Correlative relationship of pericoronary adipose tissue and
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Perivascular adipose tissue (PVAT) is mutually changing with the progression or regression of coronary artery disease. Epicardial adipose tissue (EAT) which is adjacent to the vessel wall but not total EAT showed association to underlying plaque.

Pericoronary adipose tissue (PCAT) has been linked to underlying coronary artery disease (CAD) and proposed to modulate adjacent atherosclerotic plaque formation over pro-inflammatory pathways. In vitro and ex vivo studies support the bilateral communication of adipose tissue and vessel wall. Researchers quantified PCAT and its dynamics in a low coronary risk cohort with semi-automated software in serial coronary computed tomography angiography (CTA).

Patients were retrospectively included from a tertiary care hospital who underwent serial coronary CTA with a low cardiovascular risk profile. All examinations were evaluated in a standardized approach: epicardial adipose tissue(EAT) volume and attenuation were quantified in total, in the atrioventricular(RCA, LCX) or interventricular(LAD) sulcus and within a 5 mm radius for each coronary artery(PCAT). Coronary plaques were quantified using semi-automated software and compared for progression, stability, or regression.

Of 120 patients, 59.2% showed atherosclerotic plaques. After 36months mean follow-up, 22 showed plaque regression, 39 were stable and 49 were progressive. Total EAT volume decreased in the regressive group, increased in the stable group and progressive group.

The per-vessel analysis showed a significant decrease of PCAT attenuation in patients with CAD regression compared to the stable and progressive group. Mean sulcus EAT attenuation did not show a significant change.

Conclusively, Epicardial adipose tissue volume is mutually changing with the progression or regression of coronary artery disease. Perivascular but not epicardial attenuation levels correlate to adjacent plaque and support a direct bilateral influence.

European Journal of Radiology
Source: https://doi.org/10.1016/j.ejrad.2021.109531
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