AUTHOR=Chen Mengyu , Liu Bing , Li Xu , Li Dong , Fan Lijuan 

TITLE=Relationship between peri-coronary inflammation and coronary vascular function in patients with suspected coronary artery disease

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1303529

DOI=10.3389/fcvm.2024.1303529

ISSN=2297-055X

ABSTRACT=Background: In this study, we aimed to investigate the relationship between peri-coronary adipose tissue (PCAT) attenuation in patients with suspected coronary artery disease (CAD) and coronary vascular functions assessed by coronary flow reserve (CFR).We included 364 patients who underwent 13 N-NH 3 positron emission tomography/computed tomography and coronary computed tomography angiography (CCTA). We determined the relationship between fat attenuation index (FAI), PCAT volume and other qualitative CT-derived anatomic parameters with CFR.We detected reduced CFR (<2.5) in 206 (57%) patients. On the patient level, those with reduced CFR showed a significantly higher prevalence of diffused atherosclerosis (41% vs. 23%; P< 0.001) and higher FAI (-75.5HU vs. -77.1HU; P =0.014). In patients without obstructive CAD, FAI was significantly higher in those with reduced CFR (-75.5HU vs. -77.7HU, P= 0.026). On the vessel level, 1092 vessels were analyzed and 642(59%) exhibited reduced CFR. The vessels with reduced CFR presented a significantly higher prevalence of obstructive CAD (37% vs. 26%; P< 0.001), diffused atherosclerosis (22% vs. 11%; P< 0.001) low-attenuation plaque (6% vs. 3%; P=0.030) and positive remodeling (7% vs. 2%; P=0.001). FAI was higher in vessels with reduced CFR (-80.8HU vs. -81.8HU; P =0.045) than in normal CFR. In the patient-level analysis, obstructive CAD, diffused atherosclerosis, and FAI were independently linked with CFR. FAI was still associated with global CFR after adjusting traditional risk factors (age, hypertension, diabetes, hyperlipidemia, and smoking). FAI remained independently associated with reduced CFR in patients without obstructive CAD.Coronary perivascular inflammation evaluated by CCTA was independently associated with coronary vascular function. In patients without obstructive CAD, FAI was higher in the presence of reduced CFR. Altogether, FAI can help reveal microcirculatory damage in patients who do not exhibit epicardial artery stenosis.