[Retracted] Epicardial Adipose Tissue Volume Is Associated with High Risk Plaque Profiles in Suspect CAD Patients

Abstract

Objective. To explore the association between EAT volume and plaque precise composition and high risk plaque detected by coronary computed tomography angiography (CCTA). Methods. 101 patients with suspected coronary artery disease (CAD) underwent CCTA examination from March to July 2019 were enrolled, including 70 cases acute coronary syndrome (ACS) and 31 cases stable angina pectoris (SAP). Based on CCTA image, atherosclerotic plaque precise compositions were analyzed using dedicated quantitative software. High risk plaque was defined as plaque with more than 2 high risk features (spotty calcium, positive remolding, low attenuation plaque, napkin-ring sign) on CCTA image. The association between EAT volume and plaque composition was assessed as well as the different of correlation between ACS and SAP was analyzed. Multivariable logistic regression analysis was used to explore whether EAT volume was independent risk factors of high risk plaque (HRP). Results. EAT volume in the ACS group was significantly higher than that of the SAP group ( 143.7 ± 49.8 cm3 vs. 123.3 ± 39.2 cm3, P = 0.046 ). EAT volume demonstrated a significant positive correlation with total plaque burden ( r = 0.298 , P = 0.003 ), noncalcified plaque burden ( r = 0.245 , P = 0.013 ), lipid plaque burden ( r = 0.250 , P = 0.012 ), and homocysteine ( r = 0.413 , P ≤ 0.001 ). In ACS, EAT volume was positively correlated with total plaque burden ( r = 0.309 , P = 0.009 ), noncalcified plaque burden ( r = 0.242 , P = 0.044 ), and lipid plaque burden ( r = 0.240 , P = 0.045 ); however, no correlation was observed in SAP. Patients with HRP have larger EAT volume than those without HRP ( 169 ± 6.2 cm3 vs. 130.6 ± 5.3 cm3, P = 0.002 ). After adjustment by traditional risk factors and coronary artery calcium score (CACS), EAT volume was an independent risk predictor of presence of HRP (OR: 1.018 (95% CI: 1.006-1.030), P = 0.004 ). Conclusions. With the increasing EAT volume, more dangerous plaque composition burdens increase significantly. EAT volume is a risk predictor of HRP independent of convention cardiovascular risk factors and CACS, which supports the potential impact of EAT on progression of coronary atherosclerotic plaque.

Pericardial fat volume and coronary risk factors as predictors of non-calcified coronary plaque presence among patients with coronary calcium score = 0

“…Thus, plaque burden in patients with acute coronary syndrome or sudden cardiac death is often higher than that in stable CAD, and the association of PFV with plaque burden may vary depending on the stage of CAD. 11 , 14 …”

“…Supporting this notion, increased PFV was positively correlated with non-calcified plaque burden in patients with acute coronary syndrome but not in stable CAD. 11 The authors have suggested that the effect of pericardial fat deposition on plaque composition may be more than a single mechanism, and PFV may have differential effects on non-calcified plaque depending on the phase of coronary atherosclerosis. 11 …”

“… 11 The authors have suggested that the effect of pericardial fat deposition on plaque composition may be more than a single mechanism, and PFV may have differential effects on non-calcified plaque depending on the phase of coronary atherosclerosis. 11 …”

“…Recently, several clinical reports have suggested that increased pericardial fat deposition can predict the risk of CAD regardless of CAC score. 10 , 11 However, there is scarce data linking pericardial fat volume (PFV) and classical coronary risk factors with non-calcified plaque presence in patients with CAC = 0 in the literature. The present study aimed to assess the association of PFV and classical coronary risk factors with non-calcified plaque presence in patients with suspected CAD and CAC = 0.…”

Macrophage polarization markers in subcutaneous, pericardial, and epicardial adipose tissue are altered in patients with coronary heart disease

“…EAT exerts various anti-atherogenic and anti-inflammatory activities and regulates cardiac thermogenesis (8), while PAT apparently has less antiinflammatory activity (9). Disturbances in AT composition and extension associate to adipocytes' hypertrophy, insulin resistance and pro-inflammatory processes (10). According to some studies, the EAT volume is increased in coronary artery disease (CAD) patients (11,12), although this was not confirmed by others (13), and may be a predictor of cardio-metabolic risk (14).…”