Pericoronary Fat Attenuation: Diagnosis and Clinical Implications

Maurovich-Horvat P, Bosserdt M, Kofoed KF, Rieckmann N, Benedek T, Donnelly P, et al. CT or invasive coronary angiography in stable chest pain. N Engl J Med. 2022;386(17):1591–602.

Article  PubMed  Google Scholar 

Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, et al. Heart disease and stroke statistics-2023 update: a report from the American Heart Association. Circulation. 2023;147(8):e93–621.

Article  PubMed  Google Scholar 

Andreini D, Pontone G, Mushtaq S, Gransar H, Conte E, Bartorelli AL, et al. Long-term prognostic impact of CT-Leaman score in patients with non-obstructive CAD: results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) study. Int J Cardiol. 2017;231:18–25.

Article  PubMed  Google Scholar 

Lee S-E, Sung Ji M, Andreini D, Al-Mallah Mouaz H, Budoff Matthew J, Cademartiri F, et al. Differences in progression to obstructive lesions per high-risk plaque features and plaque volumes with CCTA. JACC Cardiovasc Imaging. 2020;13(6):1409–17.

Article  PubMed  Google Scholar 

Douglas PS, Hoffmann U, Patel MR, Mark DB, Al-Khalidi HR, Cavanaugh B, et al. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med. 2015;372(14):1291–300.

Article  CAS  PubMed  PubMed Central  Google Scholar 

CT coronary angiography in patients with suspected angina due to coronary heart disease (SCOT-HEART): an open-label, parallel-group, multicentre trial. Lancet. 2015;385(9985):2383–91. https://doi.org/10.1016/S0140-6736(15)60291-4.

Fishbein MC, Siegel RJ. How big are coronary atherosclerotic plaques that rupture? Circulation. 1996;94(10):2662–6.

Article  CAS  PubMed  Google Scholar 

Fleg JL, Stone GW, Fayad ZA, Granada JF, Hatsukami TS, Kolodgie FD, et al. Detection of high-risk atherosclerotic plaque: report of the NHLBI Working Group on current status and future directions. JACC Cardiovasc Imaging. 2012;5(9):941–55.

Article  PubMed  PubMed Central  Google Scholar 

Matter CM, Stuber M, Nahrendorf M. Imaging of the unstable plaque: how far have we got? Eur Heart J. 2009;30(21):2566–74.

Article  PubMed  PubMed Central  Google Scholar 

Halațiu VB, Benedek I, Rodean IP, Cojocariu LO, Mihăilă T, Blîndu E, et al. Coronary computed tomography angiography-derived modified duke index is associated with peri-coronary fat attenuation index and predicts severity of coronary inflammation. Medicina (Kaunas). 2024;60(5). https://doi.org/10.3390/medicina60050765.

Antonopoulos AS, Sanna F, Sabharwal N, Thomas S, Oikonomou EK, Herdman L, et al. Detecting human coronary inflammation by imaging perivascular fat. Sci Transl Med. 2017;9(398). https://doi.org/10.1126/scitranslmed.aal2658.

Oikonomou EK, Marwan M, Desai MY, Mancio J, Alashi A, Hutt Centeno E, et al. Non-invasive detection of coronary inflammation using computed tomography and prediction of residual cardiovascular risk (the CRISP CT study): a post-hoc analysis of prospective outcome data. Lancet. 2018;392(10151):929–39.

Article  PubMed  PubMed Central  Google Scholar 

Ross R. Atherosclerosis–an inflammatory disease. N Engl J Med. 1999;340(2):115–26.

Article  CAS  PubMed  Google Scholar 

Mazurek T, Zhang L, Zalewski A, Mannion JD, Diehl JT, Arafat H, et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation. 2003;108(20):2460–6.

Article  PubMed  Google Scholar 

Mancio J, Oikonomou EK, Antoniades C. Perivascular adipose tissue and coronary atherosclerosis. Heart. 2018;104(20):1654–62.

Article  CAS  PubMed  Google Scholar 

Antoniades C, Antonopoulos AS, Tousoulis D, Stefanadis C. Adiponectin: from obesity to cardiovascular disease. Obes Rev. 2009;10(3):269–79.

Article  CAS  PubMed  Google Scholar 

Antonopoulos AS, Margaritis M, Coutinho P, Shirodaria C, Psarros C, Herdman L, et al. Adiponectin as a link between type 2 diabetes and vascular NADPH oxidase activity in the human arterial wall: the regulatory role of perivascular adipose tissue. Diabetes. 2015;64(6):2207–19.

Article  CAS  PubMed  Google Scholar 

Margaritis M, Antonopoulos AS, Digby J, Lee R, Reilly S, Coutinho P, et al. Interactions between vascular wall and perivascular adipose tissue reveal novel roles for adiponectin in the regulation of endothelial nitric oxide synthase function in human vessels. Circulation. 2013;127(22):2209–21.

Article  CAS  PubMed  Google Scholar 

Sagris M, Antonopoulos AS, Simantiris S, Oikonomou E, Siasos G, Tsioufis K, et al. Pericoronary fat attenuation index-a new imaging biomarker and its diagnostic and prognostic utility: a systematic review and meta-analysis. Eur Heart J Cardiovasc Imaging. 2022;23(12):e526–36.

