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Piña P, Lorenzatti D, Filtz A, Scotti A, Gil EV, Torres JD, Perea CM, Shaw LJ, Lavie CJ, Berman DS, Iacobellis G, Slomka PJ, Pibarot P, Dweck MR, Dey D, Garcia MJ, Latib A, Slipczuk L. Epicardial adipose tissue, cardiac damage, and mortality in patients undergoing TAVR for aortic stenosis. Int J Cardiovasc Imaging 2025; 41:279-290. [PMID: 39825067 PMCID: PMC11811257 DOI: 10.1007/s10554-024-03307-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2024] [Accepted: 12/12/2024] [Indexed: 01/20/2025]
Abstract
Computed tomography (CT)-derived Epicardial Adipose Tissue (EAT) is linked to cardiovascular disease outcomes. However, its role in patients undergoing Transcatheter Aortic Valve Replacement (TAVR) and the interplay with aortic stenosis (AS) cardiac damage (CD) remains unexplored. We aim to investigate the relationship between EAT characteristics, AS CD, and all-cause mortality. We retrospectively included consecutive patients who underwent CT-TAVR followed by TAVR. EAT volume and density were estimated using a deep-learning platform and CD was assessed using echocardiography. Patients were classified according to low/high EAT volume and density. All-cause mortality at 4 years was compared using Kaplan-Meier and Cox regression analyses. A total of 666 patients (median age 81 [74-86] years; 54% female) were included. After a median follow-up of 1.28 (IQR 0.53-2.57) years, 11.7% (n = 77) of patients died. The EAT volume (p = 0.017) decreased, and density increased (p < 0.001) with worsening AS CD. Patients with low EAT volume (< 49cm3) and high density (≥-86 HU) had higher all-cause mortality (log-rank p = 0.02 and p = 0.01, respectively), even when adjusted for age, sex, and clinical characteristics (HR 1.71, p = 0.02 and HR 1.73, p = 0.03, respectively). When CD was added to the model, low EAT volume (HR 1.67 p = 0.03) and CD stages 3 and 4 (HR 3.14, p = 0.03) remained associated with all-cause mortality. In patients with AS undergoing TAVR, CT-derived low EAT volume, and high density were independently associated with increased 4-year mortality and worse CD stage. Only EAT volume remained associated when adjusted for CD.
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Affiliation(s)
- Pamela Piña
- Department of Cardiology, CEDIMAT, Santo Domingo, Dominican Republic
| | - Daniel Lorenzatti
- Cardiology Division, Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210st, Bronx, NY, USA
| | - Annalisa Filtz
- Cardiology Division, Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210st, Bronx, NY, USA
| | - Andrea Scotti
- Cardiology Division, Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210st, Bronx, NY, USA
| | - Elena Virosta Gil
- Department of Cardiology, Araba-Txagorritxo University Hospital, Vitoria-Gasteiz, Spain
| | - Juan Duarte Torres
- Department of Cardiology, Gomez Ulla Central de la Defensa Hospital, Madrid, Spain
| | | | - Leslee J Shaw
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carl J Lavie
- Ochsner Clinical School, John Ochsner Heart and Vascular Institute, University of Queensland School of Medicine, New Orleans, LA, USA
| | - Daniel S Berman
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Gianluca Iacobellis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami, Miami, FL, USA
| | - Piotr J Slomka
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Philippe Pibarot
- Québec Heart and Lung Institute, Université Laval, Québec City, Québec, Canada
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, Edinburgh Heart Centre, University of Edinburgh, Edinburgh, UK
| | - Damini Dey
- Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Mario J Garcia
- Cardiology Division, Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210st, Bronx, NY, USA
| | - Azeem Latib
- Cardiology Division, Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210st, Bronx, NY, USA
| | - Leandro Slipczuk
- Cardiology Division, Montefiore Medical Center, Albert Einstein College of Medicine, 111 E 210st, Bronx, NY, USA.
