TY - JOUR
T1 - Perivascular Adipose Tissue and Coronary Atherosclerosis
T2 - from Biology to Imaging Phenotyping
AU - Lin, Andrew
AU - Dey, Damini
AU - Wong, Dennis T.L.
AU - Nerlekar, Nitesh
PY - 2019/12
Y1 - 2019/12
N2 - Purpose of Review: Perivascular adipose tissue (PVAT) has a complex, bidirectional relationship with the vascular wall. In disease states, PVAT secretes pro-inflammatory adipocytokines which may contribute to atherosclerosis. Recent evidence demonstrates that pericoronary adipose tissue (PCAT) may also function as a sensor of coronary inflammation. This review details PVAT biology and its clinical translation to current imaging phenotyping. Recent Findings: PCAT attenuation derived from routine coronary computed tomography (CT) angiography is a novel noninvasive imaging biomarker of coronary inflammation. Pro-inflammatory cytokines released from the arterial wall diffuse directly into the surrounding PCAT and inhibit adipocyte lipid accumulation in a paracrine manner. This can be detected as an increased PCAT CT attenuation, a metric which associates with high-risk plaque features and independently predicts cardiac mortality. There is also evidence that PCAT attenuation relates to coronary plaque progression and is modified by systemic anti-inflammatory therapies. Summary: Due to its proximity to the coronary arteries, PCAT has emerged as an important fat depot in cardiovascular research. PCAT CT attenuation has the potential to improve cardiovascular risk stratification, and future clinical studies should examine its role in guiding targeted medical therapy.
AB - Purpose of Review: Perivascular adipose tissue (PVAT) has a complex, bidirectional relationship with the vascular wall. In disease states, PVAT secretes pro-inflammatory adipocytokines which may contribute to atherosclerosis. Recent evidence demonstrates that pericoronary adipose tissue (PCAT) may also function as a sensor of coronary inflammation. This review details PVAT biology and its clinical translation to current imaging phenotyping. Recent Findings: PCAT attenuation derived from routine coronary computed tomography (CT) angiography is a novel noninvasive imaging biomarker of coronary inflammation. Pro-inflammatory cytokines released from the arterial wall diffuse directly into the surrounding PCAT and inhibit adipocyte lipid accumulation in a paracrine manner. This can be detected as an increased PCAT CT attenuation, a metric which associates with high-risk plaque features and independently predicts cardiac mortality. There is also evidence that PCAT attenuation relates to coronary plaque progression and is modified by systemic anti-inflammatory therapies. Summary: Due to its proximity to the coronary arteries, PCAT has emerged as an important fat depot in cardiovascular research. PCAT CT attenuation has the potential to improve cardiovascular risk stratification, and future clinical studies should examine its role in guiding targeted medical therapy.
KW - Atherosclerosis
KW - Cardiac computed tomography angiography
KW - Inflammation
KW - Perivascular adipose tissue
UR - http://www.scopus.com/inward/record.url?scp=85075114458&partnerID=8YFLogxK
U2 - 10.1007/s11883-019-0817-3
DO - 10.1007/s11883-019-0817-3
M3 - Review Article
C2 - 31741080
AN - SCOPUS:85075114458
SN - 1523-3804
VL - 21
JO - Current Atherosclerosis Reports
JF - Current Atherosclerosis Reports
IS - 12
M1 - 47
ER -