Association Between Changes in Perivascular Adipose Tissue Density and Plaque Progression

Sang Eun Lee; Ji Min Sung; Daniele Andreini; Mouaz H. Al-Mallah; Matthew J. Budoff; Filippo Cademartiri; Kavitha Chinnaiyan; Jung Hyun Choi; Eun Ju Chun; Edoardo Conte; Ilan Gottlieb; Martin Hadamitzky; Yong Jin Kim; Byoung Kwon Lee; Jonathon A. Leipsic; Erica Maffei; Hugo Marques; Pedro de Araújo Gonçalves; Gianluca Pontone; Sanghoon Shin; Pieter H. Kitslaar; Johan H.C. Reiber; Peter H. Stone; Habib Samady; Renu Virmani; Jagat Narula; Daniel S. Berman; Leslee J. Shaw; Jeroen J. Bax; Fay Y. Lin; James K. Min; Hyuk Jae Chang

doi:10.1016/j.jcmg.2022.04.016

Association Between Changes in Perivascular Adipose Tissue Density and Plaque Progression

Sang Eun Lee, Ji Min Sung, Daniele Andreini, Mouaz H. Al-Mallah, Matthew J. Budoff, Filippo Cademartiri, Kavitha Chinnaiyan, Jung Hyun Choi, Eun Ju Chun, Edoardo Conte, Ilan Gottlieb, Martin Hadamitzky, Yong Jin Kim, Byoung Kwon Lee, Jonathon A. Leipsic, Erica Maffei, Hugo Marques, Pedro de Araújo Gonçalves, Gianluca Pontone, Sanghoon ShinPieter H. Kitslaar, Johan H.C. Reiber, Peter H. Stone, Habib Samady, Renu Virmani, Jagat Narula, Daniel S. Berman, Leslee J. Shaw, Jeroen J. Bax, Fay Y. Lin, James K. Min, Hyuk Jae Chang

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

Background: The association between the change in vessel inflammation, as quantified by perivascular adipose tissue (PVAT) density, and the progression of coronary atherosclerosis remains to be determined. Objectives: The purpose of this study was to explore the association between the change in PVAT density and the progression of total and compositional plaque volume (PV). Methods: Patients were selected from a prospective multinational registry. Patients who underwent serial coronary computed tomography angiography studies with ≥2-year intervals and were scanned with the same tube voltage at baseline and follow-up were included. Total and compositional PV and PVAT density at baseline and follow-up were quantitatively analyzed for every lesion. Multivariate linear regression models using cluster analyses were constructed. Results: A total of 1,476 lesions were identified from 474 enrolled patients (mean age 61.2 ± 9.3 years; 65.0% men). The mean PVAT density was −74.1 ± 11.5 HU, and total PV was 48.1 ± 83.5 mm³ (19.2 ± 44.8 mm³ of calcified PV and 28.9 ± 51.0 mm³ of noncalcified PV). On multivariate analysis (adjusted for clinical risk factors, medication use, change in lipid levels, total PV at baseline, luminal HU attenuation, location of lesions, and tube voltage), the increase in PVAT density was positively associated with the progression of total PV (estimate = 0.275 [95% CI: 0.004-0.545]; P = 0.047), driven by the association with fibrous PV (estimate = 0.245 [95% CI: 0.070-0.420]; P = 0.006). Calcified PV progression was not associated with the increase in PVAT density (P > 0.050). Conclusions: Increase in vessel inflammation represented by PVAT density is independently associated with the progression of the lipid component of coronary atherosclerotic plaques.

Original language	English
Pages (from-to)	1760-1767
Number of pages	8
Journal	JACC: Cardiovascular Imaging
Volume	15
Issue number	10
DOIs	https://doi.org/10.1016/j.jcmg.2022.04.016
Publication status	Published - 2022 Oct

