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Fat tissue measurement with CTA may prevent MI, CVD
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A noninvasive method to measure fat tissue around arteries with CTA detected vascular inflammation before it became irreversible, according to a study published in Science Translational Medicine.
“Developing new methods that could enable early detection of the people whose coronary arteries are in the early process of developing narrowings or alternatively before the narrowings that are there develop into high-risk narrowings which do cause an [MI] ... has really been the holy grail of the management of [CV] medicine related to [CAD], but really up until this point this has not been possible,” Keith M. Channon, professor of cardiovascular medicine at the University of Oxford, said during a press conference.
Fat attenuation index
Alexios S. Antonopoulos, of the University of Oxford, and colleagues developed a fat attenuation index to be used with CTA to detect adipose tissue within a designated area.
“Our heart arteries are surrounded by fat tissue, and [we] have found that this fat has the unique ability to sense inflammation coming from these arteries,” Charalambos Antoniades, MD, PhD, associate professor of cardiovascular medicine at the University of Oxford, said during the press conference. “As a result, it changes its composition, becoming more watery and less fatty when it sits near an inflamed artery. Now, following the discovery, we then developed a new method that enables us to visualize these changes happening in the fat surrounding our arteries.”
The researchers utilized the method on 453 patients undergoing cardiac surgery. In the proof-of-principle experiment, maturation of adipocytes was linked to down-regulation of preadipocyte-secreted factor and lipid accumulation. Markers of adipocyte size were measured by the following expressions: CEBPA, FABP4 and PPARG. The index detected tissue inflammation through tissue uptake of 18F-fluorodeoxyglucose through PET with “excellent sensitivity and specificity,” the researchers wrote.
“Our new method also allows detection of those small but inflamed atherosclerotic plaques in our heart arteries that are prone to rupture; therefore, are about to cause an [MI],” Antoniades said at the press conference. “By detecting those individuals who don’t have narrowings in their heart arteries, but they are in process in developing them because the arteries are inflamed, we may be able to [detect it] early enough to prevent heart disease.”
Changes in adipose tissue
Results were validated through a secondary cohort of 273 patients. Researchers quantified coronary calcium scoring in the right coronary artery and the coronary vasculature along with atherosclerotic plaque in the surrounding right coronary artery. The fat attenuation index gradient identified early CAD and changes in perivascular adipose tissue related to inflammation.
“We are now further validating our method in larger numbers of patients in large prospective clinical studies to document and confirm the predictive value of this method for future [MIs], and if this is confirmed in larger studies, then that would offer an additional read-out on standard [CTA], and that may save lives,” Antoniades said during the press conference. – by Darlene Dobkowski
Disclosures: The study was funded by the British Heart Foundation, the British Heart Foundation Centre of Research Excellence (Oxford), the National Institute for Health Research-Oxford Biomedical Research Centre, the European Commission and the Novo Nordisk Foundation. Antonopoulos reports no relevant financial disclosures. Antoniades and Channon are founders and shareholders of Caristo Diagnostics. Please see the study for all other researchers’ relevant financial disclosures.
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