Gender differences in the association of epicardial adipose tissue and coronary artery calcification: EPICHEART study

Mâncio, Jennifer; Pinheiro, Marilia de Fátima Silva; Ferreira, Wilson; Carvalho, Mónica; Barros, António S.; Ferreira, Nuno; Vouga, Luís; Ribeiro, Vasco Gama; Leite‐Moreira, Adelino F.; Falcão-Pires, Inês; Bettencourt, Nuno

doi:10.1016/j.ijcard.2017.09.178

Cited by 33 publications

(17 citation statements)

References 40 publications

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“…Our study showed that men had significantly larger PFA than women. Mancio et al also reported that men had higher PFV than women (137 ± 65.6 vs. 106 ± 65.6 mL, P < 0.01) [9], showing that our result by PFA was consistent with the previous result by PFV. Body composition differs between men and women, and men are more likely to accumulate adipose tissue around the trunk and abdomen, whereas women usually accumulate adipose tissue around the hips and thighs [10].…”

Section: Discussionsupporting

confidence: 91%

Associations of Pericardial Fat Area Determined by Routine Chest Computed Tomography With Coronary Risk Factors and Coronary Artery Disease

et al. 2019

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BackgroundPericardial fat has been reported to be associated with coronary risk factors and severity of coronary arterial lesions. Previous studies had measured pericardial fat volume (PFV) by using contrast-enhanced cardiac computed tomography (CT) when pericardial fat was quantified. We determined pericardial fat area (PFA) in the cross section with the height of sternal angle by using routine chest CT.MethodsWe picked up 252 patients who underwent chest and abdominal CT, and we selected patients whose coronary arteries were evaluated by coronary angiography or coronary CT. Coronary artery disease (CAD) was defined as more than 75% lumen stenosis. PFA was defined as any pixel with CT attenuation of -150 to -30 Hounsfield Unit (HU) within the pericardial sac at the sternal angle level.ResultsFifty-three patients were eligible. PFA was significantly larger in men than in women. Serum high-density lipoprotein (HDL)-cholesterol level was significantly and negatively correlated with PFA. Hemoglobin A1c and carotid arterial intima-media thickness tended to be positively correlated with PFA. PFA was significantly and nearly 50% larger in patients with CAD than in patients without CAD. The cut-off value of PFA was 10.4 cm2, and sensitivity and specificity of PFA for CAD were 53.8% and 88.0%, respectively.ConclusionsPresent study is the first to show a significant association of PFA with gender and CAD. PFA can be determined by routine chest CT, and is simpler and more reproducible, and PFA is more available in a greater number of medical institutes as compared with PFV. Present study also showed a discriminatory value of PFA for CAD comparable to PFV.

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Section: Discussionsupporting

confidence: 91%

Associations of Pericardial Fat Area Determined by Routine Chest Computed Tomography With Coronary Risk Factors and Coronary Artery Disease

et al. 2019

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“…Sex-related differences in PCAT MA could be caused by several factors. Men have a higher amount of EAT than women [34,35], related to cardiovascular risk. There are sex-related differences in the regulation mechanism of pericardial adipokines [36] and in the physiological mechanism of adipose tissue [37].…”

Section: Discussionmentioning

confidence: 96%

Towards reference values of pericoronary adipose tissue attenuation: impact of coronary artery and tube voltage in coronary computed tomography angiography

