The interaction of lipomatous hypertrophy of the interatrial septum with pericardial adipose tissue biomarkers by computed tomography.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Radiology Pub Date : 2025-04-01 Epub Date: 2024-09-05 DOI:10.1007/s00330-024-11061-3

Pietro G Lacaita, Thomas Senoner, Valentin Bilgeri, Stefan Rauch, Fabian Barbieri, Benedikt Kindl, Fabian Plank, Wolfgang Dichtl, Johannes Deeg, Gerlig Widmann, Gudrun M Feuchtner

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Abstract

Objective: Novel pericardial adipose tissue imaging biomarkers are currently under investigation for cardiovascular risk stratification. However, a specific compartment of the epicardial adipose tissue (EAT), lipomatous hypertrophy of the interatrial septum (LHIS), is included in the pericardial fat volume (PCFV) quantification software. Our aim was to evaluate LHIS by computed tomography angiography (CTA), to elaborate differences to other pericardial adipose tissue components (EAT) and paracardial adipose tissue (PAT), and to compare CT with [¹⁸F]FDG-PET.

Materials and methods: Of 6983 patients screened who underwent coronary CTA for clinical indications, 190 patients with LHIS were finally included (age 62.8 years ± 9.6, 31.6% females, BMI 28.5 kg/cm² ± 4.7) in our retrospective cohort study. CT images were quantified for LHIS, EAT, and PAT density (HU), and total PCFV, with and without LHIS, was calculated. CT was compared with [¹⁸F]FDG-PET if available.

Results: CT-density of LHIS was higher (- 22.4 HU ± 22.8) than all other pericardial adipose tissue components: EAT right and left (97.4 HU ± 13 and - 95.1 HU ± 13) PAT right and left (- 107.5 HU ± 13.4 and - 106.3 HU ± 14.5) and PCFV density -83.3 HU ± 5.6 (p < 0.001). There was a mild association between LHIS and PAT right (Beta 0.338, p = 0.006, 95% CI: 0.098-577) and PAT left (Beta 0.249, p = 0.030; 95% CI: 0.024-0.474) but not EAT right (p = 0.325) and left (p = 0.351), and not with total PCFV density (p = 0.164). The segmented LHIS volume comprised 3.01% of the total PCFV, and 4.3% (range, 2.16-11.7%) in those with LHIS > 9 mm. [¹⁸F]FDG-PET: LHIS was tracer uptake positive in 83.3% (37.5%: mild and 45.8%: minimal) of 24 patients.

Conclusions: LHIS is a distinct compartment of PCFV with higher density suggesting brown fat and has no consistent association with EAT, but rather with PAT.

Clinical relevance statement: LHIS should be recognized as a distinct compartment of the EAT, when using EAT for cardiovascular risk stratification.

Key points: LHIS is currently included in EAT quantification software. LHIS density is relatively high, it is not associated with EAT, and has a high [¹⁸F]FDG-PET positive rate suggesting brown fat. LHIS is a distinct compartment of the EAT, and it may act differently as an imaging biomarker for cardiovascular risk stratification.

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通过计算机断层扫描观察房间隔脂肪肥厚与心包脂肪组织生物标志物之间的相互作用。

目的：目前正在研究用于心血管风险分层的新型心包脂肪组织成像生物标志物。然而，心外膜脂肪组织（EAT）的一个特殊区块，即房间隔脂肪瘤肥厚（LHIS），却被纳入了心包脂肪体积（PCFV）量化软件中。我们的目的是通过计算机断层扫描血管造影（CTA）评估 LHIS，阐述其与其他心包脂肪组织成分（EAT）和心旁脂肪组织（PAT）的区别，并将 CT 与 [18F]FDG-PET 进行比较：在 6983 例因临床适应症接受冠状动脉 CTA 筛查的患者中，我们的回顾性队列研究最终纳入了 190 例 LHIS 患者（年龄 62.8 岁 ± 9.6，女性 31.6%，体重指数 28.5 kg/cm2 ± 4.7）。我们对 CT 图像中的 LHIS、EAT 和 PAT 密度 (HU) 进行了量化，并计算了有 LHIS 和无 LHIS 的 PCFV 总值。如果有[18F]FDG-PET，则将CT与[18F]FDG-PET进行比较：结果：LHIS 的 CT 密度（- 22.4 HU ± 22.8）高于所有其他心包脂肪组织成分：EAT左右（97.4 HU ± 13和- 95.1 HU ± 13）PAT左右（- 107.5 HU ± 13.4和- 106.3 HU ± 14.5）和PCFV密度-83.3 HU ± 5.6（p 9 mm）。[18F]FDG-PET：24例患者中，83.3%（37.5%：轻度，45.8%：极轻度）的LHIS示踪摄取呈阳性：结论：LHIS是PCFV的一个独特分区，其密度较高，提示棕色脂肪，与EAT没有一致的关联，而是与PAT有关联：临床相关性声明：在使用 EAT 进行心血管风险分层时，LHIS 应被视为 EAT 的一个独特部分：要点：LHIS目前已被纳入EAT量化软件。要点：LHIS 目前已被纳入 EAT 定量软件。LHIS 密度相对较高，与 EAT 无关，且[18F]FDG-PET 阳性率较高，提示棕色脂肪。LHIS 是 EAT 的一个独特分区，它作为心血管风险分层的成像生物标志物可能会有不同的作用。

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.