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

Goeller M, Tamarappoo BK, Kwan AC, Cadet S, Commandeur F, Razipour A, Slomka PJ, Gransar H, Chen X, Otaki Y, Friedman JD, Cao JJ, Albrecht MH, Bittner DO, Achenbach S, Berman DS, Dey D, Marwan M (2019)

Publication Type: Journal article

Publication year: 2019

Journal

European Heart Journal - Cardiovascular Imaging Oxford University Press

Book Volume: 20

Pages Range: 636-643

Journal Issue: 6

DOI: 10.1093/ehjci/jez013

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 with CRIS profile

Stephan Achenbach Department of Medicine 2 – Cardiology and Angiology Mohamed Marwan Department of Medicine 2 – Cardiology and Angiology

Involved external institutions

Cedars-Sinai Medical Center US United States (USA) (US) St. Francis Hospital US United States (USA) (US) Universitätsklinikum Frankfurt am Main (KGU) DE Germany (DE)

How to cite

APA:

Goeller, M., Tamarappoo, B.K., Kwan, A.C., Cadet, S., Commandeur, F., Razipour, A.,... Marwan, M. (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

MLA:

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 20.6 (2019): 636-643.

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