Researchers using coronary computed tomography angiography (CCTA) have found a close association between high-risk coronary artery plaque and a common liver disease. The study, published online in the journal Radiology, found that a single CT exam can detect both conditions.
Previous research has shown that CCTA can detect high-risk coronary artery plaque, or plaque prone to life-threatening ruptures. For the new study, researchers looked at associations between high-risk plaque and non-alcoholic fatty liver disease (NAFLD), a condition characterized by abnormal liver function that is not associated with excessive alcohol consumption. NAFLD is the most common liver disease, with an estimated prevalence of 20 percent to 30 percent in the general population.
"As it is known that atherosclerosis is linked to inflammation, our next step was to look for an association of high-risk plaques with other systemic inflammatory conditions such as NAFLD," said the study's lead author, Stefan B. Puchner, M.D., from Massachusetts General Hospital and Harvard Medical School in Boston and the Medical University of Vienna, Austria. "Interestingly, both pathologies can be detected in a single CT examination."
The researchers drew patients from a large trial focusing on the use of CCTA in people who had come to the emergency department with acute chest pain. The patients underwent both non-enhanced CT to assess coronary calcium, a marker of atherosclerosis, and contrast-enhanced CCTA. Readers assessed the CCTA images for signs of high-risk plaque.
Overall, 182 of the 445 patients in the study, or 40.9 percent, had CT evidence of NAFLD. High-risk plaque was seen in 59.3 percent of patients with NAFLD, compared to only 19 percent of those without NAFLD. The association between NAFLD and high-risk plaque persisted after adjusting for the extent and severity of coronary atherosclerosis and traditional risk factors.
The results suggest that high-risk plaque and NAFLD are both part of the same systemic disease process, the metabolic syndrome.
"The clinical implications could include a wider assessment of NAFLD using the non-contrast cardiac CT scans that are commonly performed prior to the CTA," he said. "Further, the additional assessment of NAFLD with CT could improve the risk stratification of patients with suspected coronary artery disease, as our results show that the presence of NAFLD is associated with high-risk coronary plaque independent of traditional risk factors and severity of coronary artery disease."
The researchers plan to extend the study outside of the emergency department setting to see if the results apply to other categories of the general population. They also hope to learn more about why NAFLD is so prevalent among people with advanced high-risk coronary atherosclerosis. One prevailing theory is that both conditions are a consequence of systemic inflammation, an inflammatory state that affects multiple organs and can lead to life-threatening conditions.
"The aim will be to further investigate and understand, with the help of CCTA, the interplay between advanced atherosclerosis and NAFLD as part of a complex systemic inflammatory condition," Dr. Puchner said.
"High-Risk Coronary Plaque at Coronary CT Angiography Is Associated with Nonalcoholic Fatty Liver Disease, Independent of Coronary Plaque and Stenosis Burden." Collaborating with Dr. Puchner were Michael T. Lu, M.D., Thomas Mayrhofer, Ph.D., Ting Liu, M.D., Amit Pursnani, M.D., Brian B. Ghoshhajra, M.D., M.B.A., Quynh A. Truong, M.D., M.P.H., Stephen D. Wiviott, M.D., Jerome L. Fleg, M.D., Udo Hoffmann, M.D., M.P.H., and Maros Ferencik, M.D., Ph.D.
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc.
RSNA is an association of more than 54,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)
For patient-friendly information on CCTA, visit RadiologyInfo.org
Linda Brooks | EurekAlert!
One gene closer to regenerative therapy for muscular disorders
01.06.2017 | Cincinnati Children's Hospital Medical Center
The gut microbiota plays a key role in treatment with classic diabetes medication
01.06.2017 | University of Gothenburg
An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.
Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...
Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.
Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...
Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.
As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...
Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.
With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...
Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine
Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...
19.06.2017 | Event News
13.06.2017 | Event News
13.06.2017 | Event News
23.06.2017 | Physics and Astronomy
23.06.2017 | Physics and Astronomy
23.06.2017 | Information Technology