scholarly journals Assessing the Role of Pericardial Fat as a Biomarker Connected to Coronary Calcification—A Deep Learning Based Approach Using Fully Automated Body Composition Analysis

2021 ◽  
Vol 10 (2) ◽  
pp. 356
Author(s):  
Lennard Kroll ◽  
Kai Nassenstein ◽  
Markus Jochims ◽  
Sven Koitka ◽  
Felix Nensa
Keyword(s):  
Adipose Tissue ◽  
Deep Learning ◽  
Coronary Artery ◽  
Cardiac Ct ◽  
Coronary Calcification ◽  
Risk Scores ◽  
Agatston Score ◽  
Composition Analysis ◽  
Significance Level ◽  
Tissue Quantification

(1) Background: Epi- and Paracardial Adipose Tissue (EAT, PAT) have been spotlighted as important biomarkers in cardiological assessment in recent years. Since biomarker quantification is an increasingly important method for clinical use, we wanted to examine fully automated EAT and PAT quantification for possible use in cardiovascular risk stratification. (2) Methods: 966 patients with intermediate Framingham risk scores for Coronary Artery Disease referred for coronary calcium scans were included in clinical routine retrospectively. The Coronary Artery Calcium Score (CACS) was extracted and tissue quantification was performed by a deep learning network. (3) Results: The Computed Tomography (CT) segmentations predicted by the network indicated no significant correlation between EAT volume and EAT radiodensity when compared to Agatston score (r = 0.18, r = −0.09). CACS 0 category patients showed significantly lower levels of total EAT and PAT volumes and higher EAT and PAT densities than CACS 1–99 category patients (p < 0.01). Notably, this difference did not reach significance regarding EAT attenuation in male patients. Women older than 50 years, thus more likely to be postmenopausal, were shown to be at higher risk of coronary calcification (p < 0.01, OR = 4.59). CACS 1–99 vs. CACS ≥100 category patients remained below significance level (EAT volume: p = 0.087, EAT attenuation: p = 0.98). (4) Conclusions: Our study proves the feasibility of a fully automated adipose tissue analysis in clinical cardiac CT and confirms in a large clinical cohort that volume and attenuation of EAT and PAT are not correlated with CACS. Broadly available deep learning based rapid and reliable tissue quantification should thus be discussed as a method to assess this biomarker as a supplementary risk predictor in cardiac CT.

Relationship Between Coronary Artery Disease and Epicardial Adipose Tissue Quantification at Cardiac CT

2010 ◽  
Vol 17 (6) ◽  
pp. 727-734 ◽  
Author(s):  
Gorka Bastarrika ◽  
Jordi Broncano ◽  
U. Joseph Schoepf ◽  
Florian Schwarz ◽  
Yeong Shyan Lee ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Adipose Tissue ◽  
Coronary Artery ◽  
Cardiac Ct ◽  
Epicardial Adipose Tissue ◽  
Artery Disease ◽  
Tissue Quantification

scholarly journals Diagnostic and prognostic value of coronary artery calcium score of zero: is it time for guidelines to change?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Arbas Redondo ◽  
D Tebar Marquez ◽  
I.D Poveda Pinedo ◽  
R Dalmau Gonzalez-Gallarza ◽  
S.C Valbuena Lopez ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Artery Calcium ◽  
Cardiac Ct ◽  
Invasive Coronary Angiography ◽  
Agatston Score ◽  
Non Invasive ◽  
Artery Disease

Abstract Introduction Cardiac computed tomography (CT) use has progressively increased as the preferred initial test to rule out coronary artery disease (CAD) when clinical likelihood is low. Coronary artery calcium (CAC) detected by CT is a well-established marker for cardiovascular risk. However, it is not recommended for diagnosis of obstructive CAD. Absence of CAC, defined as an Agatston score of zero, has been associated to good prognosis despite underestimation of non-calcified plaques. Purpose To evaluate whether zero CAC score could help ruling out obstructive CAD in a safely manner. Methods Observational study based on a prospective database of patients (pts) referred to cardiac CT between 2017 and 2019. Pts with an Agatston score of zero were selected. Results We included 176 pts with zero CAC score and non-invasive coronary angiography performed. The median duration of follow-up was 23.9 months. Baseline characteristics of the population are shown in Table 1. In 117 pts (66.5%), cardiac CT was indicated as part of their chest pain evaluation. Mean age was 57.2 years old, 68.2% were women and only and 9.4% were active smokers. Normal coronary arteries were found in 173 pts (98.3%). Obstructive CAD, defined as ≥50% luminal diameter stenosis of a major vessel, was present in 1/176 (0.6%); while non-obstructive atherosclerotic plaques were found in 2 pts (1.1%). During follow-up, one patient died of out-of-hospital cardiac arrest. None either suffered from myocardial infarction or needed coronary revascularization. Conclusions In our cohort, a zero CAC score detected by cardiac CT rules out obstructive coronary artery disease in 98.3%, with only 1.7% of non-calcified atherosclerosis plaques and 0.6% of major adverse events. Although further research on this topic is needed, these results support the fact that non-invasive coronary angiography could be avoided in patients with low clinical likelihood of CAD and zero CAC score, facilitating the management of the increasing demand for coronary CT and reduction of radiation dose. Funding Acknowledgement Type of funding source: None

