Relation of Epicardial Adipose Tissue Radiodensity to Coronary Artery Calcium on Cardiac Computed Tomography in Patients at High Risk for Cardiovascular Disease

• Published in: The American journal of cardiology Vol. 119; no. 9; pp. 1359 - 1365
• Main Authors: Franssens, Bas T., MD, PhD, Nathoe, Hendrik M., MD PhD, Visseren, Frank LJ., MD PhD, van der Graaf, Yolanda, MD PhD, Leiner, Tim, MD PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2017; Elsevier Limited
• Subjects: Adipocytes; Adipose tissue; Adipose Tissue - diagnostic imaging; Aged; Aneurysm; Angiography; Aorta; Arches; Arteries; Arteriosclerosis; Atherosclerosis; Attenuation; Calcification; Calcification (ectopic); Calcium; Cardiovascular; Cardiovascular disease; Cardiovascular Diseases; Carotid artery; Cohort Studies; Collimation; Computation; Computed tomography; Computer programs; Coronary artery; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Correlation; Density; Diabetes mellitus; Drugs; Electric potential; Female; Health care; Health risk assessment; Health risks; Heart; Heart surgery; Humans; Hypersensitivity; Hypertension; Iodine; Kidneys; Lesions; Linear Models; Logistic Models; Male; Mathematical analysis; Medical imaging; Middle Aged; Minority & ethnic groups; Myocardium; Obesity; Odds Ratio; Pericardium - diagnostic imaging; Pharmacology; Physical activity; Plaque, Atherosclerotic - diagnostic imaging; Polarization; Prospective Studies; Quality; Renal failure; Risk; Risk factors; Skull; Statistical analysis; Tissues; Tomography; Tomography, X-Ray Computed; Transient ischemic attack; Vascular Calcification - diagnostic imaging; Vascular diseases; adipose tissue radiodensity; cardiovascular disease; epicardial adipose tissue; Computed Tomography; Coronary Artery Calcium; coronary atherosclerosis
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2017.01.031

Abstract Adipose tissue radiodensity detected by Computed Tomography (CT) is hypothesized to be associated with differences in adipose tissue composition which may contribute to the development of coronary atherosclerosis independent of epicardial adipose tissue volume. Aim of the current study was to quantify the relation between epicardial adipose tissue radiodensity and presence, distribution and density of Coronary Artery Calcium (CAC) in patients at high risk for cardiovascular disease. A total of 140 patients of the Secondary Manifestations of ARTerial disease (SMART) study underwent cardiac-CT angiography. Ordinal logistic and linear regression were used to quantify the relation between epicardial adipose tissue radiodensity (in Hounsfield Units, HU) and CAC. One Standard Deviation (SD) lower attenuation (5 HU) was associated with a 1.90 (95%CI 1.14-3.19) higher odds for men and a 1.07 (95%CI 0.41-2.75) higher odds for women of being in a higher CAC class (0, 1-100, 101-400 and >400), independent of age, CABG history, epicardial adipose tissue volume and BMI. One SD lower attenuation was not associated with more diffuse distribution of CAC, but increased the odds of being in a higher tertile of CAC density per plaque (OR 1.77, 95%CI 1.18-2.66). In conclusion, low epicardial adipose tissue CT attenuation is associated with higher CAC scores in men at high risk for cardiovascular disease, independent of epicardial depot volume and BMI. Current results suggest a potential role for epicardial adipose tissue radiodensity as a measure of adipose tissue composition and may inform on the contribution of epicardial adipose tissue composition to coronary atherosclerosis.