Association of Epicardial and Abdominal Visceral Adipose Tissue With Coronary Atherosclerosis in Patients With a Coronary Artery Calcium Score of Zero

Tsushima, Hirofumi; Yamamoto, Hideya; Kitagawa, Toshiro; Urabe, Yoji; Tatsugami, Fuminari; Awai, Kazuo; Kihara, Yasuki

doi:10.1253/circj.cj-14-1169

Cited by 34 publications

(21 citation statements)

References 34 publications

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“…This may be a reflection of the smaller number of subjects in our study compared with previous studies. Nevertheless, while we have recently reported that high EAT volume is associated with the presence of NCP on CCTA in patients with a CCS of zero [26], another group has reported that baseline and serial change in EAT volume are not related to the development of incidental coronary artery calcification in a similar population [27]. Furthermore, a recent study in a diverse population of symptomatic patients did not find a significant relationship between EAT volume and the presence and extent of coronary arterial calcification measured by cardiac CT [28].…”

Section: Volumetric Assessment Of Eatmentioning

confidence: 67%

The relationship between inflammation and neoangiogenesis of epicardial adipose tissue and coronary atherosclerosis based on computed tomography analysis

et al. 2015

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Section: Volumetric Assessment Of Eatmentioning

confidence: 67%

The relationship between inflammation and neoangiogenesis of epicardial adipose tissue and coronary atherosclerosis based on computed tomography analysis

et al. 2015

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“…In a study of intravascular ultrasound (IVUS) examinations, increased EAT volume was significantly associated with necrotic plaque tissue 30) . Other studies of cardiac CT also showed that higher EAT volume was associated with the presence of NCP 31, 32) . However, these were cross-sectional studies that cannot infer a causal relationship.…”

Section: Discussionmentioning

confidence: 79%

“…Recent cross-sectional studies showed that, among patients with a CAC score of zero, EAT measurement would have a clinical role in the detection of NCP, which cannot be detected on a CAC scan 31) . Further, increased EAT volume is associated with necrotic plaque tissue 30) .…”

Section: Discussionmentioning

confidence: 99%

Epicardial Adipose Tissue Contributes to the Development of Non-Calcified Coronary Plaque: A 5-Year Computed Tomography Follow-up Study

Hwang

Park

Choi

2017

J Atheroscler Thromb

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Aim: Epicardial adipose tissue (EAT) has been suggested as a contributing factor for coronary atherosclerosis based on the previous cross-sectional studies and pathophysiologic background. However, a causal relationship between EAT and the development of non-calcified coronary plaque (NCP) has not been investigated.Methods: A total of 122 asymptomatic individuals (age, 56.0 ± 7.6 years; male, 80.3%) without prior history of coronary artery disease (CAD) or metabolic syndrome and without NCP or obstructive CAD at baseline cardiac computed tomography (CT) were enrolled. Repeat cardiac CT was performed with an interval of more than 5 years. Epicardial fat volume index (EFVi; cm3/m2) was assessed in relation to the development of NCP on the follow-up CT where the results were classified into “calcified plaque (CP),” “no plaque,” and “NCP” groups.Results: On the follow-up CT performed with a median interval of 65.4 months, we observed newly developed NCP in 24 (19.7%) participants. Baseline EFVi was significantly higher in the NCP group (79.9 ± 30.3 cm3/m2) than in the CP group (63.7 ± 22.7 cm3/m2; P = 0.019) and in the no plaque group (62.5 ± 24.7 cm3/m2; P = 0.021). Multivariable logistic regression analysis demonstrated that the presence of diabetes (OR, 9.081; 95% CI, 1.682–49.034; P = 0.010) and the 3rd tertile of EFVi (OR, 4.297; 95% CI, 1.040–17.757; P = 0.044 compared to the 1st tertile) were the significant predictors for the development of NCP on follow-up CT.Conclusions: Greater amount of EAT at baseline CT independently predicts the development of NCP in asymptomatic individuals.

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“…The CoRE-64 study found that 19% of patients with zero CAC scores had obstructive CAD 9) . Our previous study with a 64-slice CT found NCP/PCPs in 29% and obstructive stenosis in 4% of suspected CAD patients with zero CAC scores 22) . In the present study, the prevalence of obstructive CAD in the conventional zero CAC group decreased from 9% to 5.2% with the use of 0.5-mm thin-slice reconstructions.…”

Section: Discussionmentioning

confidence: 90%

Identifying Small Coronary Calcification in Non-Contrast 0.5-mm Slice Reconstruction to Diagnose Coronary Artery Disease in Patients with a Conventional Zero Coronary Artery Calcium Score

Urabe

Yamamoto

Kitagawa

et al. 2016

JAT

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Aims: In a new-generation computed tomography (CT) scanner, coronary artery calcium (CAC) scores were measured using 3.0-mm slice reconstruction images originally acquired with 0.5 mm thickness scans in a single beat. This study investigated the usefulness of thin-slice (0.5 mm) reconstruction for identifying small calcifications in coronary arteries and evaluated the association with coronary plaques and stenosis compared to conventional 3.0-mm reconstruction images.Methods: We evaluated 132 patients with zero CAC scores in conventional 3.0-mm Agatston method using a 320-slice CT. Then, 0.5-mm slice reconstruction was performed to identify small calcifications. The presence of stenosis and coronary plaques was assessed using coronary CT angiography.Results: In total, 22 small calcifications were identified in 18 patients. There were 28 (21%) patients with any (≥ 25%) stenosis (34 lesions). Forty-seven coronary plaques were found in 33 patients (25%), including 7 calcified plaques in 7 patients (5%), 34 noncalcified plaques in 27 patients (20%), and 6 partially calcified plaques in 5 patients (4%). Patients with small calcifications had a significantly higher prevalence of noncalcified or partially calcified plaques (83% vs 14%; p < 0.001) and obstructive stenosis (33% vs 5.2%; p < 0.001) compared to those without small calcifications. The addition of small calcifications to the coronary risk factors when diagnosing stenosis significantly improved the diagnostic value.Conclusion: Small calcifications detected by thin-slice 0.5-mm reconstruction are useful for distinguishing coronary atherosclerotic lesions in patients with zero CAC scores from conventional CT reconstruction.

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Association of Epicardial and Abdominal Visceral Adipose Tissue With Coronary Atherosclerosis in Patients With a Coronary Artery Calcium Score of Zero

Cited by 34 publications

References 34 publications

The relationship between inflammation and neoangiogenesis of epicardial adipose tissue and coronary atherosclerosis based on computed tomography analysis

The relationship between inflammation and neoangiogenesis of epicardial adipose tissue and coronary atherosclerosis based on computed tomography analysis

Epicardial Adipose Tissue Contributes to the Development of Non-Calcified Coronary Plaque: A 5-Year Computed Tomography Follow-up Study

Identifying Small Coronary Calcification in Non-Contrast 0.5-mm Slice Reconstruction to Diagnose Coronary Artery Disease in Patients with a Conventional Zero Coronary Artery Calcium Score

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