Perivascular Fat: A Novel Risk Factor for Coronary Artery Disease
Abstract
:1. Introduction
2. Pathophysiology of EAT
3. The Interplay between the Vascular Wall and PVAT
4. PVAT Attenuation as a Biomarker of Vascular Inflammation
5. FAI in Assessing Coronary Atherosclerosis
6. FAI as a Biomarker of Dynamic Changes in Coronary Inflammation
6.1. FAI as a Biomarker of Plaque Instability
6.2. The Effect of Anti-Inflammatory Treatment on FAI
7. FAI as a Prognostic Tool
FAI vs. Circulating Biomarkers of Vascular Inflammation
8. FAI in Clinical Practice
9. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- Cypess, A.M. Reassessing Human Adipose Tissue. N. Engl. J. Med. 2022, 386, 768–779. [Google Scholar] [CrossRef] [PubMed]
- Antonopoulos, A.S.; Tousoulis, D. The molecular mechanisms of obesity paradox. Cardiovasc. Res. 2017, 113, 1074–1086. [Google Scholar] [CrossRef]
- Antonopoulos, A.S.; Tousoulis, D. Adipose tissue browning in cardiometabolic health and disease. Hellenic J. Cardiol. 2019, 60, 294–295. [Google Scholar] [CrossRef]
- Oikonomou, E.K.; Antoniades, C. The role of adipose tissue in cardiovascular health and disease. Nat. Rev. Cardiol. 2019, 16, 83–99. [Google Scholar] [CrossRef]
- Antonopoulos, A.S.; Antoniades, C. The role of epicardial adipose tissue in cardiac biology: Classic concepts and emerging roles. J. Physiol. 2017, 595, 3907–3917. [Google Scholar] [CrossRef]
- Antonopoulos, A.S.; Sanna, F.; Sabharwal, N.; Thomas, S.; Oikonomou, E.K.; Herdman, L.; Margaritis, M.; Shirodaria, C.; Kampoli, A.M.; Akoumianakis, I.; et al. Detecting human coronary inflammation by imaging perivascular fat. Sci. Transl. Med. 2017, 9, eaal2658. [Google Scholar] [CrossRef] [PubMed]
- Oikonomou, E.K.; Desai, M.Y.; Marwan, M.; Kotanidis, C.P.; Antonopoulos, A.S.; Schottlander, D.; Channon, K.M.; Neubauer, S.; Achenbach, S.; Antoniades, C. Perivascular Fat Attenuation Index Stratifies Cardiac Risk Associated with High-Risk Plaques in the CRISP-CT Study. J. Am. Coll. Cardiol. 2020, 76, 755–757. [Google Scholar] [CrossRef] [PubMed]
- Oikonomou, E.K.; Marwan, M.; Desai, M.Y.; Mancio, J.; Alashi, A.; Hutt Centeno, E.; Thomas, S.; Herdman, L.; Kotanidis, C.P.; Thomas, K.E.; et al. Non-invasive detection of coronary inflammation using computed tomography and prediction of residual cardiovascular risk (the CRISP CT study): A post-hoc analysis of prospective outcome data. Lancet 2018, 392, 929–939. [Google Scholar] [CrossRef] [PubMed]
- Oikonomou, E.K.; Antonopoulos, A.S.; Schottlander, D.; Marwan, M.; Mathers, C.; Tomlins, P.; Siddique, M.; Kluner, L.V.; Shirodaria, C.; Mavrogiannis, M.C.; et al. Standardized measurement of coronary inflammation using cardiovascular computed tomography: Integration in clinical care as a prognostic medical device. Cardiovasc. Res. 2021, 117, 2677–2690. [Google Scholar] [CrossRef]
- Antoniades, C.; Tousoulis, D.; Vavlukis, M.; Fleming, I.; Duncker, D.J.; Eringa, E.; Manfrini, O.; Antonopoulos, A.S.; Oikonomou, E.; Padro, T.; et al. Perivascular adipose tissue as a source of therapeutic targets and clinical biomarkers. Eur. Heart J. 2023, 44, 3827–3844. [Google Scholar] [CrossRef]
