Cardiovascular Disease from Pathophysiology to Risk Estimation: Is Inflammation Estimated through Perivascular Attenuation on Computed Tomography the Key?
Domenico TuttolomondoGiampaolo NiccoliChiara MartiniFabrizio D'AscenzoOvidio De FilippoFrancesco NicoliniFrancesco FormicaDavide CarinoFilippo Luca GurgoglioneAndrea DenegriGiulia MagnaniLuigi VignaliMassimo De FilippoNicola SverzellatiAndrea TicinesiLuca BergamaschiCarmine PizziElisa GherbesiSergio SumaNicola GaibazziPublished in: Life (Basel, Switzerland) (2024)
(1) Background: Systemic inflammation stands as a well-established risk factor for ischemic cardiovascular disease, as well as a contributing factor in the development of cardiac arrhythmias, notably atrial fibrillation. Furthermore, scientific studies have brought to light the pivotal role of localized vascular inflammation in the initiation, progression, and destabilization of coronary atherosclerotic disease. (2) Methods: We comprehensively review recent, yet robust, scientific evidence elucidating the use of perivascular adipose tissue attenuation measurement on computed tomography applied to key anatomical sites. Specifically, the investigation extends to the internal carotid artery, aorta, left atrium, and coronary arteries. (3) Conclusions: The examination of perivascular adipose tissue attenuation emerges as a non-invasive and indirect means of estimating localized perivascular inflammation. This measure is quantified in Hounsfield units, indicative of the inflammatory response elicited by dense adipose tissue near the vessel or the atrium. Particularly noteworthy is its potential utility in assessing inflammatory processes within the coronary arteries, evaluating coronary microvascular dysfunction, appraising conditions within the aorta and carotid arteries, and discerning inflammatory states within the atria, especially in patients with atrial fibrillation. The widespread applicability of perivascular adipose tissue attenuation measurement underscores its significance as a diagnostic tool with considerable potential for enhancing our understanding and management of cardiovascular diseases.
Keyphrases
- adipose tissue
- cardiovascular disease
- oxidative stress
- coronary artery
- pulmonary artery
- computed tomography
- coronary artery disease
- insulin resistance
- internal carotid artery
- high fat diet
- inflammatory response
- atrial fibrillation
- positron emission tomography
- aortic valve
- catheter ablation
- aortic stenosis
- left atrial appendage
- type diabetes
- magnetic resonance imaging
- heart failure
- vena cava
- cardiovascular events
- blood flow
- immune response
- left ventricular
- oral anticoagulants
- contrast enhanced
- pulmonary hypertension
- lps induced
- percutaneous coronary intervention
- lipopolysaccharide induced
- transcatheter aortic valve replacement
- pulmonary arterial hypertension
- subarachnoid hemorrhage
- pulmonary embolism
- toll like receptor
- image quality
- left atrial
- skeletal muscle