Cardiac Fat and Coronary Artery Disease
- Years funded:
Despite preventive strategies, heart attacks remain a major cause of death and disability. Heart attacks are often thought to be caused by inflammation. Fat around the heart arteries is rich in inflammatory molecules that are also found in the plaques of arteries of patients with heart attacks. The inflammatory molecules may travel between the artery wall and the surrounding fat layer. When fat is exposed to inflammation, it does not mature i.e. there are less fat cells with more water in between. When there is less inflammation, fat cells are larger and more mature. Fat density when measured on a CT scan (a specialised X-ray of the heart) is measured as a negative value. If there are less mature fat cells, the value is less negative than if the fat cells are larger (more negative). Therefore, a CT scan which is routinely used to diagnose patients with coronary artery plaque can also be used to measure fat density and therefore may be a surrogate for inflammation of the artery.
In this study we will perform CT's on patients with acute heart attacks, and stable patients and compare their fat density values, particularly at sites where there are specific plaques called high-risk or 'vulnerable' plaques as they are most likely to cause heart attacks. We will also perform repeat CT's after 6 months to look at the serial change in fat density and how that impacts the burden of artery disease and vulnerable plaques.
It is hoped that this technique will serve as a novel marker to predict the development, or progression of coronary artery disease.
Dr Nitesh Nerlekar