- Antoniades, C.; Antonopoulos, A.S.; Deanfield, J. Imaging residual inflammatory cardiovascular risk. Eur. Heart J. 2020, 41, 748–758. [Google Scholar] [CrossRef] [PubMed]
- Antonopoulos, A.S.; Papastamos, C.; Cokkinos, D.V.; Tsioufis, K.; Tousoulis, D. Epicardial Adipose Tissue in Myocardial Disease: From Physiology to Heart Failure Phenotypes. Curr. Probl. Cardiol. 2023, 48, 101841. [Google Scholar] [CrossRef]
- Nyawo, T.A.; Pheiffer, C.; Mazibuko-Mbeje, S.E.; Mthembu, S.X.H.; Nyambuya, T.M.; Nkambule, B.B.; Sadie-Van Gijsen, H.; Strijdom, H.; Tiano, L.; Dludla, P.V. Physical Exercise Potentially Targets Epicardial Adipose Tissue to Reduce Cardiovascular Disease Risk in Patients with Metabolic Diseases: Oxidative Stress and Inflammation Emerge as Major Therapeutic Targets. Antioxidants 2021, 10, 1758. [Google Scholar] [CrossRef]
- Antonopoulos, A.S.; Margaritis, M.; Verheule, S.; Recalde, A.; Sanna, F.; Herdman, L.; Psarros, C.; Nasrallah, H.; Coutinho, P.; Akoumianakis, I.; et al. Mutual Regulation of Epicardial Adipose Tissue and Myocardial Redox State by PPAR-gamma/Adiponectin Signalling. Circ. Res. 2016, 118, 842–855. [Google Scholar] [CrossRef]
- Simantiris, S.; Papastamos, C.; Antonopoulos, A.S.; Theofilis, P.; Sagris, M.; Bounta, M.; Konisti, G.; Galiatsatos, N.; Xanthaki, A.; Tsioufis, K.; et al. Oxidative Stress Biomarkers in Coronary Artery Disease. Curr. Top. Med. Chem. 2023, 23, 2158–2171. [Google Scholar] [CrossRef] [PubMed]
- Packer, M. Epicardial Adipose Tissue May Mediate Deleterious Effects of Obesity and Inflammation on the Myocardium. J. Am. Coll. Cardiol. 2018, 71, 2360–2372. [Google Scholar] [CrossRef] [PubMed]
- Venteclef, N.; Guglielmi, V.; Balse, E.; Gaborit, B.; Cotillard, A.; Atassi, F.; Amour, J.; Leprince, P.; Dutour, A.; Clement, K.; et al. Human epicardial adipose tissue induces fibrosis of the atrial myocardium through the secretion of adipo-fibrokines. Eur. Heart J. 2015, 36, 795–805. [Google Scholar] [CrossRef] [PubMed]
- Fox, C.S.; Gona, P.; Hoffmann, U.; Porter, S.A.; Salton, C.J.; Massaro, J.M.; Levy, D.; Larson, M.G.; D’Agostino, R.B., Sr.; O’Donnell, C.J.; et al. Pericardial fat, intrathoracic fat, and measures of left ventricular structure and function: The Framingham Heart Study. Circulation 2009, 119, 1586–1591. [Google Scholar] [CrossRef]
- Mancio, J.; Azevedo, D.; Fragao-Marques, M.; Falcao-Pires, I.; Leite-Moreira, A.; Lunet, N.; Fontes-Carvalho, R.; Bettencourt, N. Meta-Analysis of Relation of Epicardial Adipose Tissue Volume to Left Atrial Dilation and to Left Ventricular Hypertrophy and Functions. Am. J. Cardiol. 2019, 123, 523–531. [Google Scholar] [CrossRef]
- van Woerden, G.; Gorter, T.M.; Westenbrink, B.D.; Willems, T.P.; van Veldhuisen, D.J.; Rienstra, M. Epicardial fat in heart failure patients with mid-range and preserved ejection fraction. Eur. J. Heart Fail. 2018, 20, 1559–1566. [Google Scholar] [CrossRef]
- Mahabadi, A.A.; Lehmann, N.; Kalsch, H.; Bauer, M.; Dykun, I.; Kara, K.; Moebus, S.; Jockel, K.H.; Erbel, R.; Mohlenkamp, S. Association of epicardial adipose tissue and left atrial size on non-contrast CT with atrial fibrillation: The Heinz Nixdorf Recall Study. Eur. Heart J. Cardiovasc. Imaging 2014, 15, 863–869. [Google Scholar] [CrossRef] [PubMed]
