Prognostic Value of Pericoronary Fat Attenuation Index on Computed Tomography for Hospitalization for Heart Failure

Figures

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  Figure 1. Representative Case Showing Fat Attenuation Index by Coronary Computed Tomography Angiography Three-dimensional reconstruction of the heart (A) and (E); pericoronary adipose tissue attenuation between −190 HU and −30 HU in the longitudinal view (B) and (F) and cross-sectional view (C) and (G); around the proximal 40 mm of the left anterior descending artery; histogram of CT attenuation within the traced area (D) and (H). A to D show pericoronary fat attenuation index in a case with the incidence of heart failure during follow-up. E to H show pericoronary fat attenuation index in a case without incidence of heart failure during follow-up. CT = computed tomography.

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  Figure 2. Patient Flow Diagram Among 1,670 patients without a history of CAD and who underwent CCTA and TTE for suspected CAD, those with histories of CAD, thoracic surgery, and hospitalization for HF, with LVEF <50%, undergoing emodialysis, with poor image quality for measurement of pericoronary FAI of any major epicardial coronary vessel, and lost to follow-up after the day of CCTA were excluded. A total of 1,196 patients were finally enrolled. CAD = coronary artery disease; CCTA = coronary computed tomography angiography; FAI = fat attenuation index; HF = heart failure; LVEF = left ventricular ejection fraction; PCI = percutaneous coronary intervention; TTE = transthoracic echocardiography.

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  Figure 3. Comparison of Pericoronary Fat Attenuation Index of the Left Anterior Descending Artery According to Significant Stenosis and Early Revascularization The values of pericoronary FAI of the LAD were compared between patients with and without hospitalization for heart failure among those without significant stenosis. HFpEF = heart failure with preserved ejection fraction; LAD = left anterior descending artery; other abbreviations as in Figure 2.

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  Figure 4. The Cumulative Incidences of Hospitalization for Heart Failure With Preserved Ejection Fraction According to the Optimal Cutoff Value of Left Anterior Descending Artery-Fat Attenuation Index Patients with a higher LAD-FAI had a significantly higher cumulative incidence of hospitalization for HFpEF than those with a lower LAD-FAI. Abbreviations as in Figures 1, 2, and 3.

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  Central Illustration. Pericoronary Fat Attenuation Index Predicts Hospitalization for Heart Failure With a Preserved Ejection Fraction eGFR = estimated glomerular filtration rate; other abbreviation as in Figure 1.