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Relationship between epicardial fat and quantitative coronary artery plaque progression: insights from computer tomography coronary angiography

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Abstract

Epicardial fat volume (EFV) has been suggested to promote atherosclerotic plaque development in coronary arteries, and has been correlated with both coronary stenosis and acute coronary events. Although associated with progression of coronary calcification burden, a relationship with progression of coronary atheroma volume has not been previously tested. We studied patients who had clinically indicated serial 320-row multi-detector computer tomography coronary angiography with a median 25-month interval. EFV was measured at baseline and follow-up. In vessels with coronary stenosis, quantitative analysis was performed to measure atherosclerotic plaque burden, volume and aggregate plaque volume at baseline and follow-up. The study comprised 64 patients (58.4 ± 12.2 years, 27 males, 192 vessels, 193 coronary segments). 79 (41 %) coronary segments had stenosis at baseline. Stenotic segments were associated with greater baseline EFV than those without coronary stenosis (117.4 ± 45.1 vs. 102.3 ± 51.6 cm3, P = 0.046). 46 (24 %) coronary segments displayed either new plaque formation or progression of adjusted plaque burden at follow-up. These were associated with higher baseline EFV than segments without stenosis or those segments that had stenoses that did not progress (128.7 vs. 101.0 vs. 106.7 cm3 respectively, P = 0.006). On multivariate analysis, baseline EFV was the only independent predictor of coronary atherosclerotic plaque progression or new development (P = 0.014). High baseline EFV is associated with the presence of coronary artery stenosis and plaque volume progression. Accumulation of EFV may be implicated in the evolution and progression of coronary atheroma.

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Acknowledgments

DW and BK are supported by NHF (Australia) Post-Doctoral-fellowships and Robertson-Family-Research-Cardiologist-Fund. PJP is supported by a Post-doctoral Fellowship from the National Health and Medical Research Council of Australia.

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    1. Monash Heart, Monash Cardiovascular Research Centre, Monash University, Clayton, VIC, Australia

      Peter J. Psaltis, Andrew H. Talman, Kiran Munnur, James D. Cameron, Brian S. H. Ko, Ian T. Meredith, Sujith K. Seneviratne & Dennis T. L. Wong

    2. Department of Medicine, University of Adelaide and Heart Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia

      Peter J. Psaltis & Dennis T. L. Wong

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    Peter J. Psaltis and Andrew H. Talman have contributed equally to this work.

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    Psaltis, P.J., Talman, A.H., Munnur, K. et al. Relationship between epicardial fat and quantitative coronary artery plaque progression: insights from computer tomography coronary angiography. Int J Cardiovasc Imaging 32, 317–328 (2016). https://doi.org/10.1007/s10554-015-0762-3

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