Perivascular Adipose Tissue and Coronary Atherosclerosis: from Biology to Imaging Phenotyping.

Abstract:

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. 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.

journal_name

Curr Atheroscler Rep

authors

Lin A,Dey D,Wong DTL,Nerlekar N

doi

10.1007/s11883-019-0817-3

subject

Has Abstract

pub_date

2019-11-19 00:00:00

pages

47

issue

12

eissn

1523-3804

issn

1534-6242

pii

10.1007/s11883-019-0817-3

journal_volume

21

pub_type

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