Characterizing cardiac adipose tissue in post-acute myocardial infarction patients via CT imaging: a comparative cross-sectional study

Characterizing cardiac adipose tissue in post-acute myocardial infarction patients via CT imaging: a comparative cross-sectional study

European Heart Journal - Cardiovascular Imaging

10.1093/ehjci/jeaf019

https://doi.org/10.1093/ehjci/jeaf019

Xiaomeng Wang, Shuang Leng, Philip D Adamson, Charlotte E Greer, Weimin Huang, Hwee Kuan Lee, Yan Ting Loong, Nur Amirah Syahindah Raffiee, Ching Hui Sia, Swee Yaw Tan, Sock Hwee Tan, Lynette Li San Teo, Sung Lung Wong, Xiaoxun Yang, Min Sen Yew, Thon Hon Yong, Liang Zhong, Leslee J Shaw, Mark Yan Yee Chan, Derek J Hausenloy, Lohendran Baskaran

Cardiac CT scan

17 January 2025

Wang, X., Leng, S., Adamson, P. D., Greer, C. E., Huang, W., Lee, H. K., Loong, Y. T., Raffiee, N. A. S., Sia, C. H., Tan, S. Y., Tan, S. H., Teo, L. L. S., Wong, S. L., Yang, X., Yew, M. S., Yong, T. H., Zhong, L., Shaw, L. J., Chan, M. Y. Y., … Baskaran, L. (2025). Characterizing cardiac adipose tissue in post-acute myocardial infarction patients via CT imaging: a comparative cross-sectional study. European Heart Journal - Cardiovascular Imaging. https://doi.org/10.1093/ehjci/jeaf019

Abstract Aims To identify differences in CT-derived perivascular adipose tissue (PVAT) and epicardial adipose tissue (EAT) characteristics that may indicate inflammatory status differences between post-treatment acute myocardial infarction (AMI) and stable coronary artery disease (CAD) patients. Methods and results A cohort of 205 post-AMI patients (age 59.8 ± 9.2, 92.2% male) was propensity-matched with 205 stable CAD patients (age 60.5 ± 10.0, 90.2% male). Coronary CT angiography and non-contrast CT scans were performed to assess PVAT mean attenuation across major coronary segments and EAT mean attenuation and volumes, respectively. For post-AMI patients, CT scans were conducted 28.6 ± 13.8 days after the AMI incidence. Post-AMI patients showed higher non-culprit PVAT and EAT mean attenuation than stable CAD patients (8.01 HU, 95% CI 5.90–10.11 HU, P < 0.001, 2.48 HU, 95% CI 0.83–4.13 HU, P = 0.003, respectively). The EAT volume percentage at higher attenuation levels was higher in post-AMI patients compared with stable CAD (33.93 cm3, 95% CI 16.86–51.00 cm3, P < 0.001), with the difference maximized at the −70 HU threshold (4.75%, 95% CI 3.64%–5.87%, P < 0.001). PVAT mean attenuation positively correlated with EAT mean attenuations and the percentage of EAT volume > −70 HU (P < 0.001 for both). Conclusion Post-AMI patients showed higher PVAT and EAT attenuation than stable CAD patients, potentially indicating AMI-associated inflammatory cardiac adipose tissue changes. A total of −70 HU can act as a potential cut-off for inflamed EAT. These findings highlight the potential of using CT-derived adipose tissue characteristics to assess inflammation and guide post-AMI management strategies.

Publisher Copyright

This research / project is supported by the A*STAR, National Research Foundation and EDB - Industry Alignment Fund Pre-Positioning
Grant Reference no. : H20c6a0035

This research / project is supported by the National Medical Research Council Singapore - Singapore Translational Research Investigator Award
Grant Reference no. : MOH-STaR21jun-0003

This research / project is supported by the National Medical Research Council Singapore - Centre Grant scheme
Grant Reference no. : NMRC CG21APR1006

This research / project is supported by the National Medical Research Council Singapore - Collaborative Centre Grant scheme
Grant Reference no. : NMRC/CG21APRC006

This research / project is supported by the National Medical Research Council Singapore - Transition Award
Grant Reference no. : MOH-001145-00

This research / project is supported by the National Medical Research Council Singapore - Health Services Research Grant (HSRG)
Grant Reference no. : MOH-000358

This research / project is supported by the National Medical Research Council Singapore - Transition Award
Grant Reference no. : MOH-001368-00

CHS was supported by the National University of Singapore Yong Loo Lin School of Medicine's Junior Academic Fellowship Scheme.

This is a pre-copyedited, author-produced version of an article accepted for publication in European Heart Journal - Cardiovascular Imaging following peer review. The version of record Wang, X., Leng, S., Adamson, P. D., Greer, C. E., Huang, W., Lee, H. K., Loong, Y. T., Raffiee, N. A. S., Sia, C. H., Tan, S. Y., Tan, S. H., Teo, L. L. S., Wong, S. L., Yang, X., Yew, M. S., Yong, T. H., Zhong, L., Shaw, L. J., Chan, M. Y. Y., … Baskaran, L. (2025). Characterizing cardiac adipose tissue in post-acute myocardial infarction patients via CT imaging: a comparative cross-sectional study. European Heart Journal - Cardiovascular Imaging. https://doi.org/10.1093/ehjci/jeaf019 is available online at: https://doi.org/10.1093/ehjci/jeaf019

https://oar.a-star.edu.sg/communities-collections/articles/21622

2047-2404
2047-2412

Institute for Infocomm Research