European heart journal. Cardiovascular Imaging · 2025
Characterizing cardiac adipose tissue in post-acute myocardial infarction patients via CT imaging: a comparative cross-sectional study.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Wang Xiaomeng, Leng Shuang, Adamson Philip D, Greer Charlotte E, Huang Weimin, Lee Hwee Kuan, Loong Yan Ting, Raffiee Nur Amirah Syahindah, Sia Ching Hui, Tan Swee Yaw, Tan Sock Hwee, Teo Lynette Li San, Wong Sung Lung, Yang Xiaoxun, Yew Min Sen, Yong Thon Hon, Zhong Liang, Shaw Leslee J, Chan Mark Yan Yee, Hausenloy Derek J, Baskaran Lohendran
Аннотация
AIMS: To identify differences in CT-derived perivascular adipose tissue (PVAT) and epicardial adipose tissue (EAT) characteristics that may indicate inflammatory status differences between post-treatment acute myocardial infarction (AMI) and stable coronary artery disease (CAD) patients.
METHODS AND RESULTS: A cohort of 205 post-AMI patients (age 59.8 ± 9.2, 92.2% male) was propensity-matched with 205 stable CAD patients (age 60.5 ± 10.0, 90.2% male). Coronary CT angiography and non-contrast CT scans were performed to assess PVAT mean attenuation across major coronary segments and EAT mean attenuation and volumes, respectively. For post-AMI patients, CT scans were conducted 28.6 ± 13.8 days after the AMI incidence. Post-AMI patients showed higher non-culprit PVAT and EAT mean attenuation than stable CAD patients (8.01 HU, 95% CI 5.90-10.11 HU, P < 0.001, 2.48 HU, 95% CI 0.83-4.13 HU, P = 0.003, respectively). The EAT volume percentage at higher attenuation levels was higher in post-AMI patients compared with stable CAD (33.93 cm3, 95% CI 16.86-51.00 cm3, P < 0.001), with the difference maximized at the -70 HU threshold (4.75%, 95% CI 3.64%-5.87%, P < 0.001). PVAT mean attenuation positively correlated with EAT mean attenuations and the percentage of EAT volume > -70 HU (P < 0.001 for both).
CONCLUSION: Post-AMI patients showed higher PVAT and EAT attenuation than stable CAD patients, potentially indicating AMI-associated inflammatory cardiac adipose tissue changes. A total of -70 HU can act as a potential cut-off for inflamed EAT. These findings highlight the potential of using CT-derived adipose tissue characteristics to assess inflammation and guide post-AMI management strategies.
METHODS AND RESULTS: A cohort of 205 post-AMI patients (age 59.8 ± 9.2, 92.2% male) was propensity-matched with 205 stable CAD patients (age 60.5 ± 10.0, 90.2% male). Coronary CT angiography and non-contrast CT scans were performed to assess PVAT mean attenuation across major coronary segments and EAT mean attenuation and volumes, respectively. For post-AMI patients, CT scans were conducted 28.6 ± 13.8 days after the AMI incidence. Post-AMI patients showed higher non-culprit PVAT and EAT mean attenuation than stable CAD patients (8.01 HU, 95% CI 5.90-10.11 HU, P < 0.001, 2.48 HU, 95% CI 0.83-4.13 HU, P = 0.003, respectively). The EAT volume percentage at higher attenuation levels was higher in post-AMI patients compared with stable CAD (33.93 cm3, 95% CI 16.86-51.00 cm3, P < 0.001), with the difference maximized at the -70 HU threshold (4.75%, 95% CI 3.64%-5.87%, P < 0.001). PVAT mean attenuation positively correlated with EAT mean attenuations and the percentage of EAT volume > -70 HU (P < 0.001 for both).
CONCLUSION: Post-AMI patients showed higher PVAT and EAT attenuation than stable CAD patients, potentially indicating AMI-associated inflammatory cardiac adipose tissue changes. A total of -70 HU can act as a potential cut-off for inflamed EAT. These findings highlight the potential of using CT-derived adipose tissue characteristics to assess inflammation and guide post-AMI management strategies.