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Relationship between changes in pericoronary adipose tissue attenuation and coronary plaque burden quantified from coronary computed tomography angiography.
Eur Heart J Cardiovasc Imaging. 2019 Jun 01; 20(6):636-643.EH

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.

Authors+Show Affiliations

Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, S. Mark Taper Building, Los Angeles, CA, USA. Department of Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Faculty of Medicine, Erlangen, Germany.Department of Imaging and Medicine, and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.Department of Imaging and Medicine, and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.Department of Imaging and Medicine, and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, S. Mark Taper Building, Los Angeles, CA, USA.Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, S. Mark Taper Building, Los Angeles, CA, USA.Department of Imaging and Medicine, and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.Department of Imaging and Medicine, and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.Department of Imaging and Medicine, and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.Department of Imaging and Medicine, and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.Department of Imaging and Medicine, and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.Department of Cardiology, St Francis Hospital, New York, NY, USA.Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany.Department of Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Faculty of Medicine, Erlangen, Germany.Department of Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Faculty of Medicine, Erlangen, Germany.Department of Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Faculty of Medicine, Erlangen, Germany.Department of Imaging and Medicine, and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, S. Mark Taper Building, Los Angeles, CA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30789223

Citation

Goeller, Markus, et al. "Relationship Between Changes in Pericoronary Adipose Tissue Attenuation and Coronary Plaque Burden Quantified From Coronary Computed Tomography Angiography." European Heart Journal Cardiovascular Imaging, vol. 20, no. 6, 2019, pp. 636-643.
Goeller M, Tamarappoo BK, Kwan AC, et al. Relationship between changes in pericoronary adipose tissue attenuation and coronary plaque burden quantified from coronary computed tomography angiography. Eur Heart J Cardiovasc Imaging. 2019;20(6):636-643.
Goeller, M., Tamarappoo, B. K., Kwan, A. C., Cadet, S., Commandeur, F., Razipour, A., Slomka, P. J., Gransar, H., Chen, X., Otaki, Y., Friedman, J. D., Cao, J. J., Albrecht, M. H., Bittner, D. O., Marwan, M., Achenbach, S., Berman, D. S., & Dey, D. (2019). Relationship between changes in pericoronary adipose tissue attenuation and coronary plaque burden quantified from coronary computed tomography angiography. European Heart Journal Cardiovascular Imaging, 20(6), 636-643. https://doi.org/10.1093/ehjci/jez013
Goeller M, et al. Relationship Between Changes in Pericoronary Adipose Tissue Attenuation and Coronary Plaque Burden Quantified From Coronary Computed Tomography Angiography. Eur Heart J Cardiovasc Imaging. 2019 Jun 1;20(6):636-643. PubMed PMID: 30789223.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between changes in pericoronary adipose tissue attenuation and coronary plaque burden quantified from coronary computed tomography angiography. AU - Goeller,Markus, AU - Tamarappoo,Balaji K, AU - Kwan,Alan C, AU - Cadet,Sebastien, AU - Commandeur,Frederic, AU - Razipour,Aryabod, AU - Slomka,Piotr J, AU - Gransar,Heidi, AU - Chen,Xi, AU - Otaki,Yuka, AU - Friedman,John D, AU - Cao,J Jane, AU - Albrecht,Moritz H, AU - Bittner,Daniel O, AU - Marwan,Mohamed, AU - Achenbach,Stephan, AU - Berman,Daniel S, AU - Dey,Damini, PY - 2018/10/23/received PY - 2018/12/10/revised PY - 2019/01/21/accepted PY - 2019/2/23/pubmed PY - 2020/10/9/medline PY - 2019/2/22/entrez KW - CT attenuation KW - coronary CT angiography KW - coronary plaque progression KW - inflammation KW - pericoronary adipose tissue SP - 636 EP - 643 JF - European heart journal cardiovascular Imaging JO - Eur Heart J Cardiovasc Imaging VL - 20 IS - 6 N2 - 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. SN - 2047-2412 UR - https://www.unboundmedicine.com/medline/citation/30789223/Relationship_between_changes_in_pericoronary_adipose_tissue_attenuation_and_coronary_plaque_burden_quantified_from_coronary_computed_tomography_angiography_ L2 - https://academic.oup.com/ehjcimaging/article-lookup/doi/10.1093/ehjci/jez013 DB - PRIME DP - Unbound Medicine ER -