Bibliographical note

Funding Information:
This work was supported by the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT; the Ministry of Trade, Industry and Energy; the Ministry of Health and Welfare, Republic of Korea, the Ministry of Food and Drug Safety) (Project Number: 202016B02). The study was also funded in part by a grant from the Dalio Foundation. Dr Leipsic has served as a consultant for and holds stock options in HeartFlow and Circle CVI. Drs Kitslaar and Reiber are employees of Medis Medical Imaging. Dr Samady has served on the scientific advisory board of Philips; has equity interest in Covanos Inc; and has received a research grant from Medtronic. Dr Lin has received grant support from GE Healthcare. Dr Min has received funding from GE Healthcare; has served on the scientific advisory board of Arineta and GE Healthcare; and has an equity interest in and is an employee of Cleerly, Inc. Dr Chang has received funding from the Leading Foreign Research Institute Recruitment Program through the National Research Foundation (NRF) of Korea funded by the Ministry of Science and ICT (MSIT) (Grant No. 2012027176). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Publisher Copyright:
© 2022 American College of Cardiology Foundation

All Science Journal Classification (ASJC) codes

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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10.1016/j.jcmg.2022.04.016

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Lee, S. E., Sung, J. M., Andreini, D., Al-Mallah, M. H., Budoff, M. J., Cademartiri, F., Chinnaiyan, K., Choi, J. H., Chun, E. J., Conte, E., Gottlieb, I., Hadamitzky, M., Kim, Y. J., Lee, B. K., Leipsic, J. A., Maffei, E., Marques, H., de Araújo Gonçalves, P., Pontone, G., ... Chang, H. J. (2022). Association Between Changes in Perivascular Adipose Tissue Density and Plaque Progression. JACC: Cardiovascular Imaging, 15(10), 1760-1767. https://doi.org/10.1016/j.jcmg.2022.04.016

@article{8d3cee3926b44716b660690284efb0dc,

title = "Association Between Changes in Perivascular Adipose Tissue Density and Plaque Progression",

abstract = "Background: The association between the change in vessel inflammation, as quantified by perivascular adipose tissue (PVAT) density, and the progression of coronary atherosclerosis remains to be determined. Objectives: The purpose of this study was to explore the association between the change in PVAT density and the progression of total and compositional plaque volume (PV). Methods: Patients were selected from a prospective multinational registry. Patients who underwent serial coronary computed tomography angiography studies with ≥2-year intervals and were scanned with the same tube voltage at baseline and follow-up were included. Total and compositional PV and PVAT density at baseline and follow-up were quantitatively analyzed for every lesion. Multivariate linear regression models using cluster analyses were constructed. Results: A total of 1,476 lesions were identified from 474 enrolled patients (mean age 61.2 ± 9.3 years; 65.0% men). The mean PVAT density was −74.1 ± 11.5 HU, and total PV was 48.1 ± 83.5 mm3 (19.2 ± 44.8 mm3 of calcified PV and 28.9 ± 51.0 mm3 of noncalcified PV). On multivariate analysis (adjusted for clinical risk factors, medication use, change in lipid levels, total PV at baseline, luminal HU attenuation, location of lesions, and tube voltage), the increase in PVAT density was positively associated with the progression of total PV (estimate = 0.275 [95% CI: 0.004-0.545]; P = 0.047), driven by the association with fibrous PV (estimate = 0.245 [95% CI: 0.070-0.420]; P = 0.006). Calcified PV progression was not associated with the increase in PVAT density (P > 0.050). Conclusions: Increase in vessel inflammation represented by PVAT density is independently associated with the progression of the lipid component of coronary atherosclerotic plaques.",

author = "Lee, {Sang Eun} and Sung, {Ji Min} and Daniele Andreini and Al-Mallah, {Mouaz H.} and Budoff, {Matthew J.} and Filippo Cademartiri and Kavitha Chinnaiyan and Choi, {Jung Hyun} and Chun, {Eun Ju} and Edoardo Conte and Ilan Gottlieb and Martin Hadamitzky and Kim, {Yong Jin} and Lee, {Byoung Kwon} and Leipsic, {Jonathon A.} and Erica Maffei and Hugo Marques and {de Ara{\'u}jo Gon{\c c}alves}, Pedro and Gianluca Pontone and Sanghoon Shin and Kitslaar, {Pieter H.} and Reiber, {Johan H.C.} and Stone, {Peter H.} and Habib Samady and Renu Virmani and Jagat Narula and Berman, {Daniel S.} and Shaw, {Leslee J.} and Bax, {Jeroen J.} and Lin, {Fay Y.} and Min, {James K.} and Chang, {Hyuk Jae}",