- Akoumianakis, I.; Tarun, A.; Antoniades, C. Perivascular adipose tissue as a regulator of vascular disease pathogenesis: Identifying novel therapeutic targets. Br. J. Pharmacol. 2017, 174, 3411–3424. [Google Scholar] [CrossRef] [PubMed]
- Ouchi, N.; Kihara, S.; Arita, Y.; Okamoto, Y.; Maeda, K.; Kuriyama, H.; Hotta, K.; Nishida, M.; Takahashi, M.; Muraguchi, M.; et al. Adiponectin, an adipocyte-derived plasma protein, inhibits endothelial NF-kappaB signaling through a cAMP-dependent pathway. Circulation 2000, 102, 1296–1301. [Google Scholar] [CrossRef] [PubMed]
- Chen, H.; Montagnani, M.; Funahashi, T.; Shimomura, I.; Quon, M.J. Adiponectin stimulates production of nitric oxide in vascular endothelial cells. J. Biol. Chem. 2003, 278, 45021–45026. [Google Scholar] [CrossRef]
- Dong, Z.; Zhuang, Q.; Ye, X.; Ning, M.; Wu, S.; Lu, L.; Wan, X. Adiponectin Inhibits NLRP3 Inflammasome Activation in Nonalcoholic Steatohepatitis via AMPK-JNK/ErK1/2-NFkappaB/ROS Signaling Pathways. Front. Med. 2020, 7, 546445. [Google Scholar] [CrossRef]
- Almabrouk, T.A.; Ewart, M.A.; Salt, I.P.; Kennedy, S. Perivascular fat, AMP-activated protein kinase and vascular diseases. Br. J. Pharmacol. 2014, 171, 595–617. [Google Scholar] [CrossRef]
- Wulster-Radcliffe, M.C.; Ajuwon, K.M.; Wang, J.; Christian, J.A.; Spurlock, M.E. Adiponectin differentially regulates cytokines in porcine macrophages. Biochem. Biophys. Res. Commun. 2004, 316, 924–929. [Google Scholar] [CrossRef]
- Leandro, A.; Queiroz, M.; Azul, L.; Seica, R.; Sena, C.M. Omentin: A novel therapeutic approach for the treatment of endothelial dysfunction in type 2 diabetes. Free Radic. Biol. Med. 2021, 162, 233–242. [Google Scholar] [CrossRef]
- Kim, H.W.; Shi, H.; Winkler, M.A.; Lee, R.; Weintraub, N.L. Perivascular Adipose Tissue and Vascular Perturbation/Atherosclerosis. Arterioscler. Thromb. Vasc. Biol. 2020, 40, 2569–2576. [Google Scholar] [CrossRef]
- Ichikawa, K.; Miyoshi, T.; Ohno, Y.; Osawa, K.; Nakashima, M.; Nishihara, T.; Miki, T.; Toda, H.; Yoshida, M.; Ito, H. Association between High Pericoronary Adipose Tissue Computed Tomography Attenuation and Impaired Flow-Mediated Dilation of the Brachial Artery. J. Atheroscler. Thromb. 2023, 30, 364–376. [Google Scholar] [CrossRef]
- Saely, C.H.; Leiherer, A.; Muendlein, A.; Vonbank, A.; Rein, P.; Geiger, K.; Malin, C.; Drexel, H. High plasma omentin predicts cardiovascular events independently from the presence and extent of angiographically determined atherosclerosis. Atherosclerosis 2016, 244, 38–43. [Google Scholar] [CrossRef] [PubMed]
- Guzik, T.J.; Skiba, D.S.; Touyz, R.M.; Harrison, D.G. The role of infiltrating immune cells in dysfunctional adipose tissue. Cardiovasc. Res. 2017, 113, 1009–1023. [Google Scholar] [CrossRef] [PubMed]
- Bokarewa, M.; Nagaev, I.; Dahlberg, L.; Smith, U.; Tarkowski, A. Resistin, an adipokine with potent proinflammatory properties. J. Immunol. 2005, 174, 5789–5795. [Google Scholar] [CrossRef]