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Guo T, Wang XP, Xia R, Gu Z, Dou XF. Correlation Between Fat Attenuation Index and Plaque Parameters in Coronary CT Angiography: An Observational Study in Stable Coronary Artery Disease. Clin Appl Thromb Hemost 2025; 31:10760296241313459. [PMID: 40325857 PMCID: PMC12059409 DOI: 10.1177/10760296241313459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Revised: 12/16/2024] [Accepted: 12/30/2024] [Indexed: 05/07/2025] Open
Abstract
BackgroundThe purpose of this prospective observational study was to predict plaque vulnerability, stenosis, and hemodynamic problems based on coronary CT angiography (CCTA) using the Fat Attenuation Index (FAI) as a marker.MethodsPatients with stable coronary artery disease (CAD) who underwent CCTA between January 2021 and January 2023 were included in this study. Data on basic patient information, plaque parameters, and Fractional Flow Reserve (FFR) were collected and analyzed. Multiple linear analysis was performed to explore the association between FAI and FFR. Additionally, regression models were developed to predict dependent variables such as FFR, plaque vulnerability, and the degree of stenosis based on FAI values. We also explored specific thresholds of FAI to classify plaques into vulnerable and non-vulnerable categories.ResultsA total of 62 patients with 84 coronary arteries were included in the final analysis. Based on FAI levels, the study subjects were divided into FAI-negative group (FAI ≤ -70.1 HU, 52 cases) and FAI-positive group (FAI > -70.1 HU, 32 cases). Patients in the FAI-positive group had significantly lower FFR values compared to those in the FAI-negative group, and the proportion of vulnerable plaques was significantly higher in the FAI-positive group. Furthermore, as the degree of stenosis observed on CCTA increased, FAI values showed a significant increase. Analysis of plaque types revealed that FAI in vulnerable plaques was significantly higher than in other plaque types. In the multiple linear analysis, lesion length, TPB and FFR was negatively correlated with FAI (β = -0.25, -0.13 and -41.72).ConclusionThe results support the use of FAI as a valuable tool in clinical practice. Its predictive capabilities regarding hemodynamic dysfunction and plaque susceptibility make it an essential component of modern cardiovascular risk assessment strategies.
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Affiliation(s)
- Ting Guo
- Institute of Clinical Medicine, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China
| | - Xiu-Ping Wang
- Medical Imaging Department, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China
| | - Rui Xia
- Medical Imaging Department, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China
| | - Zihan Gu
- Massey Institute, Nanjing University of Finance & Economics, Nanjing, China
| | - Xiao-Feng Dou
- Medical Imaging Department, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China
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Lakshmanan S, Tzolos E, Kroon J, Stroes ESG, Zheng KH, Dey D, Williams MC, Newby DE, Dweck MR. Lipoprotein(a) and peri-coronary adipose tissue. Eur Heart J Cardiovasc Imaging 2024; 25:e244-e245. [PMID: 38978501 DOI: 10.1093/ehjci/jeae166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Accepted: 07/02/2024] [Indexed: 07/10/2024] Open
Affiliation(s)
| | - Evangelos Tzolos
- British Heart Foundation Centre of Research Excellence, University of Edinburgh, The Chancellor's Building, Little France Crescent, Edinburgh EH26 0NL, UK
| | - Jeffrey Kroon
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Erik S G Stroes
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Kang H Zheng
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Damini Dey
- Departments of Biomedical Sciences and Medicine, Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA, USA
| | - Michelle C Williams
- British Heart Foundation Centre of Research Excellence, University of Edinburgh, The Chancellor's Building, Little France Crescent, Edinburgh EH26 0NL, UK
| | - David E Newby
- British Heart Foundation Centre of Research Excellence, University of Edinburgh, The Chancellor's Building, Little France Crescent, Edinburgh EH26 0NL, UK
| | - Marc R Dweck
- British Heart Foundation Centre of Research Excellence, University of Edinburgh, The Chancellor's Building, Little France Crescent, Edinburgh EH26 0NL, UK
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Krauz K, Kempiński M, Jańczak P, Momot K, Zarębiński M, Poprawa I, Wojciechowska M. The Role of Epicardial Adipose Tissue in Acute Coronary Syndromes, Post-Infarct Remodeling and Cardiac Regeneration. Int J Mol Sci 2024; 25:3583. [PMID: 38612394 PMCID: PMC11011833 DOI: 10.3390/ijms25073583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Epicardial adipose tissue (EAT) is a fat deposit surrounding the heart and located under the visceral layer of the pericardium. Due to its unique features, the contribution of EAT to the pathogenesis of cardiovascular and metabolic disorders is extensively studied. Especially, EAT can be associated with the onset and development of coronary artery disease, myocardial infarction and post-infarct heart failure which all are significant problems for public health. In this article, we focus on the mechanisms of how EAT impacts acute coronary syndromes. Particular emphasis was placed on the role of inflammation and adipokines secreted by EAT. Moreover, we present how EAT affects the remodeling of the heart following myocardial infarction. We further review the role of EAT as a source of stem cells for cardiac regeneration. In addition, we describe the imaging assessment of EAT, its prognostic value, and its correlation with the clinical characteristics of patients.
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Affiliation(s)
- Kamil Krauz
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Marcel Kempiński
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Paweł Jańczak
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Karol Momot
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Maciej Zarębiński
- Department of Invasive Cardiology, Independent Public Specialist Western Hospital John Paul II, Lazarski University, Daleka 11, 05-825 Grodzisk Mazowiecki, Poland; (M.Z.); (I.P.)
| | - Izabela Poprawa
- Department of Invasive Cardiology, Independent Public Specialist Western Hospital John Paul II, Lazarski University, Daleka 11, 05-825 Grodzisk Mazowiecki, Poland; (M.Z.); (I.P.)
| | - Małgorzata Wojciechowska
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
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