note = "Funding Information: This work was supported by the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT; the Ministry of Trade, Industry and Energy; the Ministry of Health and Welfare, Republic of Korea, the Ministry of Food and Drug Safety) (Project Number: 202016B02). The study was also funded in part by a grant from the Dalio Foundation. Dr Leipsic has served as a consultant for and holds stock options in HeartFlow and Circle CVI. Drs Kitslaar and Reiber are employees of Medis Medical Imaging. Dr Samady has served on the scientific advisory board of Philips; has equity interest in Covanos Inc; and has received a research grant from Medtronic. Dr Lin has received grant support from GE Healthcare. Dr Min has received funding from GE Healthcare; has served on the scientific advisory board of Arineta and GE Healthcare; and has an equity interest in and is an employee of Cleerly, Inc. Dr Chang has received funding from the Leading Foreign Research Institute Recruitment Program through the National Research Foundation (NRF) of Korea funded by the Ministry of Science and ICT (MSIT) (Grant No. 2012027176). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Publisher Copyright: {\textcopyright} 2022 American College of Cardiology Foundation",

year = "2022",

month = oct,

doi = "10.1016/j.jcmg.2022.04.016",

language = "English",

volume = "15",

pages = "1760--1767",

journal = "JACC: Cardiovascular Imaging",

issn = "1936-878X",

publisher = "Elsevier Inc.",

number = "10",

}

Lee, SE, Sung, JM, Andreini, D, Al-Mallah, MH, Budoff, MJ, Cademartiri, F, Chinnaiyan, K, Choi, JH, Chun, EJ, Conte, E, Gottlieb, I, Hadamitzky, M, Kim, YJ, Lee, BK, Leipsic, JA, Maffei, E, Marques, H, de Araújo Gonçalves, P, Pontone, G, Shin, S, Kitslaar, PH, Reiber, JHC, Stone, PH, Samady, H, Virmani, R, Narula, J, Berman, DS, Shaw, LJ, Bax, JJ, Lin, FY, Min, JK & Chang, HJ 2022, 'Association Between Changes in Perivascular Adipose Tissue Density and Plaque Progression', JACC: Cardiovascular Imaging, vol. 15, no. 10, pp. 1760-1767. https://doi.org/10.1016/j.jcmg.2022.04.016

TY - JOUR

T1 - Association Between Changes in Perivascular Adipose Tissue Density and Plaque Progression

AU - Lee, Sang Eun

AU - Sung, Ji Min

AU - Andreini, Daniele

AU - Al-Mallah, Mouaz H.

AU - Budoff, Matthew J.

AU - Cademartiri, Filippo

AU - Chinnaiyan, Kavitha

AU - Choi, Jung Hyun

AU - Chun, Eun Ju

AU - Conte, Edoardo

AU - Gottlieb, Ilan

AU - Hadamitzky, Martin

AU - Kim, Yong Jin

AU - Lee, Byoung Kwon

AU - Leipsic, Jonathon A.

AU - Maffei, Erica

AU - Marques, Hugo

AU - de Araújo Gonçalves, Pedro

AU - Pontone, Gianluca

AU - Shin, Sanghoon

AU - Kitslaar, Pieter H.

AU - Reiber, Johan H.C.

AU - Stone, Peter H.

AU - Samady, Habib

AU - Virmani, Renu

AU - Narula, Jagat

AU - Berman, Daniel S.

AU - Shaw, Leslee J.

AU - Bax, Jeroen J.

AU - Lin, Fay Y.

AU - Min, James K.

AU - Chang, Hyuk Jae

N1 - Funding Information: This work was supported by the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT; the Ministry of Trade, Industry and Energy; the Ministry of Health and Welfare, Republic of Korea, the Ministry of Food and Drug Safety) (Project Number: 202016B02). The study was also funded in part by a grant from the Dalio Foundation. Dr Leipsic has served as a consultant for and holds stock options in HeartFlow and Circle CVI. Drs Kitslaar and Reiber are employees of Medis Medical Imaging. Dr Samady has served on the scientific advisory board of Philips; has equity interest in Covanos Inc; and has received a research grant from Medtronic. Dr Lin has received grant support from GE Healthcare. Dr Min has received funding from GE Healthcare; has served on the scientific advisory board of Arineta and GE Healthcare; and has an equity interest in and is an employee of Cleerly, Inc. Dr Chang has received funding from the Leading Foreign Research Institute Recruitment Program through the National Research Foundation (NRF) of Korea funded by the Ministry of Science and ICT (MSIT) (Grant No. 2012027176). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Publisher Copyright: © 2022 American College of Cardiology Foundation