Article  PubMed  PubMed Central  Google Scholar 

Antonopoulos AS, Sanna F, Sabharwal N, Thomas S, Oikonomou EK, Herdman L, et al. Detecting human coronary inflammation by imaging perivascular fat. Sci Transl Med. 2017;9(398):eaal2658.

Article  PubMed  Google Scholar 

Joshi NV, Vesey AT, Williams MC, Shah AS, Calvert PA, Craighead FH, et al. 18F-fluoride positron emission tomography for identification of ruptured and high-risk coronary atherosclerotic plaques: a prospective clinical trial. Lancet. 2014;383(9918):705–13.

Article  PubMed  Google Scholar 

Wang K-L, Balmforth C, Meah Mohammed N, Daghem M, Moss Alastair J, Tzolos E, et al. Coronary atherosclerotic plaque activity and risk of myocardial infarction. J Am Coll Cardiol. 2024;83(22):2135–44.

Article  CAS  PubMed  Google Scholar 

Maurovich-Horvat P, Ferencik M, Voros S, Merkely B, Hoffmann U. Comprehensive plaque assessment by coronary CT angiography. Nat Rev Cardiol. 2014;11(7):390–402.

Article  PubMed  Google Scholar 

Hong MK, Mintz GS, Lee CW, Lee BK, Yang TH, Kim YH, et al. The site of plaque rupture in native coronary arteries: a three-vessel intravascular ultrasound analysis. J Am Coll Cardiol. 2005;46(2):261–5.

Article  PubMed  Google Scholar 

Chan K, Wahome E, Tsiachristas A, Antonopoulos AS, Patel P, Lyasheva M, et al. Inflammatory risk and cardiovascular events in patients without obstructive coronary artery disease: the ORFAN multicentre, longitudinal cohort study. Lancet. 2024. https://doi.org/10.1016/S0140-6736(24)00596-8.

Oikonomou EK, Williams MC, Kotanidis CP, Desai MY, Marwan M, Antonopoulos AS, et al. A novel machine learning-derived radiotranscriptomic signature of perivascular fat improves cardiac risk prediction using coronary CT angiography. Eur Heart J. 2019;40(43):3529–43.

Article  PubMed  PubMed Central  Google Scholar 

Hoshino M, Yang S, Sugiyama T, Zhang J, Kanaji Y, Yamaguchi M, et al. Peri-coronary inflammation is associated with findings on coronary computed tomography angiography and fractional flow reserve. J Cardiovasc Comput Tomogr. 2020;14(6):483–9.

Article  PubMed  Google Scholar 

Yu M, Dai X, Deng J, Lu Z, Shen C, Zhang J. Diagnostic performance of perivascular fat attenuation index to predict hemodynamic significance of coronary stenosis: a preliminary coronary computed tomography angiography study. Eur Radiol. 2020;30(2):673–81.

Article  PubMed  Google Scholar 

Wen D, Li J, Ren J, Zhao H, Li J, Zheng M. Pericoronary adipose tissue CT attenuation and volume: diagnostic performance for hemodynamically significant stenosis in patients with suspected coronary artery disease. Eur J Radiol. 2021;140:109740.

Article  PubMed  Google Scholar 

Ahmed AI, Saad JM, Han Y, Alahdab F, Malahfji M, Nabi F, et al. Coronary microvascular health in patients with prior COVID-19 infection. JACC Cardiovasc Imaging. 2022;15(12):2153–5.

Google Scholar 

Malahfji M, Crudo V, Ahmed AI, Saeed M, Saad JM, Zoghbi WA, et al. Coronary microvascular dysfunction and COVID-19: implications for long COVID patients. J Nucl Cardiol. 2023;30(5):2204–6.

Article  PubMed  Google Scholar 

Wang Y, Perlman S. COVID-19: inflammatory profile. Annu Rev Med. 2022;73:65–80.

Article  CAS  PubMed  Google Scholar 

Jiang Y, Zhao T, Zhou X, Xiang Y, Gutierrez-Castrellon P, Ma X. Inflammatory pathways in COVID-19: mechanism and therapeutic interventions. MedComm (2020). 2022;3(3):e154.

Article  CAS  PubMed  Google Scholar 

Zapata MR, Pandit T, Goyal L, Ajmera K, Chourasia P, Pandit R. Multisystem inflammatory syndrome due to COVID-19 infection in vaccinated versus unvaccinated adolescents: a case report. Cureus. 2023;15(9):e45564.

PubMed  PubMed Central  Google Scholar 

Mátyás BB, Benedek I, Blîndu E, Gerculy R, Roșca A, Rat N, et al. Elevated FAI index of pericoronary inflammation on coronary CT identifies increased risk of coronary plaque vulnerability after COVID-19 infection. Int J Mol Sci. 2023;24(8). https://doi.org/10.3390/ijms24087398.

Sevilla T, Aparisi-Sanz Á, Aristizábal-Duque C, Gómez-Salvador I, Baladrón C, San RA. Epicardial adipose tissue attenuation in admitted patients with COVID-19. Rev Esp Cardiol (Engl Ed). 2022;75(1):98–100.

Comments (0)

No login
gif