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Comparative Analysis of Perivascular Adipose Tissue Attenuation on Chest Computed Tomography Angiography in Patients
Domenico Tuttolomondo1, Francesco Secchi2,3, Nicola Gaibazzi1
1Cardiology Unit, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126 Parma, Italy.
Abstract:
Background: Marfan syndrome (MFS) is a rare autosomal dominant disorder affecting connective tissues due to mutations in the fibrillin-1 gene. These genetic changes often result in severe cardiovascular conditions, including asymptomatic thoracic aortic dilation potentially leading to dissection or rupture. Perivascular adipose tissue attenuation (PVAT) observed on computed tomography may serve as a marker of localized inflammation and indicate early histopathological changes in the vascular walls of MFS patients compared to healthy individuals. Objective: This study aimed to compare PVAT values between patients with MFS and healthy controls in order to explore whether MFS patients show higher PVAT secondary to these histopathological abnormalities. Methods: This case-control study assessed PVAT on ascending aorta through computed tomography angiography (CTA) in 54 genetically confirmed MFS patients and 43 controls with low ischemic risk, excluding those with known aortic aneurysms. Results: PVAT analysis revealed significant differences between the MFS patients and healthy controls (-70.6 HU [-72.6 HU to -68.5 HU] versus -75.1 HU [-77.1 HU to -73.1 HU], p = 0.002), suggesting potential early vascular changes in the MFS group. Conclusions: The findings underscore the potential diagnostic role of PVAT in patients with genetically confirmed MFS but normal ascending aorta diameter.
Insights
Perivascular adipose tissue attenuation (PVAT) is higher in Marfan syndrome (MFS) patients, indicating early vascular changes. This finding suggests PVAT may aid in diagnosing MFS even with normal aorta diameter.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Radiology
Background:
- Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder caused by fibrillin-1 gene mutations.
- MFS frequently leads to severe cardiovascular complications, notably thoracic aortic dilation, dissection, or rupture.
- Perivascular adipose tissue (PVAT) attenuation on CT may reflect localized inflammation and early vascular wall changes in MFS.
Purpose of the Study:
- To compare PVAT values between MFS patients and healthy controls.
- To investigate if MFS patients exhibit increased PVAT due to underlying histopathological abnormalities.
- To explore PVAT as a potential early marker for vascular changes in MFS.
Main Methods:
- A case-control study design was employed.
- Computed tomography angiography (CTA) was used to assess ascending aorta PVAT.
- The study included 54 genetically confirmed MFS patients and 43 healthy controls without known aortic aneurysms.
Main Results:
- Significant differences in PVAT were observed between MFS patients and healthy controls (p = 0.002).
- MFS patients showed higher PVAT values (-70.6 HU) compared to controls (-75.1 HU).
- These results suggest potential early vascular alterations in MFS patients.
Conclusions:
- PVAT analysis may serve as a diagnostic indicator in genetically confirmed MFS.
- PVAT could be valuable for detecting early vascular changes, especially when the ascending aorta diameter is normal.
- This highlights a potential non-invasive imaging marker for MFS-related vascular abnormalities.
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