- Chen, C.; Jiang, J.; Lu, J.M.; Chai, H.; Wang, X.; Lin, P.H.; Yao, Q. Resistin decreases expression of endothelial nitric oxide synthase through oxidative stress in human coronary artery endothelial cells. Am. J. Physiol. Heart Circ. Physiol. 2010, 299, H193–H201. [Google Scholar] [CrossRef]
- Marketou, M.; Kontaraki, J.; Kalogerakos, P.; Plevritaki, A.; Chlouverakis, G.; Kassotakis, S.; Maragkoudakis, S.; Danelatos, C.; Zervakis, S.; Savva, E.; et al. Differences in MicroRNA Expression in Pericoronary Adipose Tissue in Coronary Artery Disease Compared to Severe Valve Dysfunction. Angiology 2023, 74, 22–30. [Google Scholar] [CrossRef]
- Vacca, M.; Di Eusanio, M.; Cariello, M.; Graziano, G.; D’Amore, S.; Petridis, F.D.; D’Orazio, A.; Salvatore, L.; Tamburro, A.; Folesani, G.; et al. Integrative miRNA and whole-genome analyses of epicardial adipose tissue in patients with coronary atherosclerosis. Cardiovasc. Res. 2016, 109, 228–239. [Google Scholar] [CrossRef] [PubMed]
- Liu, Y.; Sun, Y.; Lin, X.; Zhang, D.; Hu, C.; Liu, J.; Zhu, Y.; Gao, A.; Han, H.; Chai, M.; et al. Perivascular adipose-derived exosomes reduce macrophage foam cell formation through miR-382-5p and the BMP4-PPARgamma-ABCA1/ABCG1 pathways. Vascul Pharmacol. 2022, 143, 106968. [Google Scholar] [CrossRef]
- Margaritis, M.; Antonopoulos, A.S.; Digby, J.; Lee, R.; Reilly, S.; Coutinho, P.; Shirodaria, C.; Sayeed, R.; Petrou, M.; De Silva, R.; et al. Interactions between vascular wall and perivascular adipose tissue reveal novel roles for adiponectin in the regulation of endothelial nitric oxide synthase function in human vessels. Circulation 2013, 127, 2209–2221. [Google Scholar] [CrossRef]
- Antonopoulos, A.S.; Antoniades, C. Perivascular Fat Attenuation Index by Computed Tomography as a Metric of Coronary Inflammation. J. Am. Coll. Cardiol. 2018, 71, 2708–2709. [Google Scholar] [CrossRef]
- Theofilis, P.; Sagris, M.; Antonopoulos, A.S.; Oikonomou, E.; Tsioufis, K.; Tousoulis, D. Non-Invasive Modalities in the Assessment of Vulnerable Coronary Atherosclerotic Plaques. Tomography 2022, 8, 1742–1758. [Google Scholar] [CrossRef]
- Kwiecinski, J.; Dey, D.; Cadet, S.; Lee, S.E.; Otaki, Y.; Huynh, P.T.; Doris, M.K.; Eisenberg, E.; Yun, M.; Jansen, M.A.; et al. Peri-Coronary Adipose Tissue Density Is Associated with (18)F-Sodium Fluoride Coronary Uptake in Stable Patients with High-Risk Plaques. JACC Cardiovasc. Imaging 2019, 12, 2000–2010. [Google Scholar] [CrossRef] [PubMed]
- Oikonomou, E.K.; Williams, M.C.; Kotanidis, C.P.; Desai, M.Y.; Marwan, M.; Antonopoulos, A.S.; Thomas, K.E.; Thomas, S.; Akoumianakis, I.; Fan, L.M.; et al. A novel machine learning-derived radiotranscriptomic signature of perivascular fat improves cardiac risk prediction using coronary CT angiography. Eur. Heart J. 2019, 40, 3529–3543. [Google Scholar] [CrossRef]
- Marwan, M.; Hell, M.; Schuhback, A.; Gauss, S.; Bittner, D.; Pflederer, T.; Achenbach, S. CT Attenuation of Pericoronary Adipose Tissue in Normal Versus Atherosclerotic Coronary Segments as Defined by Intravascular Ultrasound. J. Comput. Assist. Tomogr. 2017, 41, 762–767. [Google Scholar] [CrossRef] [PubMed]
