Reciprocal communication of pericoronary adipose tissue and coronary atherogenesis

Highlights: • Perivascular adipose tissue (PVAT) is mutually changing with the progression or regression of coronary artery disease. • Epicardial adipose tissue (EAT) adjacent to the vessal wall but not total EAT showed association to underlying plaque. • (Semi)automated analysis of adipose tissue and coronary plaques increases the study's reproducibility. Pericoronary adipose tissue (PCAT) has been linked to underlying coronary artery disease (CAD) and proposed to modulate adjacent atherosclerotic plaque formation over pro-inflammatory pathways. In vitro and ex vivo studies support the bilateral communication of adipose tissue and vessel wall. We quantified PCAT and its dynamics in a low coronary risk cohort with a semi-automated software in serial coronary computed tomography angiography (CTA).