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Pericoronary and periaortic adipose tissue density are associated with inflammatory disease activity in Takayasu arteritis and atherosclerosis

Published version
Peer-reviewed

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Authors

Wall, Christopher 
Huang, Yuan 
Le, Elizabeth 
Corovic, Andrej 
Uy, Christopher 

Abstract

Aims To examine pericoronary (PCAT) and periaortic (PAAT) adipose tissue density on coronary computed tomography angiography (CCTA) for assessing arterial inflammation in Takayasu arteritis (TAK) and atherosclerosis. Methods and results PCAT and PAAT density was measured in coronary (n=1016) and aortic (n=108) segments from 108 subjects (TAK+coronary artery disease (CAD), n=36; TAK, n=18; atherosclerotic CAD, n=32; matched controls, n=22). Median PCAT and PAAT densities varied between groups (mPCAT: p<0.0001; PAAT: p=0.0002). PCAT density was 7.01 ± SEM 1.78 Hounsfield Unit (HU) higher in coronary segments from TAK+CAD patients than stable CAD patients (p=0.0002), and 8.20 ± SEM 2.04 HU higher in TAK patients without CAD than controls (p=0.0001). mPCAT density was correlated with Indian Takayasu Clinical Activity Score (r=0.43, p=0.001) and C-reactive protein (r=0.41, p<0.0001), and was higher in active versus inactive TAK (p=0.002). mPCAT density above -74 HU had 100% sensitivity and 95% specificity for differentiating active TAK from controls (AUC=0.99 [95% CI 0.97-1]). The association of PCAT density and coronary arterial inflammation measured by 68Ga-DOTATATE positron emission tomography equated to an increase of 2.44 ± SEM 0.77 HU in PCAT density for each unit increase in 68Ga-DOTATATE maximum tissue-to-blood ratio (p=0.002). These findings remained in multivariable sensitivity analyses adjusted for potential confounders. Conclusions PCAT and PAAT density are higher in TAK than atherosclerotic CAD or controls, and are associated with clinical, biochemical and PET markers of inflammation. Owing to excellent diagnostic accuracy, PCAT density could be useful as a clinical adjunct for assessing disease activity in TAK.

Description

Keywords

Coronary artery disease, Pericoronary adipose tissue density, Takayasu arteritis

Journal Title

European Heart Journal Open

Conference Name

Journal ISSN

2752-4191
2752-4191

Volume Title

1

Publisher

Oxford Academic
Sponsorship
Wellcome Trust (104492/Z/14/Z)
Wellcome Trust (211100/Z/18/Z)
Engineering and Physical Sciences Research Council (EP/N014588/1)
EPSRC (EP/T017961/1)
British Heart Foundation (RE/18/1/34212)
British Heart Foundation (CH/2000003/12800)
British Heart Foundation (FS/CRTF/20/24035)