Segmental peri-coronary epicardial adipose tissue volume and coronary plaque characteristics

Abstract

Peri-coronary epicardial adipose tissue volume is significantly associated with the extent and severity of coronary atherosclerosis and may be a determinant of plaque vulnerability.

The Effect of Periplaque Fat on Coronary Plaque Vulnerability in Patients with Stable Coronary Artery Disease – a 128-multislice CT-based Study

“…Their results revealed a significant correlation between segmental epicardial fat volume and increasing luminal stenosis (p <0.001), and lesions with mixed plaques and low-attenuation non-calcified plaques presented significantly greater volumes of segmental epicardial fat volumes compared to lesions with calcified or CT attenuation plaques. 25 Our study found significant linear correlations between periplaque fat volume and several plaque-related volumes, which indicate a propensity towards higher vulnerability, including the non-calcified, lipid-rich, and fibro-fatty volumes. This finding suggests that a larger adipose tissue located near a hemodynamically significant coronary lesion is correlated with increased volumes of soft plaque components, which offers a higher degree of lesion instability.…”

“…23 Recent studies connected the epicardial adipose tissue with the presence of high-risk coronary plaques, defined as presenting one of the following features: low attenuation, positive remodeling, napkin ring sign, spotty calcifications; studies have also shown that patients with high-risk plaques present a larger volume of epicardial fat, compared to those with no high-risk plaques. 24,25 Pericoronary and periplaque fat Pericoronary adipose tissue, as a fragment of the total epicardial fat, is located in direct contact to the coronary artery wall and has pro-inflammatory properties through its paracrine effect and local release of inflammatory cytokines, which can trigger plaque formation, progression, vulnerabilization, and even rupture. 26 Pericoronary fat (PF) has also been associated with the presence of vulnerable coronary plaques, even after adjustment for obesity and smoking.…”

Micro‐environment and intracellular metabolism modulation of adipose tissue macrophage polarization in relation to chronic inflammatory diseases

“…AS, which is the most common pathological process leading to CVDs, has been thought as a chronic inflammatory disease. Numerous studies have verified that AT inflammation is significantly associated with the severity of AS through systemic and local effects . Initially, inflammation in AT promotes insulin resistance and lipid and glucose metabolic dysfunction that have been considered as classical risk factors for the progression of AS .…”

“…Numerous studies have verified that AT inflammation is significantly associated with the severity of AS through systemic and local effects. 95 Initially, inflammation in AT promotes insulin resistance and lipid and glucose metabolic dysfunction that have been considered as classical risk factors for the progression of AS. 96 Second, a post-mortem study has shown that tissue-specific AT, such as coronary perivascular adipose tissue (PVAT), which tightly wraps around the coronary artery, may directly induce a local pro-inflammatory environment that contributes to the progression of AS in CAD patients.…”

Epicardial Adipose Tissue as a Predictor of Plaque Vulnerability in Patients With Mild Chronic Kidney Disease

“…5 Recent research reconfirmed that segmental precoronary EAT volume evaluated with multidetector computed tomography was associated with the severity of coronary atherosclerosis and may be a determinant of plaque vulnerability. 7 Chronic kidney disease (CKD) is now an emerging global cardiovascular risk that affects up to 15% of the population. 8 The absolute cardiovascular risk of patients with CKD is similar to that of patients with established coronary artery disease, and the severity of CKD is associated with increased cardiovascular risk.…”