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. 2011 Oct;261(1):109-15.
doi: 10.1148/radiol.11110346. Epub 2011 Aug 16.

The association of pericardial fat with coronary artery plaque index at MR imaging: The Multi-Ethnic Study of Atherosclerosis (MESA)

Cuilian Miao  1 , Shaoguang Chen, Jingzhong Ding, Kiang Liu, Debiao Li, Robson Macedo, Shenghan Lai, Jens Vogel-Claussen, Elizabeth R Brown, João A C Lima, David A Bluemke
Affiliations

The association of pericardial fat with coronary artery plaque index at MR imaging: The Multi-Ethnic Study of Atherosclerosis (MESA)

Cuilian Miao et al. Radiology. 2011 Oct.

Abstract

Purpose: To determine the relationship of pericardial fat, which secretes proinflammatory markers that have been implicated in coronary atherosclerosis, with atherosclerotic plaque in an asymptomatic population-based cohort.

Materials and methods: In this institutional review board-approved study, all participants supplied written informed consent. One hundred eighty-three participants (89 women, 94 men; mean age, 61 years ± 9 [standard deviation]) from the community-based Multi-Ethnic Study of Atherosclerosis (MESA) were included. The coronary artery eccentricity (ratio of maximal to minimal coronary artery wall thickness) was determined by using magnetic resonance (MR) imaging and served as an index of plaque burden. The pericardial fat volume was determined by using computed tomography. Linear regression coefficient analysis was used to correlate pericardial fat volume with coronary artery wall thickness and plaque eccentricity.

Results: Pericardial fat volume correlated significantly with degree of plaque eccentricity (P < .05) in both men and women. After adjustments for body mass index (BMI) and waist circumference, traditional risk factors, C-reactive protein level, and coronary artery calcium content, the relationship between pericardial fat and plaque eccentricity remained significant in men (P < .01) but not in women. BMI and waist circumference correlated with degree of plaque eccentricity in the univariate model (P < .05) but not after adjustment for pericardial fat volume or traditional risk factors.

Conclusion: Pericardial fat volume, rather than BMI and waist circumference, was more strongly related to plaque eccentricity as a measure of coronary atherosclerotic plaque burden. The results support the proposed role of pericardial fat in association with atherosclerosis.

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Figures

Figure 1a:
Figure 1a:
Coronary artery MR images in 70-year-old man. (a) Coronary MR angiogram shows normal right coronary artery (RCA), smaller left main artery (LM), and left descending coronary artery (LAD) without significant stenosis. (b–d) Cross-sectional coronary artery wall MR images show irregular wall thickness in left anterior descending artery (arrow in b), right coronary artery (arrow in c), and left main artery (arrow in d), with average eccentricity index of 5.7. Insets in bottom right corner show magnified views of vessels.
Figure 1b:
Figure 1b:
Coronary artery MR images in 70-year-old man. (a) Coronary MR angiogram shows normal right coronary artery (RCA), smaller left main artery (LM), and left descending coronary artery (LAD) without significant stenosis. (b–d) Cross-sectional coronary artery wall MR images show irregular wall thickness in left anterior descending artery (arrow in b), right coronary artery (arrow in c), and left main artery (arrow in d), with average eccentricity index of 5.7. Insets in bottom right corner show magnified views of vessels.
Figure 1c:
Figure 1c:
Coronary artery MR images in 70-year-old man. (a) Coronary MR angiogram shows normal right coronary artery (RCA), smaller left main artery (LM), and left descending coronary artery (LAD) without significant stenosis. (b–d) Cross-sectional coronary artery wall MR images show irregular wall thickness in left anterior descending artery (arrow in b), right coronary artery (arrow in c), and left main artery (arrow in d), with average eccentricity index of 5.7. Insets in bottom right corner show magnified views of vessels.
Figure 1d:
Figure 1d:
Coronary artery MR images in 70-year-old man. (a) Coronary MR angiogram shows normal right coronary artery (RCA), smaller left main artery (LM), and left descending coronary artery (LAD) without significant stenosis. (b–d) Cross-sectional coronary artery wall MR images show irregular wall thickness in left anterior descending artery (arrow in b), right coronary artery (arrow in c), and left main artery (arrow in d), with average eccentricity index of 5.7. Insets in bottom right corner show magnified views of vessels.
Figure 2a:
Figure 2a:
(a) Axial cardiac CT image in 68-year-old man shows minimal pericardial fat; pericardial fat volume is 26.8 cm3. (b) Cross-sectional right coronary artery wall MR image in same patient shows minimal plaque eccentricity, with average eccentricity index of 1.5. (c) Axial cardiac CT image in 70-year-old man shows large amount of pericardial fat (∗); pericardial fat volume is 248.6 cm3. (d) Cross-sectional right coronary artery wall MR image in same patient shows high degree of plaque eccentricity, with average eccentricity index of 9.8. Arrow 5 right coronary artery. Insets in bottom right corner show magnified views of vessels.
Figure 2b:
Figure 2b:
(a) Axial cardiac CT image in 68-year-old man shows minimal pericardial fat; pericardial fat volume is 26.8 cm3. (b) Cross-sectional right coronary artery wall MR image in same patient shows minimal plaque eccentricity, with average eccentricity index of 1.5. (c) Axial cardiac CT image in 70-year-old man shows large amount of pericardial fat (∗); pericardial fat volume is 248.6 cm3. (d) Cross-sectional right coronary artery wall MR image in same patient shows high degree of plaque eccentricity, with average eccentricity index of 9.8. Arrow 5 right coronary artery. Insets in bottom right corner show magnified views of vessels.
Figure 2c:
Figure 2c:
(a) Axial cardiac CT image in 68-year-old man shows minimal pericardial fat; pericardial fat volume is 26.8 cm3. (b) Cross-sectional right coronary artery wall MR image in same patient shows minimal plaque eccentricity, with average eccentricity index of 1.5. (c) Axial cardiac CT image in 70-year-old man shows large amount of pericardial fat (∗); pericardial fat volume is 248.6 cm3. (d) Cross-sectional right coronary artery wall MR image in same patient shows high degree of plaque eccentricity, with average eccentricity index of 9.8. Arrow 5 right coronary artery. Insets in bottom right corner show magnified views of vessels.
Figure 2d:
Figure 2d:
(a) Axial cardiac CT image in 68-year-old man shows minimal pericardial fat; pericardial fat volume is 26.8 cm3. (b) Cross-sectional right coronary artery wall MR image in same patient shows minimal plaque eccentricity, with average eccentricity index of 1.5. (c) Axial cardiac CT image in 70-year-old man shows large amount of pericardial fat (∗); pericardial fat volume is 248.6 cm3. (d) Cross-sectional right coronary artery wall MR image in same patient shows high degree of plaque eccentricity, with average eccentricity index of 9.8. Arrow 5 right coronary artery. Insets in bottom right corner show magnified views of vessels.
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