In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

This content is currently on FREE ACCESS

Association between pericoronary fat thickness and coronary vascular function by 82Rb PET/CT in patients with suspected coronary artery disease and normal myocardial perfusion imaging

Session Moderated Posters 5

Speaker Carmela Nappi

Event : ICNC, Nuclear Cardiology & Cardiac CT 2019

  • Topic : imaging
  • Sub-topic : Hybrid and Fusion Imaging
  • Session type : Moderated Posters

Authors : C Nappi (Naples,IT), W Acampa (Naples,IT), V Gaudieri (Naples,IT), Z Zampella (Naples,IT), R Assante (Naples,IT), P Buongiorno (Naples,IT), T Mannarino (Naples,IT), M Raddi (Naples,IT), A Genova (Naples,IT), A D'antonio (Naples,IT), P Arumugam (Manchester, United Kingdom,GB), A Cuocolo (Naples,IT)

C Nappi1 , W Acampa1 , V Gaudieri2 , Z Zampella1 , R Assante1 , P Buongiorno1 , T Mannarino1 , M Raddi1 , A Genova1 , A D'antonio1 , P Arumugam3 , A Cuocolo1 , 1Federico II University of Naples, Department of Advanced Biomedical Sciences - Naples - Italy , 2National Research Council, Institute of Biostructure and Bioimaging - Naples - Italy , 3Central Manchester Foundation Trust, Department of Nuclear Medicine - Manchester, United Kingdom - United Kingdom of Great Britain & Northern Ireland ,


Background. Coronary flow reserve (CFR) is a sensitive indicator of vascular damage and it could help to identify patients at increased  cardiovascular risk. Recently, it has been suggested that pericoronary fat thickness (PCFT), by releasing inflammatory mediators, may have a local pro-atherosclerotic effect. However, the association of global and regional PCFT and CFR has not been investigated yet.
Purpose. We evaluated the relationship between PCFT and both CFR and hyperemic myocardial blood flow (MBF) in patients with suspected CAD and normal myocardial perfusion imaging (MPI).
Method. From a pool of 1550 subjects referred for the evaluation of suspected or known CAD to stress-rest 82Rb PET/CT, 583 patients without overt CAD showing normal MPI were considered. To estimate the regional PCFT, the maximum fat thickness, assessed as the largest distance from the myocardium to the visceral epicardium, was measured (mm) on unenhanced CT images, in the left anterior descending (LAD), left circumflex (LCx), and right (RCA) coronary artery. The mean PCFT value of the three coronary arteries was used to calculate the global PCFT. Myocardial perfusion was considered normal when the summed stress score was <3. Absolute MBF was computed (in milliliters per minute per gram) from the dynamic rest and stress imaging series. CFR was defined as the ratio of hyperemic to baseline MBF and CFR < 2 was considered reduced.
Results. Among 583 patients with normal MPI, 103(18%) patients showed reduced CFR and 479 (82%) normal CFR. Compared to patients with normal CFR, those with impaired CFR were older (69.9±13.6 vs 58.9±12.7, P<0.001) and showed higher prevalence of hypertension and diabetes (92% vs 75 %; 44% vs 22% respectively; both P<0.005).  While baseline MBF did not differ between the two groups, patients with impaired CFR demonstrated blunted response to pharmacological stressor (1.95±0.57 vs 2.89±0.70; P<0.001) and higher values of global PCFT values (11.6±1.9 vs 10.93±2.1; P<0.005), as compared to those with normal CFR. At univariate linear regression analyses, age, hypertension, diabetes, and PCFT were predictors of both decreasing CFR and hyperemic MBF (all P<0.005). The relationship of PCFT of each coronary with MBF and CFR of the underlying vessel was also evaluated. While baseline MBF of each vessel was not associated with analogous PCFT values, a significant inverse correlation of each regional PCFT with corresponding hyperemic MBF was found (r=-0.290 for LAD; -0.190 for LCx; and -0.113 for RCA, respectively, all P<0.001). Such a relationship was also seen between LAD and LCx PCFT and corresponding CFR values (both P<0.001).
Conclusions. In patients with suspected CAD and normal MPI, a significant decrease of global and regional hyperemic MBF was observed with increasing global and regional PCFT. LAD and LCx PCFT are also associated with corresponding CFR values. Our findings suggest that PCFT may have a local effect on underlying coronary function.

Based on your interests

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are