue attenuation (PCATa), derived from coronary computed tomography angiography (CCTA), is a novel marker of inflammation in the arteries. Patients with type 2 diabetes mellitus (T2DM) are at elevated risk artery disease (CAD), potentially due to systemic inflammation. This study evaluated whether baseline PCATa predicts changes plaque composition and burden over 12 months. Methods prospective longitudinal included 200 participants T2DM, who had neither symptoms nor prior diagnosis CAD (mean age 61 ± 9.4 years, 72% male). was measured scan along proximal 40 mm each major artery, values were averaged calculate participant-level PCATa. High levels determined using validated cut-off -70.1 Hounsfield units. Compositional quantified as differences between 12-month scans, calculated normalized atheroma volume. Multivariable regression analyses assessed associations compositional factors, including high PCATa, predicting non-calcified progression. Results Plaque volumes increased months, while remained stable. After multivariable adjustments, significantly associated total volume (β = 0.005, p 0.005), 0.006, 0.007), 1.7, 2.0, 0.006), but not calcified or burden. observed 44 (22%) only independent predictor progression (odds ratio 3.5, 0.002). Conclusions Baseline increases months T2DM without known CAD. uniquely predict progression, suggesting that may serve for subclinical atherosclerosis warrants further investigation into cardiovascular assessment, particularly high-risk populations such individuals T2DM. Trial registration registration: NCT06644651. Graphical abstract Adipose Tissue attenuation. Type mellitus. Coronary Artery Disease. N numbers. CCTA CT angiography. Created BioRender. Research insights What currently about this topic? (CAD) share inflammatory mechanisms. Individuals face two- four-fold compared those (PCATa) key research question? Can CAD? new? relates higher (NCP) after adjustment. associates total- NCP (> HU) independently How might influence clinical practice? be

Language: Английский

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

European Radiology, Journal Year: 2021, Volume and Issue: 31(10), P. 7251 - 7261

Published: April 16, 2021

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

Language: Английский

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Evaluation of pericoronary adipose tissue attenuation on CT

British Journal of Radiology, Journal Year: 2023, Volume and Issue: 96(1145)

Published: Jan. 6, 2023

Pericoronary adipose tissue (PCAT) is the fat deposit surrounding coronary arteries. Although PCAT part of larger epicardial (EAT) depot, it has different pathophysiological features and roles in atherosclerosis process. While EAT evaluation been studied for years, a relatively new concept. PCAT, especially mean attenuation derived from CT images may be used to evaluate inflammatory status arteries non-invasively. The most commonly measure, PCATMA, 3 mm thickness around proximal right artery with length 40 mm. PCATMA can analyzed on per-lesion, per-vessel or per-patient basis. Apart other measures have studied, such as thickness, volume. Studies shown associations between anatomical functional severity disease. associated plaque components high-risk features, discriminate patients flow obstructing stenosis myocardial infarction. Whether value an individual patient basis remains determined. Furthermore, imaging settings, kV levels clinical factors age sex affect measurements, which complicate implementation practice. For widely implemented, standardized methodology needed. This review gives overview reported methodologies current literature potential use cases

Language: Английский

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Sex-Specific Association Between Perivascular Inflammation and Plaque Vulnerability

Circulation Cardiovascular Imaging, Journal Year: 2024, Volume and Issue: 17(2)

Published: Feb. 1, 2024

BACKGROUND: It is not known whether there a sex difference in the association between perivascular inflammation and plaque vulnerability. The aim of this study was to investigate sex-specific METHODS: Patients who underwent coronary computed tomography angiography optical coherence were enrolled. All images analyzed at core laboratory. level assessed by pericoronary adipose tissue attenuation on vulnerability tomography. classified into 3 groups according tertile levels culprit vessel (low inflammation, ≤−73.1 Hounsfield units; moderate −73.0 −67.0 or high ≥−66.9 units). RESULTS: A total 968 lesions 409 patients included: 184 82 women (2.2 plaques per patient) 784 327 men (2.4 patient). Women older (median age, 71 versus 65 years; P <0.001) had less severe artery disease with lower burden than men. In women, it found that significantly associated vulnerability, higher prevalence thin-cap fibroatheroma greater macrophage grades group compared low women: 18.5% 31.8% 46.9%, =0.002 for inflammation; 4 12, <0.001 respectively). However, no significant differences observed among CONCLUSIONS: Perivascular more accumulation but REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04523194.

Language: Английский

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The pericoronary adipose tissue attenuation in CT strongly depends on kernels and iterative reconstructions

European Radiology, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 18, 2024

To investigate the influence of kernels and iterative reconstructions on pericoronary adipose tissue (PCAT) attenuation in coronary CT angiography (CCTA).

Language: Английский

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Imaging of the Pericoronary Adipose Tissue (PCAT) Using Cardiac Computed Tomography

Journal of Thoracic Imaging, Journal Year: 2021, Volume and Issue: 36(3), P. 149 - 161

Published: March 11, 2021

Modern coronary computed tomography angiography (CTA) is the gold standard to visualize epicardial adipose tissue (EAT) and pericoronary (PCAT). The EAT a metabolic active fat depot enclosed by visceral pericardium surrounds arteries. In disease states with increased volume dysfunctional adipocytes, secretes an amount of adipocytokines resulting imbalance proinflammatory anti-inflammatory mediators potentially causes atherogenic effects on vessel wall in paracrine way (“outside-to-inside” signaling). These EAT-induced are reported increase risk for development artery disease, myocardial ischemia, high-risk plaque features, future major adverse cardiac events. Coronary inflammation plays key role progression disease; however, its noninvasive detection remains challenging. future, this clinical dilemma might be changed CTA-derived analysis PCAT. On basis concept “inside-to-outside” signaling between inflamed surrounding PCAT recent evidence demonstrates that attenuation especially around right derived from routine CTA promising imaging biomarker “sensor” noninvasively detect inflammation. This review summarizes biological technical principles highlights implications improve modern cardiovascular prevention strategies.

Language: Английский

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Increased coronary pericoronary adipose tissue attenuation in diabetic patients compared to non-diabetic controls: A propensity score matching analysis

Journal of cardiovascular computed tomography, Journal Year: 2022, Volume and Issue: 16(4), P. 327 - 335

Published: Jan. 26, 2022

Language: Английский

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Radiomics features of pericoronary adipose tissue improve CT-FFR performance in predicting hemodynamically significant coronary artery stenosis

European Radiology, Journal Year: 2022, Volume and Issue: 33(3), P. 2004 - 2014

Published: Oct. 18, 2022

Language: Английский

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Ethnic Differences in Pericoronary Adipose Tissue Attenuation

JACC Asia, Journal Year: 2025, Volume and Issue: 5(1), P. 12 - 14

Published: Jan. 1, 2025

Language: Английский

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High-risk plaque features and perivascular inflammation

Journal of cardiovascular computed tomography, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

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