Association Between Changes in Perivascular Adipose Tissue Density and Plaque Progression.

Area of Science:

• Cardiovascular Imaging
• Atherosclerosis Research
• Medical Diagnostics

Background:

• The relationship between changes in vessel inflammation, measured by perivascular adipose tissue (PVAT) density, and the progression of coronary atherosclerosis is not well understood.
• PVAT density serves as a quantitative marker for inflammation surrounding blood vessels.

Purpose of the Study:

• To investigate the association between changes in PVAT density and the progression of total and compositional plaque volume (PV) in coronary arteries.
• To determine if PVAT density changes predict the growth of atherosclerotic plaques.

Main Methods:

• Utilized data from a prospective multinational registry of patients undergoing serial coronary computed tomography angiography (CCTA) at intervals of ≥2 years.
• Quantitatively analyzed total and compositional plaque volume (PV) and PVAT density for each lesion at baseline and follow-up using CCTA.
• Employed multivariate linear regression models with cluster analyses to assess associations, adjusting for various clinical and imaging factors.

Main Results:

• Analysis of 1,476 lesions from 474 patients revealed that an increase in PVAT density was positively associated with the progression of total plaque volume.
• This association was primarily driven by the fibrous (noncalcified) component of plaque, with increased PVAT density linked to fibrous plaque progression.
• No significant association was found between increased PVAT density and the progression of calcified plaque volume.

Conclusions:

• Increased vessel inflammation, as indicated by rising PVAT density, is independently associated with the progression of the lipid component of coronary atherosclerotic plaques.
• These findings highlight the role of inflammation in atherosclerotic plaque development and suggest PVAT density as a potential imaging biomarker.