Coronary Plaque Geometry and Thoracic Fat Distribution in Patients with Acute Chest Pain – a CT Angiography Study

Abstract

The aim of our study was to investigate the correlation between volumes of thoracic fat distributed in different compartments and the geometry of vulnerable coronary plaques assessed by coronary computed tomography angiography (CCTA), in patients with acute chest pain. Methods: This was a non-randomized, observational, single-center study, including 50 patients who presented in the emergency department with acute chest pain who underwent 128-slice single-source CCTA. Plaque geometry was evaluated in transversal and longitudinal planes, and the assessment of adipose tissue was performed using the Syngo.via Frontier (Siemens AG, Healthcare Sector, Forchheim, Germany) research platform. Results: Eccentric plaques presented a significantly higher incidence of spotty calcification (40% vs. 22%, p = 0.018), whereas positive remodeling, volume of low attenuation plaque, and incidence of napkin-ring sign were not significantly different between the study groups or in ascending versus descending plaques. The volume of pericoronary fat around the plaque was significantly larger near eccentric lesions (707.68 ± 454.08 mm3 vs. 483.25 ± 306.98 mm3, p = 0.046) and descendent plaques (778.26 ± 479.37 mm3 vs. 473.60 ± 285.27 mm3, p = 0.016). Compared to ascending lesions, descendent ones presented a significantly larger volume of thoracic fat (1,599.25 ± 589.12 mL vs. 1,240.71 ± 291.50 mL), while there was no significant correlation between thoracic fat and cross-sectional eccentricity. Conclusions: The phenotype of plaque distribution and geometry seems to be associated with a higher vulnerability of coronary lesions and may be influenced by the local accumulation of inflammatory mediators released by the pericoronary epicardial adipose tissue.

Relation of cardiac adipose tissue to coronary calcification and myocardial microvascular function in type 1 and type 2 diabetes

“…We applied robust methodology: CT acquisition and assessment followed standard methods and cardiac adipose tissue was automatically quantified using the cardiac software, Syngo.via Frontier [26,27]. The volumes of cardiac adipose tissue observed in this study were consistent with those previously reported [6,[28][29][30].…”

Consistency in Geometry Among Coronary Atherosclerotic Plaques Extracted From Computed Tomography Angiography

“…Non-calcified, partially calcified, and calcified plaques could be extracted separately based on their attenuation values (Daghem et al, 2020). Therefore, CCTA has been widely applied in the analysis of coronary plaque geometry (Rinehart et al, 2011;Ratiu et al, 2019).…”

Computer-Aided Biomedical Imaging of Periiliac Adipose Tissue Identifies Perivascular Fat as a Marker of Disease Complexity in Patients with Lower Limb Ischemia

“…It has been recently suggested that the adipose tissue may play a significant role in the complex process of atheromatous plaque progression and destabilization [2]. Adipose tissue is a tissue present throughout the body and has multiple roles in the complex thermoregulation process.…”