- Yu, M.; Dai, X.; Deng, J.; Lu, Z.; Shen, C.; Zhang, J. Diagnostic performance of perivascular fat attenuation index to predict hemodynamic significance of coronary stenosis: A preliminary coronary computed tomography angiography study. Eur. Radiol. 2020, 30, 673–681. [Google Scholar] [CrossRef]
- Hoshino, M.; Yang, S.; Sugiyama, T.; Zhang, J.; Kanaji, Y.; Yamaguchi, M.; Hada, M.; Sumino, Y.; Horie, T.; Nogami, K.; et al. Peri-coronary inflammation is associated with findings on coronary computed tomography angiography and fractional flow reserve. J. Cardiovasc. Comput. Tomogr. 2020, 14, 483–489. [Google Scholar] [CrossRef]
- Nomura, C.H.; Assuncao-Jr, A.N.; Guimaraes, P.O.; Liberato, G.; Morais, T.C.; Fahel, M.G.; Giorgi, M.C.P.; Meneghetti, J.C.; Parga, J.R.; Dantas-Jr, R.N.; et al. Association between perivascular inflammation and downstream myocardial perfusion in patients with suspected coronary artery disease. Eur. Heart J. Cardiovasc. Imaging 2020, 21, 599–605. [Google Scholar] [CrossRef]
- Goeller, M.; Achenbach, S.; Cadet, S.; Kwan, A.C.; Commandeur, F.; Slomka, P.J.; Gransar, H.; Albrecht, M.H.; Tamarappoo, B.K.; Berman, D.S.; et al. Pericoronary Adipose Tissue Computed Tomography Attenuation and High-Risk Plaque Characteristics in Acute Coronary Syndrome Compared with Stable Coronary Artery Disease. JAMA Cardiol. 2018, 3, 858–863. [Google Scholar] [CrossRef] [PubMed]
- Lin, A.; Kolossvary, M.; Yuvaraj, J.; Cadet, S.; McElhinney, P.A.; Jiang, C.; Nerlekar, N.; Nicholls, S.J.; Slomka, P.J.; Maurovich-Horvat, P.; et al. Myocardial Infarction Associates With a Distinct Pericoronary Adipose Tissue Radiomic Phenotype: A Prospective Case-Control Study. JACC Cardiovasc. Imaging 2020, 13, 2371–2383. [Google Scholar] [CrossRef] [PubMed]
- Balcer, B.; Dykun, I.; Schlosser, T.; Forsting, M.; Rassaf, T.; Mahabadi, A.A. Pericoronary fat volume but not attenuation differentiates culprit lesions in patients with myocardial infarction. Atherosclerosis 2018, 276, 182–188. [Google Scholar] [CrossRef]
- Sagris, M.; Antonopoulos, A.S.; Simantiris, S.; Oikonomou, E.; Siasos, G.; Tsioufis, K.; Tousoulis, D. Pericoronary fat attenuation index-a new imaging biomarker and its diagnostic and prognostic utility: A systematic review and meta-analysis. Eur. Heart J. Cardiovasc. Imaging 2022, 23, e526–e536. [Google Scholar] [CrossRef]
- Kuneman, J.H.; van Rosendael, S.E.; van der Bijl, P.; van Rosendael, A.R.; Kitslaar, P.H.; Reiber, J.H.C.; Jukema, J.W.; Leon, M.B.; Ajmone Marsan, N.; Knuuti, J.; et al. Pericoronary Adipose Tissue Attenuation in Patients with Acute Coronary Syndrome Versus Stable Coronary Artery Disease. Circ. Cardiovasc. Imaging 2023, 16, e014672. [Google Scholar] [CrossRef]
- Antonopoulos, A.S.; Simantiris, S. Detecting the Vulnerable Patient: Toward Preventive Imaging by Coronary Computed Tomography Angiography. Circ. Cardiovasc. Imaging 2023, 16, e015135. [Google Scholar] [CrossRef] [PubMed]
- Goeller, M.; Tamarappoo, B.K.; Kwan, A.C.; Cadet, S.; Commandeur, F.; Razipour, A.; Slomka, P.J.; Gransar, H.; Chen, X.; Otaki, Y.; et al. Relationship between changes in pericoronary adipose tissue attenuation and coronary plaque burden quantified from coronary computed tomography angiography. Eur. Heart J. Cardiovasc. Imaging 2019, 20, 636–643. [Google Scholar] [CrossRef]
