title: Inflammatory activity of pericoronary adipose tissue may affect plaque composition in patients with acute coronary syndrome without persistent ST-segment elevation: preliminary results.
abstract: BACKGROUND
  The extravascular expression of inflammatory mediators may adversely influence coronary lesion formation and plaque stability through outside-to-inside signalling. It has been shown that the maximal standardised uptake value (SUV) of 18-fluorodeoxyglucose detected by positron emission tomography (PET/CT) is proportional to macrophage density.
  
  
  OBJECTIVE
  To investigate whether the inflammatory activity of pericoronary adipose tissue (PVAT) may influence plaque composition in acute coronary syndrome without persistent ST-segment elevation (NSTE-ACS) patients.
  
  
  METHODS
  In a prospective study, 36 coronary arteries (LM, RCA, LCX, LAD) were investigated in non-diabetic patients with a low or intermediate risk of NSTE-ACS (GRACE ≤ 140). SUV was measured in fat surrounding coronary arteries on the sections corresponding to proximal and medial segments (Siemens biograph 64-PET/CT system). Additionally, SUV was measured in subcutaneous fat (SC), visceral thoracic fat (VS), and epicardial fat over the right ventricle (EPI). Virtual histology intravascular ultrasound (VH-IVUS) was performed to assess plaque composition (Volcano, USA). PET/CT sections were further examined in segments corresponding to coronary plaques.
  
  
  RESULTS
  PVAT SUV in NSTE-ACS patients was significantly greater than in other fat locations (LM SUV: 1.60; RCA SUV: 1.54; LCX SUV: 1.94; LAD SUV: 2.37 vs.
  0.57; VS SUV: 0.77; EPI SUV: 0.98; p < 0.001; ANOVA). PVAT SUV positively correlated with plaque burden (r = 0.49, p < 0.05) and necrotic core plaque rate (r = 0.68, p < 0.05), and negatively correlated with fibrous plaque rate (r = -0.52, p < 0.05).
  
  
  CONCLUSIONS
  The inflammatory activity of PVAT reflected by SUV is greater than in subcutaneous, visceral thoracic, or epicardial tissue in NSTE-ACS patients; PVAT SUV correlates with the plaque burden and necrotic core component of coronary plaque.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Mazurek
authors.affiliation: I Katedra i Klinika Kardiologii Warszawski Uniwersytet Medyczny. jkochman@wum.edu.pl.
authors.forename: Janusz
authors.initials: J
authors.lastname: Kochman
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Kobylecka
authors.forename: Radosław
authors.initials: R
authors.lastname: Wilimski
authors.forename: Krzysztof J
authors.initials: KJ
authors.lastname: Filipiak
authors.forename: Leszek
authors.initials: L
authors.lastname: Królicki
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
mesh_terms: D054058:Acute Coronary Syndrome / Q000473:pathology*; D000273:Adipose Tissue / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D010496:Pericardium / Q000473:pathology; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D011446:Prospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods