Identification of patients with acute coronary syndrome and representation of their degree of inflammation: application of pericoronary adipose tissue within different radial distances of the proximal coronary arteries

Dong, Xiaolin; Zhu, Chentao; Li, Na; Shi, Ke; Si, Nuo; Wang, Yujia; Peng, Hong; Shi, Zhenzhou; Wang, Zhen; Zhao, Min; Zhang, Tong

doi:10.21037/qims-22-864

Cited by 6 publications

(5 citation statements)

References 38 publications

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“…The attenuation value of PCAT is considered as a noninvasive biomarker of coronary inflammation ( 3 , 25 ). The mechanism is that inflammatory signals released from the inflamed vessels can diffuse directly to PCAT, inducing its breakdown and inhibiting its formation, while promoting pericoronary edema ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Is there an association between coronary artery inflammation and coronary atherosclerotic burden?

Jing,

Xi,

Zhu

et al. 2023

Quant Imaging Med Surg

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Background As for the coronary artery inflammation and coronary atherosclerotic burden, which are used to assess the risk of adverse cardiac events in patients, it is unclear whether there is any certain correlation between them. Therefore, the purpose of this study was to explore the potential relationship between coronary artery inflammation and coronary atherosclerotic burden. Methods A total of 346 eligible patients underwent assessment of computed tomography (CT) attenuation values of pericoronary adipose tissue (PCAT) in the right coronary artery and Agatston coronary artery calcium (CAC) based on coronary CT angiography. These measurements were utilized to evaluate coronary inflammation and atherosclerotic burden, respectively. Patients with a CAC score of 0 were categorized into groups based on the presence or absence of coronary artery disease (CAD). CAC scores of 10, 100, and 400 were chosen as cutoff values to compare differences in PCAT attenuation values across different CAC scores. Results When comparing all CAD patients to non-CAD patients, a significantly higher PCAT attenuation was observed in CAD patients (−87.54±9.39 vs. −93.45±7.42 HU, P=0.000). The PCAT attenuation in CAD patients with a CAC score of 0 was significantly higher than that in patients with a CAC score greater than 0 and in non-CAD patients with a CAC score of 0 (−82.63±8.70 vs. −90.38±8.59 vs. −93.45±7.42 HU, P=0.000). The PCAT attenuation values did not exhibit significant differences among different CAC scores (all P>0.05); however, it was highest in CAD patients with a CAC score of 0 (P<0.05). Body mass index, hyperlipidemia, hypertension, and PCAT attenuation were identified as independent risk factors in both CAD patients with a CAC score of 0 and patients with a CAC score greater than 0 (all P<0.05). Conclusions The results of this study suggest that a direct relationship between coronary inflammation and coronary atherosclerotic burden is not evident. Nonetheless, it is noteworthy that coronary inflammation was most pronounced in CAD patients with a CAC score of 0, while CAC score did not demonstrate an association with inflammation.

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Section: Discussionmentioning

confidence: 99%

Is there an association between coronary artery inflammation and coronary atherosclerotic burden?

Jing,

Xi,

Zhu

et al. 2023

Quant Imaging Med Surg

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show abstract

“…Another study also found different FAI values with the radial distance for PCAT proximal to the coronary artery. As shown, FAI ref (within the radial distance from the outer vessel wall equal to the coronary vessel diameter) proximal to LAD could better represent the inflammation of culprit lesions in patients with ACS than FAI with any other radial distances proximal to the coronary arteries or FAI around culprit lesions ( 22 ). In our study, we confirmed that there are indeed differences in the PCAT attenuation at different locations.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of peri-plaque pericoronary adipose tissue attenuation in coronary atherosclerosis using a dual-layer spectral detector CT

Jia,

Zou,

Xue

et al. 2024

Front. Med.

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PurposeThis study aimed to evaluate the differences between pericoronary adipose tissue (PCAT) attenuation at different measured locations in evaluating coronary atherosclerosis using spectral computed tomography (CT) and to explore valuable imaging indicators.MethodsA total of 330 patients with suspicious coronary atherosclerosis were enrolled and underwent coronary CT angiography with dual-layer spectral detector CT (SDCT). Proximal and peri-plaque fat attenuation index (FAI) of stenosis coronary arteries were measured using both conventional images (CIs) and virtual monoenergetic images (VMIs) ranging from 40 keV to 100 keV. The slopes of the spectral attenuation curve (λ) of proximal and peri-plaque PCAT at three different monoenergetic intervals were calculated. Additionally, peri-plaque FAI on CI and virtual non-contrast images, and effective atomic number were measured manually.ResultsA total of 231 coronary arteries with plaques and lumen stenosis were finally enrolled. Peri-plaque FAICI and FAIVMI were significantly higher in severe stenosis than in mild and moderate stenosis (p < 0.05), while peri-plaque λ, proximal FAI, and proximal λ were not statistically different. Proximal FAI, peri-plaque FAI, and peri-plaque λ were significantly higher in low-density non-calcified plaque (LD-NCP) and non-calcified plaque (NCP) than in calcified plaque (p < 0.01). Peri-plaque FAI was the highest in the LD-NCP group, while proximal FAI was the highest in the NCP group. In severe stenosis and in LD-NCP, peri-plaque FAI was significantly higher than proximal FAI (p < 0.05). The manually measured parameters related to peri-plaque PCAT attenuation had a positive correlation with the results of peri-plaque FAI measured automatically.ConclusionPeri-plaque PCAT has more value in assessing coronary atherosclerosis than proximal PCAT. Peri-plaque PCAT attenuation is expected to be used as a standard biomarker for evaluating plaque vulnerability and hemodynamic characteristics.

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“…The different environments for the development of atherosclerotic plaques may contribute to differences in the risk of acute coronary events among different coronary arteries. In addition, the FAI around the LAD demonstrated the highest correlation with the FAI around culprit lesions in patients with acute coronary syndrome (ACS), which could be used to represent whole heart inflammation and could improve the identification of patients with ACS and stable CAD ( 33 ). Therefore, this study has presented that perivascular FAI measures may be an important imaging biomarker for tracking asymptomatic CVD progression in PIWH ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Quantification of subclinical plaque characteristics and perivascular fat using coronary computed tomography angiography (CCTA) among individuals with human immunodeficiency virus (HIV)

Zhou,

Jin,

Ding

et al. 2024

Quant Imaging Med Surg

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Background People infected with human immunodeficiency virus (PIWH) have a higher risk of cardiovascular events. This study was designed to compare the differences in plaque characteristics and perivascular fat between subclinical coronary atherosclerosis in PIWH and healthy controls (HC) by coronary computed tomography angiography (CCTA). We also assessed the associations between human immunodeficiency virus (HIV) infection, antiretroviral therapy (ART), and coronary artery disease (CAD). Methods This cross-sectional study included a total of 158 PIWH and 79 controls. CCTA was used to evaluate coronary artery plaque prevalence, coronary stenosis severity, plaque composition, plaque volume, and perivascular fat attenuation index (FAI). Logistic regression analyses were used to assess the associations between the prevalence of coronary artery plaque and HIV-related clinical indicators. Results There was no difference in total coronary artery plaque prevalence between PIWH and controls (44.3% vs. 32.9%; P=0.09), but the prevalence of noncalcified plaque was significantly higher in PIWH compared with the controls (33.5% vs. 16.5%; P=0.006). After adjustment for age, sex, statin use, and family history of cardiovascular disease (CVD), the prevalence of noncalcified plaque remained 2 times higher in PIWH [odds ratio (OR), 2.082; 95% confidence interval (CI): 1.007–4.304; P=0.048]. The perivascular FAI measured around the left anterior descending artery (LAD) was higher in PIWH (−71.4±5.7 vs. −73.5±7.0; P=0.03) compared with that of the controls. The intra-group analyses of PIWH suggested that the decrease in nadir CD4+ T-cell count was associated with the increased prevalence of noncalcified plaque (OR, 4.139; 95% CI: 1.312–13.060; P=0.02). Conclusions PIWH have a higher risk of developing noncalcified plaque and greater perivascular fat. In addition, the increased noncalcified plaque prevalence in PIWH may be associated with the immunodeficiency caused by HIV.

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Identification of patients with acute coronary syndrome and representation of their degree of inflammation: application of pericoronary adipose tissue within different radial distances of the proximal coronary arteries

Cited by 6 publications

References 38 publications

Is there an association between coronary artery inflammation and coronary atherosclerotic burden?

Is there an association between coronary artery inflammation and coronary atherosclerotic burden?

Evaluation of peri-plaque pericoronary adipose tissue attenuation in coronary atherosclerosis using a dual-layer spectral detector CT

Quantification of subclinical plaque characteristics and perivascular fat using coronary computed tomography angiography (CCTA) among individuals with human immunodeficiency virus (HIV)

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