Relation of Perivascular Adipose Tissues on Computed Tomography to Coronary Vasospasm

Abstract

Background: Coronary computed tomography angiography (CTA) can be used to quantitatively and qualitatively evaluate the characteristics of perivascular adipose tissue (PVAT), including PVAT volume and perivascular fat attenuation index (FAI). Moreover, PVAT volume and perivascular FAI on CTA are reportedly high in patients with vasospastic angina (VSA); however, previous investigations have focused on the patient rather than vessel-level analyses. Therefore, this study aimed to assess the relationship between coronary vasospasm and PVAT or FAI by using coronary CTA at the vessel level. Methods: This retrospective study included 51 patients who underwent intracoronary acetylcholine (ACh) provocation testing for the VSA diagnosis and coronary CTA within a 6-month interval. A total of 125 coronary vessels were evaluated. PVAT and FAI on CTA were quantitatively evaluated. The primary interest of the present study was to determine the relationship between PVAT volume and FAI- and ACh-induced coronary vasospasms at the vessel level. Results: Of the 51 patients, 24 (47.1%) had a positive ACh provocation test (VSA), with 40 of 125 (32.0%) vessels having ACh-induced vasospasm. Obstructive epicardial coronary artery disease was observed in 12 vessels (9.6%). No significant differences in PVAT volume or FAI were identified between vessels with and without ACh-induced vasospasms. Similarly, PVAT volume and FAI did not differ significantly in the individual major coronary arteries between patients with and without positive ACh provocation test results. In contrast, FAI was significantly higher in vessels with obstructive coronary artery disease than in those without. Conclusions: In patients undergoing intracoronary ACh provocation tests and coronary CTA, no significant association was observed between ACh-induced coronary vasospasm and PVAT volume or FAI at the vessel level. However, FAI significantly increased in vessels with epicardial coronary disease.

Keywords

• computed tomography
• acetylcholine
• vasospastic angina
• inflammation