Pericarotid Fat As a Marker of Cerebrovascular Risk

Overview

Journal AJNR Am J Neuroradiol

Specialty Neurology

Date 2024 Aug 15

PMID 39147585

Authors

Riccardo Cau

Nicoletta Anzalone

Lorenzo Mannelli

Myriam Edjlali

Antonella Balestrieri

Valentina Nardi

Giuseppe Lanzino

Amir Lerman

Jasjit S Suri

Luca Saba

Affiliations

Soon will be listed here.

Abstract

Vascular inflammation is widely recognized as an important factor in the atherosclerotic process, particularly in terms of plaque development and progression. Conventional tests, such as measuring circulating inflammatory biomarkers, lack the precision to identify specific areas of vascular inflammation. In this context, noninvasive imaging modalities can detect perivascular fat changes, serving as a marker of vascular inflammation. This review aims to provide a comprehensive overview of the key concepts related to perivascular carotid fat and its pathophysiology. Additionally, we examine the existing literature on the association of pericarotid fat with features of plaque vulnerability and cerebrovascular events. Finally, we scrutinize the advantages and limitations of the noninvasive assessment of pericarotid fat.

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PMID: 39790197 PMC: 11707487. DOI: 10.21037/cdt-24-344.

References

Cau R, Flanders A, Mannelli L, Politi C, Faa G, Suri J . Artificial intelligence in computed tomography plaque characterization: A review. Eur J Radiol. 2021; 140:109767. DOI: 10.1016/j.ejrad.2021.109767. View

Zhang D, Jin J, Zhu C, Chen Q, He X . Association between carotid artery perivascular fat density and cerebral small vessel disease. Aging (Albany NY). 2021; 13(14):18839-18851. PMC: 8351687. DOI: 10.18632/aging.203327. View

Yu M, Meng Y, Zhang H, Wang W, Qiu S, Wang B . Associations between pericarotid fat density and image-based risk characteristics of carotid plaque. Eur J Radiol. 2022; 153:110364. DOI: 10.1016/j.ejrad.2022.110364. View

Kim H, Belin de Chantemele E, Weintraub N . Perivascular Adipocytes in Vascular Disease. Arterioscler Thromb Vasc Biol. 2019; 39(11):2220-2227. PMC: 6812617. DOI: 10.1161/ATVBAHA.119.312304. View

Verhagen S, Visseren F . Perivascular adipose tissue as a cause of atherosclerosis. Atherosclerosis. 2010; 214(1):3-10. DOI: 10.1016/j.atherosclerosis.2010.05.034. View

Mazighi M, Labreuche J, Gongora-Rivera F, Duyckaerts C, Hauw J, Amarenco P . Autopsy prevalence of intracranial atherosclerosis in patients with fatal stroke. Stroke. 2008; 39(4):1142-7. DOI: 10.1161/STROKEAHA.107.496513. View

Skilton M, Serusclat A, Sethu A, Brun S, Bernard S, Balkau B . Noninvasive measurement of carotid extra-media thickness: associations with cardiovascular risk factors and intima-media thickness. JACC Cardiovasc Imaging. 2009; 2(2):176-82. DOI: 10.1016/j.jcmg.2008.09.013. View

Gencer E, Yilmaz E, Arsava E, Gocmen R, Topcuoglu M . Carotid Artery Perivascular Adipose Tissue Density and Response to Intravenous Tissue Plasminogen Activator in Acute Ischemic Stroke. Angiology. 2023; 75(5):472-479. DOI: 10.1177/00033197231174654. View

Kaczynski J, Sellers S, Seidman M, Syed M, Dennis M, Mcnaught G . F-NaF PET/MRI for Detection of Carotid Atheroma in Acute Neurovascular Syndrome. Radiology. 2022; 305(1):137-148. PMC: 9523682. DOI: 10.1148/radiol.212283. View

10.

Mazurek T, Zhang L, Zalewski A, Mannion J, Diehl J, Arafat H . Human epicardial adipose tissue is a source of inflammatory mediators. Circulation. 2003; 108(20):2460-6. DOI: 10.1161/01.CIR.0000099542.57313.C5. View

11.

Alkhalil M, Edmond E, Edgar L, Digby J, Omar O, Robson M . The relationship of perivascular adipose tissue and atherosclerosis in the aorta and carotid arteries, determined by magnetic resonance imaging. Diab Vasc Dis Res. 2018; 15(4):286-293. PMC: 6039860. DOI: 10.1177/1479164118757923. View

12.

Katsiki N, Mikhailidis D . Perivascular Adipose Tissue: Pathophysiological Links With Inflammation, Atherosclerosis, and Thrombosis. Angiology. 2021; 73(3):195-196. DOI: 10.1177/00033197211014676. View

13.

Saw J . Spontaneous coronary artery dissection. Can J Cardiol. 2013; 29(9):1027-33. DOI: 10.1016/j.cjca.2012.12.018. View

14.

Zhang S, Gu H, Yu X, Kang B, Yuan X, Wang X . Association Between Carotid Artery Perivascular Fat Density and Intraplaque Hemorrhage. Front Cardiovasc Med. 2021; 8:735794. PMC: 8488125. DOI: 10.3389/fcvm.2021.735794. View

15.

Nosalski R, Guzik T . Perivascular adipose tissue inflammation in vascular disease. Br J Pharmacol. 2017; 174(20):3496-3513. PMC: 5610164. DOI: 10.1111/bph.13705. View

16.

Henrichot E, Juge-Aubry C, Pernin A, Pache J, Velebit V, Dayer J . Production of chemokines by perivascular adipose tissue: a role in the pathogenesis of atherosclerosis?. Arterioscler Thromb Vasc Biol. 2005; 25(12):2594-9. DOI: 10.1161/01.ATV.0000188508.40052.35. View

17.

Saba L, Cau R, Murgia A, Nicolaides A, Wintermark M, Castillo M . Carotid Plaque-RADS: A Novel Stroke Risk Classification System. JACC Cardiovasc Imaging. 2023; 17(1):62-75. DOI: 10.1016/j.jcmg.2023.09.005. View

18.

Hop H, de Boer S, Reijrink M, Kamphuisen P, de Borst M, Pol R . F-sodium fluoride positron emission tomography assessed microcalcifications in culprit and non-culprit human carotid plaques. J Nucl Cardiol. 2018; 26(4):1064-1075. PMC: 6660502. DOI: 10.1007/s12350-018-1325-5. View

19.

Cho Y, Lee S, Lee H, Hur J, Lee S, Youn S . Adipokine resistin is a key player to modulate monocytes, endothelial cells, and smooth muscle cells, leading to progression of atherosclerosis in rabbit carotid artery. J Am Coll Cardiol. 2010; 57(1):99-109. DOI: 10.1016/j.jacc.2010.07.035. View

20.

Haberka M, Gasior Z . A carotid extra-media thickness, PATIMA combined index and coronary artery disease: Comparison with well-established indexes of carotid artery and fat depots. Atherosclerosis. 2015; 243(1):307-13. DOI: 10.1016/j.atherosclerosis.2015.09.022. View