Key result
Acute aortic dissection is linked to increased pericoronary adipose tissue attenuation regardless of coronary stenosis.
Why the study?
Because periaortic fat is linked to coronary disease, it was hypothesized that inflammation from acute aortic dissection spreads to pericoronary adipose tissue via thoracic periaortic fat.
Is acute aortic dissection associated with increased pericoronary adipose tissue attenuation in patients presenting with chest pain?
Observational
Is acute aortic dissection associated with increased pericoronary adipose tissue attenuation in patients presenting with chest pain?
Odds Ratio: 0.014 (95% CI 0.001–0.177)
p-value: p=0.001
Pericoronary adipose tissue attenuation on CT is increased in patients with acute aortic dissection independent of coronary artery disease, suggesting the presence of vascular inflammation.
Elevated PCATa may signal perivascular inflammation in AAD independent of CAD; leaves open its value as a predictive biomarker pending prospective studies.
Background: Periaortic fat is associated with coronary disease. Thus, it was hypothesized that the inflammation associated with acute aortic dissection (AAD) spreads to pericoronary adipose tissue (PCAT) via thoracic periaortic fat. Pericoronary adipose tissue attenuation (PCATa) serves as a marker for inflammation of perivascular adipose tissue (PVAT). This study sought to examine PCATa in individuals diagnosed with AAD. Methods: Consecutive patients with chest pain from May 2020 to September 2022 were prospectively enrolled in this study and underwent coronary computed tomography angiography (CCTA) and/or aorta computed tomography angiography (CTA). Based on the results of the CTA, the patients were divided into the following two groups: (I) the AAD group; and (II) the non-AAD group. PCATa of the right coronary angiography (RCA), left anterior descending (LAD), and left circumflex (LCx) was quantified for each patient using semi-automated software. The PCATa values were compared between the AAD and non-AAD patients according to the atherosclerosis of the coronary arteries. Similarly, the PCATa values of the AAD patients were compared between the preoperative and postoperative steady states. Results: values were associated with AAD regardless of the degree of stenosis [odds ratio (OR) =0.014; 95% confidence interval (CI): 0.001-0.177; P=0.001 and OR =0.010; 95% CI: 0.001-0.189; P=0.002]. Conclusions: PCATa on computed tomography was increased in patients with AAD regardless of the presence or absence of coronary artery disease (CAD). This suggests that vascular inflammation is present in AAD independent of CAD. Further research should be conducted to investigate the potential of this imaging biomarker to predict AAD and monitor patients' responses to therapies for AAD.
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Tu et al. (2023) conducted an observational in Acute aortic dissection. Acute aortic dissection vs. Non-acute aortic dissection was evaluated on Pericoronary adipose tissue attenuation (PCATa) (OR 0.014, 95% CI 0.001-0.177, p=0.001). Acute aortic dissection was associated with increased pericoronary adipose tissue attenuation regardless of coronary stenosis degree (OR 0.014; 95% CI 0.001-0.177; P=0.001).
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