- Dai, X.; Yu, L.; Lu, Z.; Shen, C.; Tao, X.; Zhang, J. Serial change of perivascular fat attenuation index after statin treatment: Insights from a coronary CT angiography follow-up study. Int. J. Cardiol. 2020, 319, 144–149. [Google Scholar] [CrossRef]
- Nakahara, T.; Dweck, M.R.; Narula, N.; Pisapia, D.; Narula, J.; Strauss, H.W. Coronary Artery Calcification: From Mechanism to Molecular Imaging. JACC Cardiovasc. Imaging 2017, 10, 582–593. [Google Scholar] [CrossRef]
- Hoffmann, H.; Frieler, K.; Schlattmann, P.; Hamm, B.; Dewey, M. Influence of statin treatment on coronary atherosclerosis visualised using multidetector computed tomography. Eur. Radiol. 2010, 20, 2824–2833. [Google Scholar] [CrossRef]
- Elnabawi, Y.A.; Oikonomou, E.K.; Dey, A.K.; Mancio, J.; Rodante, J.A.; Aksentijevich, M.; Choi, H.; Keel, A.; Erb-Alvarez, J.; Teague, H.L.; et al. Association of Biologic Therapy with Coronary Inflammation in Patients with Psoriasis as Assessed by Perivascular Fat Attenuation Index. JAMA Cardiol. 2019, 4, 885–891. [Google Scholar] [CrossRef] [PubMed]
- Farina, C.J.; Davidson, M.H.; Shah, P.K.; Stark, C.; Lu, W.; Shirodaria, C.; Wright, T.; Antoniades, C.A.; Nilsson, J.; Mehta, N.N. Inhibition of oxidized low-density lipoprotein with orticumab inhibits coronary inflammation and reduces residual inflammatory risk in psoriasis: A pilot randomized, double-blind placebo-controlled trial. Cardiovasc. Res. 2024, 120, 678–680. [Google Scholar] [CrossRef] [PubMed]
- Antonopoulos, A.S.; Angelopoulos, A.; Tsioufis, K.; Antoniades, C.; Tousoulis, D. Cardiovascular risk stratification by coronary computed tomography angiography imaging: Current state-of-the-art. Eur. J. Prev. Cardiol. 2022, 29, 608–624. [Google Scholar] [CrossRef]
- Antonopoulos, A.S.; Simantiris, S. Preventative Imaging with Coronary Computed Tomography Angiography. Curr. Cardiol. Rep. 2023, 25, 1623–1632. [Google Scholar] [CrossRef]
- Investigators, S.-H.; Newby, D.E.; Adamson, P.D.; Berry, C.; Boon, N.A.; Dweck, M.R.; Flather, M.; Forbes, J.; Hunter, A.; Lewis, S.; et al. Coronary CT Angiography and 5-Year Risk of Myocardial Infarction. N. Engl. J. Med. 2018, 379, 924–933. [Google Scholar] [CrossRef]
- Tousoulis, D. Novel risk factors in coronary artery disease: Are they clinically relevant? Hellenic J. Cardiol. 2019, 60, 149–151. [Google Scholar] [CrossRef]
- van Diemen, P.A.; Bom, M.J.; Driessen, R.S.; Schumacher, S.P.; Everaars, H.; de Winter, R.W.; van de Ven, P.M.; Freiman, M.; Goshen, L.; Heijtel, D.; et al. Prognostic Value of RCA Pericoronary Adipose Tissue CT-Attenuation Beyond High-Risk Plaques, Plaque Volume, and Ischemia. JACC Cardiovasc. Imaging 2021, 14, 1598–1610. [Google Scholar] [CrossRef]
- Ichikawa, K.; Miyoshi, T.; Osawa, K.; Nakashima, M.; Miki, T.; Nishihara, T.; Toda, H.; Yoshida, M.; Ito, H. High pericoronary adipose tissue attenuation on computed tomography angiography predicts cardiovascular events in patients with type 2 diabetes mellitus: Post-hoc analysis from a prospective cohort study. Cardiovasc. Diabetol. 2022, 21, 44. [Google Scholar] [CrossRef]