Abstract P104: Higher Leptin Levels Are Associated With Increased Odds Of Coronary Artery Calcium Progression: The Multi-ethnic Study Of Atherosclerosis

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Bhavya Varma ◽  
Oluseye Ogunmoroti ◽  
Chiadi Ndumele ◽  
Di Zhao ◽  
Moyses Szklo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cardiac Ct ◽  
Subclinical Atherosclerosis ◽  
Community Dwelling ◽  
Ct Scans ◽  
Agatston Score ◽  
Cvd Risk ◽  
Ethnic Study ◽  
History Of

Background: Adipokines are secreted by adipose tissue, play a role in cardiometabolic pathways, and have differing associations with cardiovascular disease (CVD). Coronary artery calcium (CAC) and its progression indicate subclinical atherosclerosis and prognosticate CVD risk. However the association of adipokines with CAC progression is not well established. We examined the association of adipokines with the odds of a history of CAC progression in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: We performed an analysis of 1,904 community dwelling adults free of clinical CVD in MESA. Participants underwent measurement of serum adipokines [leptin, resistin and adiponectin] at visits 2 or 3 (randomly assigned) and a contemporaneous cardiac CT scan at same visit. Participants also had a prior cardiac CT at visit 1, at a median of 2.4 years earlier. On both CTs, CAC was quantified by Agatston score. We defined a history of CAC progression between the CT scans at visit 1 and at visit 2 or 3 as those with >0 Agatston units of change per year (and compared to those with ≤0 units of change per year). We used logistic regression to examine the odds of having a history of CAC progression by adipokine tertiles using progressively adjusted models. Results: The mean participant age was 65 (10) years; 50% were women, 40% White, 13% Chinese, 21% Black and 26% Hispanic. The prevalences of CAC at visits 1 and 2/3 were 49% and 58%, respectively. There were 1,001 (53%) who had CAC progression between the 2 CT scans. In demographic-adjusted models (model 1, Table), higher leptin and lower adiponectin were associated with increased odds of prior CAC progression. In models fully adjusted for BMI and other CVD risk factors (model 3), only the highest tertile of leptin remained associated with a greater odds of prior CAC progression [OR 1.55 (95% CI 1.04, 2.30)]. Conclusions: Higher leptin levels were independently associated with a history of CAC progression. Atherosclerosis progression may be one mechanism through which leptin confers increased CVD risk

scholarly journals Epicardial Adipose Tissue Reflects the Presence of Coronary Artery Disease: Comparison with Abdominal Visceral Adipose Tissue

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Masayoshi Oikawa ◽  
Takashi Owada ◽  
Hiroyuki Yamauchi ◽  
Tomofumi Misaka ◽  
Hirofumi Machii ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Adipose Tissue ◽  
Coronary Artery ◽  
Visceral Adipose Tissue ◽  
Coronary Calcification ◽  
Atheromatous Plaque ◽  
Multivariable Logistic Regression Analysis ◽  
Artery Disease ◽  
Visceral Adipose ◽  
Adipose Tissue Depot

Accumulation of visceral adipose tissue is associated with a risk of coronary artery disease (CAD). The aim of this study was to examine whether different types of adipose tissue depot may play differential roles in the progression of CAD. Consecutive 174 patients who underwent both computed tomography (CT) and echocardiography were analyzed. Cardiac and abdominal CT scans were performed to measure epicardial and abdominal visceral adipose tissue (EAT and abdominal VAT, resp.). Out of 174 patients, 109 and 113 patients, respectively, presented coronary calcification (CC) and coronary atheromatous plaque (CP). The EAT and abdominal VAT areas were larger in patients with CP compared to those without it. Interestingly, the EAT area was larger in patients with CC compared to those without CC, whereas no difference was observed in the abdominal VAT area between patients with CC and those without. Multivariable logistic regression analysis revealed that the presence of echocardiographic EAT was an independent predictor of CP and CC, but the abdominal VAT area was not. These results suggest that EAT and abdominal VAT may play differential pathological roles in CAD. Given the importance of CC and CP, we should consider the precise assessment of CAD when echocardiographic EAT is detected.

scholarly journals Sinogram-Affirmed Iterative Reconstruction Negatively Impacts the Risk Category Based on Agatston Score: A Study Combining Coronary Calcium Score Measurement and Coronary CT Angiography