PY - 2022/10

Y1 - 2022/10

N2 - Background: The association between the change in vessel inflammation, as quantified by perivascular adipose tissue (PVAT) density, and the progression of coronary atherosclerosis remains to be determined. Objectives: The purpose of this study was to explore the association between the change in PVAT density and the progression of total and compositional plaque volume (PV). Methods: Patients were selected from a prospective multinational registry. Patients who underwent serial coronary computed tomography angiography studies with ≥2-year intervals and were scanned with the same tube voltage at baseline and follow-up were included. Total and compositional PV and PVAT density at baseline and follow-up were quantitatively analyzed for every lesion. Multivariate linear regression models using cluster analyses were constructed. Results: A total of 1,476 lesions were identified from 474 enrolled patients (mean age 61.2 ± 9.3 years; 65.0% men). The mean PVAT density was −74.1 ± 11.5 HU, and total PV was 48.1 ± 83.5 mm3 (19.2 ± 44.8 mm3 of calcified PV and 28.9 ± 51.0 mm3 of noncalcified PV). On multivariate analysis (adjusted for clinical risk factors, medication use, change in lipid levels, total PV at baseline, luminal HU attenuation, location of lesions, and tube voltage), the increase in PVAT density was positively associated with the progression of total PV (estimate = 0.275 [95% CI: 0.004-0.545]; P = 0.047), driven by the association with fibrous PV (estimate = 0.245 [95% CI: 0.070-0.420]; P = 0.006). Calcified PV progression was not associated with the increase in PVAT density (P > 0.050). Conclusions: Increase in vessel inflammation represented by PVAT density is independently associated with the progression of the lipid component of coronary atherosclerotic plaques.

AB - Background: The association between the change in vessel inflammation, as quantified by perivascular adipose tissue (PVAT) density, and the progression of coronary atherosclerosis remains to be determined. Objectives: The purpose of this study was to explore the association between the change in PVAT density and the progression of total and compositional plaque volume (PV). Methods: Patients were selected from a prospective multinational registry. Patients who underwent serial coronary computed tomography angiography studies with ≥2-year intervals and were scanned with the same tube voltage at baseline and follow-up were included. Total and compositional PV and PVAT density at baseline and follow-up were quantitatively analyzed for every lesion. Multivariate linear regression models using cluster analyses were constructed. Results: A total of 1,476 lesions were identified from 474 enrolled patients (mean age 61.2 ± 9.3 years; 65.0% men). The mean PVAT density was −74.1 ± 11.5 HU, and total PV was 48.1 ± 83.5 mm3 (19.2 ± 44.8 mm3 of calcified PV and 28.9 ± 51.0 mm3 of noncalcified PV). On multivariate analysis (adjusted for clinical risk factors, medication use, change in lipid levels, total PV at baseline, luminal HU attenuation, location of lesions, and tube voltage), the increase in PVAT density was positively associated with the progression of total PV (estimate = 0.275 [95% CI: 0.004-0.545]; P = 0.047), driven by the association with fibrous PV (estimate = 0.245 [95% CI: 0.070-0.420]; P = 0.006). Calcified PV progression was not associated with the increase in PVAT density (P > 0.050). Conclusions: Increase in vessel inflammation represented by PVAT density is independently associated with the progression of the lipid component of coronary atherosclerotic plaques.

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UR - http://www.scopus.com/inward/citedby.url?scp=85138408377&partnerID=8YFLogxK

U2 - 10.1016/j.jcmg.2022.04.016

DO - 10.1016/j.jcmg.2022.04.016

M3 - Article

C2 - 36202455

AN - SCOPUS:85138408377

SN - 1936-878X

VL - 15

SP - 1760

EP - 1767

JO - JACC: Cardiovascular Imaging

JF - JACC: Cardiovascular Imaging

IS - 10

ER -

Association Between Changes in Perivascular Adipose Tissue Density and Plaque Progression

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