- Kim, T.N.; Kim, S.; Yang, S.J.; Yoo, H.J.; Seo, J.A.; Kim, S.G.; Kim, N.H.; Baik, S.H.; Choi, D.S.; Choi, K.M. Vascular inflammation in patients with impaired glucose tolerance and type 2 diabetes: Analysis with 18F-fluorodeoxyglucose positron emission tomography. Circ. Cardiovasc. Imaging 2010, 3, 142–148. [Google Scholar] [CrossRef]
- Azul, L.; Leandro, A.; Boroumand, P.; Klip, A.; Seica, R.; Sena, C.M. Increased inflammation, oxidative stress and a reduction in antioxidant defense enzymes in perivascular adipose tissue contribute to vascular dysfunction in type 2 diabetes. Free Radic. Biol. Med. 2020, 146, 264–274. [Google Scholar] [CrossRef]
- Yudkin, J.S.; Eringa, E.; Stehouwer, C.D. “Vasocrine” signalling from perivascular fat: A mechanism linking insulin resistance to vascular disease. Lancet 2005, 365, 1817–1820. [Google Scholar] [CrossRef]
- Qin, B.; Li, Z.; Zhou, H.; Liu, Y.; Wu, H.; Wang, Z. The Predictive Value of the Perivascular Adipose Tissue CT Fat Attenuation Index for Coronary In-stent Restenosis. Front. Cardiovasc. Med. 2022, 9, 822308. [Google Scholar] [CrossRef]
- Bengs, S.; Haider, A.; Warnock, G.I.; Fiechter, M.; Pargaetzi, Y.; Rampidis, G.; Etter, D.; Wijnen, W.J.; Portmann, A.; Osto, E.; et al. Quantification of perivascular inflammation does not provide incremental prognostic value over myocardial perfusion imaging and calcium scoring. Eur. J. Nucl. Med. Mol. Imaging 2021, 48, 1806–1812. [Google Scholar] [CrossRef]
- Antonopoulos, A.S.; Antoniades, C. Reply to: Quantification of perivascular inflammation does not provide incremental prognostic value over myocardial perfusion imaging and calcium scoring. Eur. J. Nucl. Med. Mol. Imaging 2021, 48, 1707–1708. [Google Scholar] [CrossRef]
- Kato, S.; Utsunomiya, D.; Horita, N.; Hoshino, M.; Kakuta, T. Prognostic significance of the perivascular fat attenuation index derived by coronary computed tomography: A meta-analysis. Hellenic J. Cardiol. 2022, 67, 73–75. [Google Scholar] [CrossRef]
- Antonopoulos, A.S.; Angelopoulos, A.; Papanikolaou, P.; Simantiris, S.; Oikonomou, E.K.; Vamvakaris, K.; Koumpoura, A.; Farmaki, M.; Trivella, M.; Vlachopoulos, C.; et al. Biomarkers of Vascular Inflammation for Cardiovascular Risk Prognostication: A Meta-Analysis. JACC Cardiovasc. Imaging 2022, 15, 460–471. [Google Scholar] [CrossRef]
- Lawler, P.R.; Bhatt, D.L.; Godoy, L.C.; Luscher, T.F.; Bonow, R.O.; Verma, S.; Ridker, P.M. Targeting cardiovascular inflammation: Next steps in clinical translation. Eur. Heart J. 2021, 42, 113–131. [Google Scholar] [CrossRef]
- Visseren, F.L.J.; Mach, F.; Smulders, Y.M.; Carballo, D.; Koskinas, K.C.; Back, M.; Benetos, A.; Biffi, A.; Boavida, J.M.; Capodanno, D.; et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur. Heart J. 2021, 42, 3227–3337. [Google Scholar] [CrossRef]
- Baritussio, A.; Williams, M.C. Gaining evidence on coronary inflammation. J. Cardiovasc. Comput. Tomogr. 2021, 15, 455–456. [Google Scholar] [CrossRef]
- Tan, N.; Dey, D.; Marwick, T.H.; Nerlekar, N. Pericoronary Adipose Tissue as a Marker of Cardiovascular Risk: JACC Review Topic of the Week. J. Am. Coll. Cardiol. 2023, 81, 913–923. [Google Scholar] [CrossRef]
