{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:05:35Z","timestamp":1790985935028,"version":"4.1.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,3,17]],"date-time":"2024-03-17T00:00:00Z","timestamp":1710633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To assess pericoronary adipose tissue (PCAT) density on coronary computed tomography angiography (CCTA) as a marker of inflammatory disease activity in coronary allograft vasculopathy (CAV).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>PCAT density, lesion volumes, and total vessel volume-to-myocardial mass ratio (V\/M) were retrospectively measured in 126 CCTAs from 94 heart transplant patients [mean age 49 (SD 14.5) years, 40% female] who underwent imaging between 2010 and 2021; age- and sex-matched controls; and patients with atherosclerosis. PCAT density was higher in transplant patients with CAV [n = 40; \u221273.0 HU (SD 9.3)] than without CAV [n = 86; \u221277.9 HU (SD 8.2)], and controls [n = 12; \u221286.2 HU (SD 5.4)], P &amp;lt; 0.01 for both. Unlike patients with atherosclerotic coronary artery disease (n = 32), CAV lesions were predominantly non-calcified and comprised of mostly fibrous or fibrofatty tissue. V\/M was lower in patients with CAV than without [32.4\u2005mm3\/g (SD 9.7) vs. 41.4\u2005mm3\/g (SD 12.3), P &amp;lt; 0.0001]. PCAT density and V\/M improved the ability to predict CAV from area under the receiver operating characteristic curve (AUC) 0.75\u20130.85 when added to donor age and donor hypertension status (P &amp;lt; 0.0001). PCAT density above \u221266 HU was associated with a greater incidence of all-cause mortality {odds ratio [OR] 18.0 [95% confidence interval (CI) 3.25\u201399.6], P &amp;lt; 0.01} and the composite endpoint of death, CAV progression, acute rejection, and coronary revascularization [OR 7.47 (95% CI 1.8\u201331.6), P = 0.01] over 5.3 (SD 2.1) years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Heart transplant patients with CAV have higher PCAT density and lower V\/M than those without. Increased PCAT density is associated with adverse clinical outcomes. These CCTA metrics could be useful for the diagnosis and monitoring of CAV severity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeae069","type":"journal-article","created":{"date-parts":[[2024,3,17]],"date-time":"2024-03-17T17:56:37Z","timestamp":1710698197000},"page":"1018-1027","source":"Crossref","is-referenced-by-count":11,"title":["Computed tomography pericoronary adipose tissue density predicts coronary allograft vasculopathy and adverse clinical outcomes after cardiac transplantation"],"prefix":"10.1093","volume":"25","author":[{"given":"Christopher","family":"Wall","sequence":"first","affiliation":[{"name":"Section of Cardiorespiratory Medicine, University of Cambridge , Victor Phillip Dahdaleh Heart and Lung Research Institute, Papworth Road, Cambridge Biomedical Campus, Cambridge, CB2 0BB , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Weir-McCall","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Cambridge , Cambridge , UK"},{"name":"Department of Radiology, Royal Papworth Hospital , Cambridge , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharine","family":"Tweed","sequence":"additional","affiliation":[{"name":"Department of Radiology, Royal Papworth Hospital , Cambridge , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen P","family":"Hoole","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Papworth Hospital , Cambridge , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8079-205X","authenticated-orcid":false,"given":"Deepa","family":"Gopalan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Cambridge University Hospitals NHS Trust , Cambridge , UK"},{"name":"Department of Radiology, Imperial College Healthcare NHS Trust , London , 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