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Wei Wang ◽  
Yan E. Zhao ◽  
Li Qi ◽  
Chang Sheng Zhou ◽  
Meng Jie Lu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Calcium Score ◽  
Coronary Calcification ◽  
Artery Stenosis ◽  
Agatston Score ◽  
Risk Category ◽  
Gradual Reduction ◽  
Coronary Ct ◽  
Risk Categories

Purpose. To assess the impact of sinogram-affirmed iterative reconstruction (SAFIRE) on risk category for coronary artery disease by combining coronary calcium score measurement and coronary CT angiography (CCTA). Materials and Methods. Eighty-nine patients (64.0% male) older than 18 years (64.4±10.3 years) underwent coronary artery calcium scanning and prospectively ECG-triggered sequential CCTA examination. All raw data acquired in coronary artery calcium scanning were reconstructed by both filtered back projection (FBP) and SAFIRE algorithms with 5 different levels. Objective image quality and calcium quantification were evaluated and compared between FBP and all SAFIRE levels by the Sphericity Assumed test or Greenhouse-Geisser ε correction coefficient. Coronary artery stenosis was assessed in CCTA. Risk categories of all patients and of the patients with coronary artery stenosis in CCTA were compared between FBP and all SAFIRE levels by the Friedman test. Results. The reconstruction protocol from traditional FBP to SAFIRE 5 was associated with a gradual reduction in CT value and image noise (P<0.001) but associated with a gradual improvement in the signal-to-noise ratio (P<0.001). There was a gradual reduction in coronary calcification quantification (Agatston score: from 73.5 in FBP to 38.1 in SAFIRE 5, P<0.001) from traditional FBP to SAFIRE 5. There was a significant difference for the risk category between FBP and all levels of SAFIRE in all patients (from 3.5 in FBP to 3.2 in SAFIRE 5, P<0.001) and in the patients with coronary artery stenosis in CCTA (from 4.0 in FBP to 3.6 in SAFIRE 5, P<0.001). Conclusions. SAFIRE significantly reduces coronary calcification quantification compared to FBP, resulting in the reduction of risk categories based on the Agatston score. The risk categories of the patients with coronary artery stenosis in CCTA may also decline. Thus, SAFIRE may lead risk categories to underestimate the existence of significant coronary artery stenosis.

scholarly journals Agatston score of the descending aorta is independently associated with coronary events in a low-risk population

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000893 ◽  
Author(s):  
Elton A M P Dudink ◽  
Frederique E C M Peeters ◽  
Sibel Altintas ◽  
Luuk I B Heckman ◽  
Rutger J Haest ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Ct ◽  
Significant Coronary Artery Disease ◽  
Low Risk ◽  
Agatston Score ◽  
Descending Aorta ◽  
Coronary Syndrome ◽  
Coronary Events ◽  
Artery Disease

ObjectivesA standard coronary artery calcium scan includes part of the aorta. This additional information is often not included in routine analyses. We aimed to determine the feasibility of assessing the Agatston score of the descending aorta calcification (DAC) on standard coronary calcium scans and the association of this score with coronary events in a low-risk study population.MethodsBetween January 2008 and March 2011, 390 consecutive patients who were referred for cardiac CT as part of work-up for pulmonary vein isolation (n=115) or assessment of presence of coronary artery disease (n=275) were included. At baseline, all patients were free of a history of cardiovascular disease. Two independent observers determined the Agatston score of the ascending aorta and descending aorta.ResultsA total of 16 patients (4.1%) developed coronary events (acute coronary syndrome (n=6) and symptomatic significant coronary artery disease requiring treatment (n=10)) during a follow-up of 67±12 months, with more events in patients with calcifications in the descending aorta than in those without (8.4% vs 3.7 %; p=0.08). Multivariable Cox regression, corrected for Framingham Risk Score (FRS) and coronary Agatston score (CAC), revealed that DAC was independently associated with coronary events (per 100 units; HR: 1.06, 95% CI 1.02 to 1.09; p=0.001). DAC furthermore increased the identification of patients that will experience a coronary event (area under the curve: 0.68 for FRS only, 0.75 for FRS+CAC and 0.78 for FRS+CAC+DAC).ConclusionsThe Agatston score of the descending aorta could be included in the standard analysis of cardiac CT scans of low-risk patients since it holds valuable information for the prediction of coronary events.

The Effect Of Deep Learning Noise Reduction Image Reconstruction On CT Coronary Artery Calcium Agatston Score

2020 ◽  
Vol 14 (3) ◽  
pp. S23
Author(s):  
E. Udoh ◽  
T. Cohoon ◽  
M. Kolossváry ◽  
S. Newlander ◽  
B. Szilveszter ◽  
...  
Keyword(s):  
Deep Learning ◽  
Coronary Artery ◽  
Image Reconstruction ◽  
Noise Reduction ◽  
Coronary Artery Calcium ◽  
Agatston Score
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