Epicardial adipose tissue attenuation on computed tomography in women with coronary microvascular dysfunction: A pilot, hypothesis generating study.

Autor: Patel NH; J. Willis Hurst Internal Medicine Residency Program, Emory University, USA., Dave EK; Emory Women's Heart Center, Division of Cardiology, Emory University School of Medicine, USA., Fatade YA; J. Willis Hurst Internal Medicine Residency Program, Emory University, USA., De Cecco CN; Department of Radiology, Emory University School of Medicine, USA., Ko YA; Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University, USA., Chen Y; Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University, USA., Sharma A; Division of Hospital Medicine, Emory University School of Medicine, USA., Rashid F; Emory Women's Heart Center, Division of Cardiology, Emory University School of Medicine, USA., Vatsa N; Emory Women's Heart Center, Division of Cardiology, Emory University School of Medicine, USA., Samady H; Northeast Georgia Medical Center, GA, USA., Toleva O; Northeast Georgia Medical Center, GA, USA., Quyyumi A; Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University, USA., Mehta PK; Emory Women's Heart Center, Division of Cardiology, Emory University School of Medicine, USA; Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University, USA. Electronic address: pkmehta@emory.edu., Stillman AE; Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University, USA; Department of Radiology, Emory University School of Medicine, USA.
Jazyk: angličtina
Zdroj: Atherosclerosis [Atherosclerosis] 2024 Aug; Vol. 395, pp. 118520. Date of Electronic Publication: 2024 Jun 15.
DOI: 10.1016/j.atherosclerosis.2024.118520
Abstrakt: Background: Patients with myocardial ischemia without obstructive coronary artery disease often have coronary microvascular dysfunction (CMD) and associated increased risk of cardiovascular (CV) events and anginal hospitalizations. Epicardial adipose tissue (EAT) covers much of the myocardium and coronary arteries and when dysfunctional, secretes proinflammatory cytokines and is associated with CV events. While oxidative stress and systemic inflammation are associated with CMD, the relationship between EAT and CMD in women is not well known.
Methods: Women diagnosed with CMD (n = 21) who underwent coronary computed tomography with coronary artery calcium (CAC) scoring were compared to a reference group (RG) of women referred for CAC screening for preventive risk assessment (n = 181). EAT attenuation (Hounsfield units (HU)) was measured adjacent to the proximal right coronary artery, along with subcutaneous adipose tissue (SCAT). Two-sample t-tests with unequal variances were utilized.
Results: Mean age of the CMD group was 56 ± 8 years and body mass index (BMI) was 31.6 ± 6.8 kg/m 2 . CV risk factors in the CMD group were prevalent: 67 % hypertension, 44 % hyperlipidemia, and 33 % diabetes. Both CMD and RG had similar CAC score (25.86 ± 59.54 vs. 24.17 ± 104.6; p = 0.21. In the CMD group, 67 % had a CAC of 0. Minimal atherosclerosis (CAD-RADS 1) was present in 76 % of women with CMD. The CMD group had lower EAT attenuation than RG (-103.3 ± 6.33 HU vs. -97.9 ± 8.3 HU, p = 0.009, respectively). There were no differences in SCAT attenuation. Hypertension, smoking history, age, BMI, and CAC score did not correlate with EAT in either of the groups.
Conclusions: Women with CMD have decreased EAT attenuation compared to RG women. EAT-mediated inflammation and changes in vascular tone may be a mechanistic contributor to abnormal microvascular reactivity. Clinical trials testing therapeutic strategies to decrease EAT may be warranted in the management of CMD.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Puja K. Mehta reports financial support was provided by National Institutes of Health. Carlo N. De Cecco reports a relationship with Siemens Healthineers that includes: funding grants. Carlo N. De Cecco reports a relationship with Covanos, Inc. that includes: consulting or advisory. Carlo N. De Cecco reports a relationship with Bayer that includes: consulting or advisory. Carlo N. De Cecco reports a relationship with Xeos that includes: consulting or advisory. Habib Samady reports a relationship with Philips and Abbott Vascular that includes: consulting or advisory. Habib Samady reports a relationship with Covanos, Inc. that includes: equity or stocks. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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