- Antoniades, C.; Patel, P.; Antonopoulos, A.S. Using artificial intelligence to study atherosclerosis, predict risk and guide treatments in clinical practice. Eur. Heart J. 2023, 44, 437–439. [Google Scholar] [CrossRef]
- Chan, K.; Wahome, E.; Tsiachristas, A.; Antonopoulos, A.S.; Patel, P.; Lyasheva, M.; Kingham, L.; West, H.; Oikonomou, E.K.; Volpe, L.; et al. Inflammatory risk and cardiovascular events in patients without obstructive coronary artery disease: The ORFAN multicentre, longitudinal cohort study. Lancet 2024, 403, 2606–2618. [Google Scholar] [CrossRef]
- Fragkou, P.C.; Moschopoulos, C.D.; Dimopoulou, D.; Triantafyllidi, H.; Birmpa, D.; Benas, D.; Tsiodras, S.; Kavatha, D.; Antoniadou, A.; Papadopoulos, A. Cardiovascular disease and risk assessment in people living with HIV: Current practices and novel perspectives. Hellenic J. Cardiol. 2023, 71, 42–54. [Google Scholar] [CrossRef]
- Liu, Y.; Dai, L.; Dong, Y.; Ma, C.; Cheng, P.; Jiang, C.; Liao, H.; Li, Y.; Wang, X.; Xu, X. Coronary inflammation based on pericoronary adipose tissue attenuation in type 2 diabetic mellitus: Effect of diabetes management. Cardiovasc. Diabetol. 2024, 23, 108. [Google Scholar] [CrossRef]
- Panagiotakos, D.; Chrysohoou, C.; Pitsavos, C.; Tsioufis, K. Prediction of 10-Year Cardiovascular Disease Risk, by Diabetes status and Lipoprotein-a levels; the HellenicSCORE II. Hellenic J. Cardiol. 2023. [Google Scholar] [CrossRef] [PubMed]
WAT | BAT | BeAT | |
---|---|---|---|
Location | SAT, abdominal VAT, thoracic VAT including EAT and PVAT | Interscapular, paravertebral, perirenal, supraclavicular | Same as WAT |
Cell shape | Spherical | Elliptical | Spherical |
Cell morphology | Large, single lipid droplet, contains few mitochondria | Smaller than WAT, multiple lipid droplets, contains large number of mitochondria | Small lipid droplets after stimulation, contains moderate to large number of mitochondria after stimulation |
Role | Energy storage, thermal insulation, mechanical protection, adipokine secretion | Thermogenesis (non-shivering), anti-inflammatory effects, adipokine secretion | Thermogenesis after stimulation, adipokine secretion |
Activators | PPARγ, SREBP1c, FABP4 | UCP1, PGC-1α, PRDM16 | Similar to BAT |
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Simantiris, S.; Pappa, A.; Papastamos, C.; Korkonikitas, P.; Antoniades, C.; Tsioufis, C.; Tousoulis, D. Perivascular Fat: A Novel Risk Factor for Coronary Artery Disease. Diagnostics 2024, 14, 1830. https://doi.org/10.3390/diagnostics14161830
Simantiris S, Pappa A, Papastamos C, Korkonikitas P, Antoniades C, Tsioufis C, Tousoulis D. Perivascular Fat: A Novel Risk Factor for Coronary Artery Disease. Diagnostics. 2024; 14(16):1830. https://doi.org/10.3390/diagnostics14161830
Chicago/Turabian StyleSimantiris, Spyridon, Aikaterini Pappa, Charalampos Papastamos, Panagiotis Korkonikitas, Charalambos Antoniades, Constantinos Tsioufis, and Dimitris Tousoulis. 2024. "Perivascular Fat: A Novel Risk Factor for Coronary Artery Disease" Diagnostics 14, no. 16: 1830. https://doi.org/10.3390/diagnostics14161830