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Epicardial adipose tissue characteristics and CT high-risk plaque features: correlation with coronary thin-cap fibroatheroma determined by intravascular ultrasound

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Abstract

To investigate the correlation of epicardial adipose tissue (EAT) characteristics and high-risk plaque features characterized by coronary CT angiography (CCTA) for identifying the presence of thin-cap fibroatheroma (TCFA). Patients who underwent both CCTA and intravascular ultrasound (IVUS) within 4 weeks were retrospectively included. CT-derived quantitative and qualitative parameters, including diameter stenosis, low attenuation plaque (LAP), napkin-ring sign (NRS), positive remodeling and spotty calcification, were recorded. EAT volume and density were also measured. TCFA lesions and non-TCFA lesions were determined by IVUS. Multivariate regression analysis was used to determine the independent predictors of TCFA lesions. Sixty-eight patients (mean age: 68.6 ± 9.7 years; 40 males) with 91 lesions were finally included in our study. For CT-derived plaque features, LAP (77.8% versus 25%, p < 0.001) and NRS (40.7% versus 9.4%, p < 0.001) was more frequently presented in TCFA lesions than was in non-TCFA lesions. For EAT characteristics, EAT volume (110 ± 14 cm3 versus 98 ± 12 cm3, p < 0.001) was significantly larger whereas EAT density (−77 ± 4 HU versus −80 ± 5, p = 0.003) was markedly higher in TCFA lesions. According to multivariate logistic regression analysis, LAP, EAT volume and EAT density were significant predictors (odds ratio: 9.758, 1.095 and 1.202, all p value < 0.05) for the presence of TCFA lesions. EAT volume and density was greater in patients with TCFA lesions whereas LAP and NRS was more frequently presented. In addition, EAT characteristics and LAP were independent predictors of vulnerable plaques as determined by IVUS.

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Funding

Mingyuan Yuan was funded by 2017 People’s Livelihood Project of PuDong Committee On Science and Technology in Shanghai (PKJ2017-Y39). Mingyuan Yuan was funded by Key and weak Specialty Construction Program of Pudong Health Bureau of Shanghai (PWZbr2017-11). Mingyuan Yuan was funded by Innovative and Collaborative Project Funding of Shanghai University of Medicine and Health Sciences (SPCI-18-17-001). Mingyuan Yuan was funded by 2017 General Research Projects of Health Bureau of Shanghai (201740199).

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Authors and Affiliations

  1. Department of Radiology, Affiliated Zhoupu Hospital, Shanghai University of Medicine and Health Science, #1500, Zhouyuan Rd, Shanghai, China

    Mingyuan Yuan, Hao Wu & Rongxian Li

  2. Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, #600, Yishan Rd, Shanghai, China

    Lihua Yu & Jiayin Zhang

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  1. Mingyuan Yuan
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  2. Hao Wu
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  4. Lihua Yu
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  5. Jiayin Zhang
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Correspondence to Jiayin Zhang.

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Yuan, M., Wu, H., Li, R. et al. Epicardial adipose tissue characteristics and CT high-risk plaque features: correlation with coronary thin-cap fibroatheroma determined by intravascular ultrasound. Int J Cardiovasc Imaging 36, 2281–2289 (2020). https://doi.org/10.1007/s10554-020-01917-2

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