TY - JOUR
T1 - Relationship between impaired myocardial blood flow by positron emission tomography and low-attenuation plaque burden and pericoronary adipose tissue attenuation from coronary computed tomography
T2 - From the prospective PACIFIC trial
AU - Kuronuma, Keiichiro
AU - van Diemen, Pepijn A.
AU - Han, Donghee
AU - Lin, Andrew
AU - Grodecki, Kajetan
AU - Kwiecinski, Jacek
AU - Motwani, Manish
AU - McElhinney, Priscilla
AU - Tomasino, Guadalupe Flores
AU - Park, Caroline
AU - Kwan, Alan
AU - Tzolos, Evangelos
AU - Klein, Eyal
AU - Shou, Benjamin
AU - Tamarappoo, Balaji
AU - Cadet, Sebastien
AU - Danad, Ibrahim
AU - Driessen, Roel S.
AU - Berman, Daniel S.
AU - Slomka, Piotr J.
AU - Dey, Damini
AU - Knaapen, Paul
N1 - Funding Information: This work was supported in part by grants from the National Heart, Lung, and Blood Institute, United States 1R01HL148787-01A1 and 1R01HL151266. This work was also supported by a grant from the Dr Miriam and Sheldon G. Adelson Medical Research Foundation. K.K. receives funding support from the Society of Nuclear Medicine and Molecular Imaging Wagner-Torizuka Fellowship grant and the Nihon University School of Medicine Alumni Association Research Grant. E.T. (FS/CRTF/20/24086) is supported by the British Heart Foundation. Funding Information: Outside of the current work, S.C., P.S., and D.D. received software royalties from Cedars-Sinai Medical Center. D.B, P.S., and D.D. hold a patent (US8885905B2 in USA and WO patent WO2011069120A1, Method and System for Plaque Characterization). P.K. has received research grants from HeartFlow Inc. Funding Information: This work was supported in part by grants from the National Heart, Lung, and Blood Institute, United States 1R01HL148787-01A1 and 1R01HL151266. This work was also supported by a grant from the Dr Miriam and Sheldon G. Adelson Medical Research Foundation. K.K. receives funding support from the Society of Nuclear Medicine and Molecular Imaging Wagner-Torizuka Fellowship grant and the Nihon University School of Medicine Alumni Association Research Grant. E.T. (FS/CRTF/20/24086) is supported by the British Heart Foundation. Outside of the current work, S.C., P.S., and D.D. received software royalties from Cedars-Sinai Medical Center. D.B, P.S., and D.D. hold a patent (US8885905B2 in USA and WO patent WO2011069120A1, Method and System for Plaque Characterization). P.K. has received research grants from HeartFlow Inc. Publisher Copyright: © 2023, The Author(s) under exclusive licence to American Society of Nuclear Cardiology.
PY - 2023/8
Y1 - 2023/8
N2 - Background: Positron emission tomography (PET) is the clinical gold standard for quantifying myocardial blood flow (MBF). Pericoronary adipose tissue (PCAT) attenuation may detect vascular inflammation indirectly. We examined the relationship between MBF by PET and plaque burden and PCAT on coronary CT angiography (CCTA). Methods: This post hoc analysis of the PACIFIC trial included 208 patients with suspected coronary artery disease (CAD) who underwent [15O]H2O PET and CCTA. Low-attenuation plaque (LAP, < 30HU), non-calcified plaque (NCP), and PCAT attenuation were measured by CCTA. Results: In 582 vessels, 211 (36.3%) had impaired per-vessel hyperemic MBF (≤ 2.30 mL/min/g). In multivariable analysis, LAP burden was independently and consistently associated with impaired hyperemic MBF (P = 0.016); over NCP burden (P = 0.997). Addition of LAP burden improved predictive performance for impaired hyperemic MBF from a model with CAD severity and calcified plaque burden (P < 0.001). There was no correlation between PCAT attenuation and hyperemic MBF (r = − 0.11), and PCAT attenuation was not associated with impaired hyperemic MBF in univariable or multivariable analysis of all vessels (P > 0.1). Conclusion: In patients with stable CAD, LAP burden was independently associated with impaired hyperemic MBF and a stronger predictor of impaired hyperemic MBF than NCP burden. There was no association between PCAT attenuation and hyperemic MBF.
AB - Background: Positron emission tomography (PET) is the clinical gold standard for quantifying myocardial blood flow (MBF). Pericoronary adipose tissue (PCAT) attenuation may detect vascular inflammation indirectly. We examined the relationship between MBF by PET and plaque burden and PCAT on coronary CT angiography (CCTA). Methods: This post hoc analysis of the PACIFIC trial included 208 patients with suspected coronary artery disease (CAD) who underwent [15O]H2O PET and CCTA. Low-attenuation plaque (LAP, < 30HU), non-calcified plaque (NCP), and PCAT attenuation were measured by CCTA. Results: In 582 vessels, 211 (36.3%) had impaired per-vessel hyperemic MBF (≤ 2.30 mL/min/g). In multivariable analysis, LAP burden was independently and consistently associated with impaired hyperemic MBF (P = 0.016); over NCP burden (P = 0.997). Addition of LAP burden improved predictive performance for impaired hyperemic MBF from a model with CAD severity and calcified plaque burden (P < 0.001). There was no correlation between PCAT attenuation and hyperemic MBF (r = − 0.11), and PCAT attenuation was not associated with impaired hyperemic MBF in univariable or multivariable analysis of all vessels (P > 0.1). Conclusion: In patients with stable CAD, LAP burden was independently associated with impaired hyperemic MBF and a stronger predictor of impaired hyperemic MBF than NCP burden. There was no association between PCAT attenuation and hyperemic MBF.
KW - Coronary artery disease
KW - Positron emission tomography
KW - coronary computed tomography angiography
KW - low-attenuation plaque
KW - myocardial blood flow
KW - pericoronary adipose tissue
UR - http://www.scopus.com/inward/record.url?scp=85146294652&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s12350-022-03194-z
DO - https://doi.org/10.1007/s12350-022-03194-z
M3 - Article
C2 - 36645580
SN - 1071-3581
VL - 30
SP - 1558
EP - 1569
JO - Journal of Nuclear Cardiology
JF - Journal of Nuclear Cardiology
IS - 4
ER -