Ties

Assen

et al. 2020

Eur Radiol

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Objectives To determine normal pericoronary adipose tissue mean attenuation (PCATMA) values for left the anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA) in patients without plaques on coronary CT angiography (cCTA), taking into account tube voltage influence. Methods This retrospective study included 192 patients (76 (39.6%) men; median age 49 years (range, 19–79)) who underwent cCTA with third-generation dual-source CT for the suspicion of CAD between 2015 and 2017. We selected patients without plaque on cCTA. PCATMA was measured semi-automatically on cCTA images in the proximal segment of the three main coronary arteries with 10 mm length. Paired t-testing was used to compare PCATMA between combinations of two coronary arteries within each patient, and one-way ANOVA testing was used to compare PCATMA in different kV groups. Results The overall mean ± standard deviation (SD) PCATMA was − 90.3 ± 11.1 HU. PCATMA in men was higher than that in women: − 88.5 ± 10.5 HU versus − 91.5 ± 11.3 HU (p = 0.001). PCATMA of LAD, LCX, and RCA was − 92.4 ± 11.6 HU, − 88.4 ± 9.9 HU, and − 90.2 ± 11.4 HU, respectively. Pairwise comparison of the arteries showed significant difference in PCATMA: LAD and LCX (p < 0.001), LAD and RCA (p = 0.009), LCX and RCA (p = 0.033). PCATMA of the 70 kV, 80 kV, 90 kV, 100 kV, and 120 kV groups was − 95.6 ± 9.6 HU, − 90.2 ± 11.5 HU, − 87.3 ± 9.9 HU, − 82.7 ± 6.2 HU, and − 79.3 ± 6.8 HU, respectively (p < 0.001). Conclusions In patients without plaque on cCTA, PCATMA varied by tube voltage, with minor differences in PCATMA between coronary arteries (LAD, LCX, RCA). PCATMA values need to be interpreted taking into account tube voltage setting. Key Points • In patients without plaque on cCTA, PCATMAdiffers slightly by coronary artery (LAD, LCX, RCA). • Tube voltage of cCTA affects PCATMAmeasurement, with mean PCATMAincreasing linearly with increasing kV. • For longitudinal cCTA analysis of PCATMA, the use of equal kV setting is strongly recommended.

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“…EAT holds similar pathogenic characteristics with a pro-inflammatory secretory capacity [21] and a high lipolytic activity which exceeds that of intra-abdominal fat [22]. Men are known to have more cardiac fat compared to women [23], yet, it is not known whether this translates to an increased risk of CVD.…”

Section: Introductionmentioning

confidence: 99%

Epicardial adipose tissue predicts incident cardiovascular disease and mortality in patients with type 2 diabetes

Christensen

Scholten

Hansen

et al. 2019

Cardiovasc Diabetol

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Background Cardiac fat is a cardiovascular biomarker but its importance in patients with type 2 diabetes is not clear. The aim was to evaluate the predictive potential of epicardial (EAT), pericardial (PAT) and total cardiac (CAT) fat in type 2 diabetes and elucidate sex differences. Methods EAT and PAT were measured by echocardiography in 1030 patients with type 2 diabetes. Follow-up was performed through national registries. The end-point was the composite of incident cardiovascular disease (CVD) and all-cause mortality. Analyses were unadjusted (model 1), adjusted for age and sex (model 2), plus systolic blood pressure, body mass index (BMI), low-density lipoprotein (LDL), smoking, diabetes duration and glycated hemoglobin (HbA 1c ) (model 3). Results Median follow-up was 4.7 years and 248 patients (191 men vs. 57 women) experienced the composite end-point. Patients with high EAT (> median level) had increased risk of the composite end-point in model 1 [Hazard ratio (HR): 1.46 (1.13; 1.88), p = 0.004], model 2 [HR: 1.31 (1.01; 1.69), p = 0.038], and borderline in model 3 [HR: 1.32 (0.99; 1.77), p = 0.058]. For men, but not women, high EAT was associated with a 41% increased risk of CVD and mortality in model 3 ( p = 0.041). Net reclassification index improved when high EAT was added to model 3 (19.6%, p = 0.035). PAT or CAT were not associated with the end-point. Conclusion High levels of EAT were associated with the composite of incident CVD and mortality in patients with type 2 diabetes, particularly in men, after adjusting for CVD risk factors. EAT modestly improved risk prediction over CVD risk factors.

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Gender differences in the association of epicardial adipose tissue and coronary artery calcification: EPICHEART study

Cited by 33 publications

References 40 publications

Associations of Pericardial Fat Area Determined by Routine Chest Computed Tomography With Coronary Risk Factors and Coronary Artery Disease

Associations of Pericardial Fat Area Determined by Routine Chest Computed Tomography With Coronary Risk Factors and Coronary Artery Disease

Towards reference values of pericoronary adipose tissue attenuation: impact of coronary artery and tube voltage in coronary computed tomography angiography

Epicardial adipose tissue predicts incident cardiovascular disease and mortality in patients with type 2 diabetes

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