Clin Imaging. 2026 Jul 13;138:110899. doi: 10.1016/j.clinimag.2026.110899. Online ahead of print.
ABSTRACT
BACKGROUND: Coronary plaque characteristics, rather than luminal stenosis, are important determinants of cardiovascular risk. The role of pericardial fat in non-stenotic coronary artery disease (CAD) remains unclear. This study investigated the association between pericardial fat volume (PFV) and coronary plaque burden in patients with non-stenotic CAD.
METHODS: This retrospective study included patients with CAD-RADS 0-2 who underwent coronary CT angiography. Patients with >50% stenosis, prior coronary intervention, or chronic systemic disease were excluded. Plaque burden and composition were quantified using dedicated software. PFV was measured by semi-automatic segmentation and indexed to body surface area (IFV). Associations between IFV, coronary plaque burden, and cardiovascular risk factors were evaluated using correlation analysis and multivariable regression models, including logistic regression for high plaque burden and linear regression for continuous plaque volume measures.
RESULTS: A total of 197 patients (47.7% male) were included. IFV was positively correlated with total plaque burden (p < 0.001), with modest associations for non-calcified plaques. Patients with high IFV had greater total and subtype plaque volumes, older age, higher fasting blood glucose levels, and more frequent hypertension (p < 0.05). Age, male sex, serum FBG, and IFV were independent predictors of increased coronary atheroma burden in multivariable logistic regression analysis (all p ≤ 0.005). However, IFV was not independently associated with continuous plaque volumes in multivariable linear regression models, while age remained independently associated with non-calcified plaque burden (β = 0.439, p = 0.017).
CONCLUSION: IFV showed modest associations with coronary atherosclerotic plaque burden and non-calcified plaques, but is not an independent determinant of plaque volume.
PMID:42456243 | DOI:10.1016/j.clinimag.2026.110899