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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2009;29:781.)
© 2009 American Heart Association, Inc.

Clinical and Population Studies

Pericardial Adipose Tissue Determined by Dual Source CT Is a Risk Factor for Coronary Atherosclerosis

Martin Greif; Alexander Becker; Franz von Ziegler; Corinna Lebherz; Michael Lehrke; Uli C. Broedl; Janine Tittus; Klaus Parhofer; Christoph Becker; Maximilian Reiser; Andreas Knez; Alexander W. Leber

From the Departments of Cardiology (M.G., A.B., F.v.Z., C.L., U.C.B., J.T., A.K., A.W.L.), Endocrinology (M.L., K.P.), and Radiology (C.B., M.R.) Klinikum Grosshadern, University Hospital of Munich, Germany.

Correspondence to Alexander W. Leber, Department of Cardiology, Klinikum Grosshadern, University Hospital of Munich, Marchioninistrasse 15, 81377 Munich, Germany. E-mail dr_leber{at}gmx.de

Objectives— Pericardial fat as a visceral fat depot may be involved in the pathogenesis of coronary atherosclerosis. To gain evidence for that concept we sought to investigate the relation of pericardial fat volumes to risk factors, serum adiponectin levels, inflammatory biomarkers, and the quantity and morphology of coronary atherosclerosis.

Methods and Results— Using Dual source CT angiography pericardial fat volume and coronary atherosclerosis were assessed simultaneously. Plaques were classified as calcified, mixed, and noncalcified, and the number of affected segments served as quantitative score. Patients with atherosclerotic lesions had significant larger PAT volumes (226 cm³±92 cm³) than patients without atherosclerosis (134 cm³±56 cm³; P>0.001). No association was found between BMI and coronary atherosclerosis. PAT volumes >300 cm³ were the strongest independent risk factor for coronary atherosclerosis (odds ratio 4.1; CI 3.63 to 4.33) also significantly stronger compared to the Framingham score. We furthermore demonstrated that elevated PAT volumes are significantly associated with low adiponectin levels, low HDL levels, elevated TNF- levels, and hsCRP.

Conclusion— In the present study we demonstrated that elevated PAT volumes are associated with coronary atherosclerosis, hypoadiponectinemia, and inflammation and represent the strongest risk factor for the presence of atherosclerosis and may be important for risk stratification and monitoring.

The amount of PAT volume is significantly elevated in patients with coronary atherosclerosis compared to those without. We could demonstrate that PAT volumes >300 cm³ represent the strongest risk factor for the presence of coronary atherosclerosis in comparison with traditional risk factors.

Key Words: cardiac CT • pericardial fat • obesity • adiponectin • plaque imaging

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