Němečková Eliška, Krása Kryštof, Malý Martin
Department of Medicine, First Faculty of Medicine, Charles University in Prague and the Military University Hospital, 16902 Prague, Czech Republic.
J Clin Med. 2025 Jul 4;14(13):4753. doi: 10.3390/jcm14134753.
Cardiovascular disease remains the leading global cause of mortality, with inflammation now recognized as a central driver of atherosclerosis and other cardiometabolic conditions. Recent advances have repositioned perivascular adipose tissue from a passive structural element to an active endocrine and immunomodulatory organ, now a key focus in cardiovascular and metabolic research. Among the most promising tools for assessing perivascular adipose tissue inflammation is the fat attenuation index, a non-invasive imaging biomarker derived from coronary computed tomography angiography. This review explores the translational potential of the fat attenuation index for cardiovascular risk stratification and treatment monitoring in both coronary artery disease and systemic inflammatory or metabolic conditions (psoriasis, systemic lupus erythematosus, inflammatory bowel disease, obesity, type 2 diabetes, and non-obstructive coronary syndromes). We summarize evidence linking perivascular adipose tissue dysfunction to vascular inflammation and adverse cardiovascular outcomes. Clinical studies reviewing the fat attenuation index highlight its ability to detect subclinical inflammation and monitor treatment response. As research advances, standardization of measurement protocols and imaging thresholds will be essential for routine clinical implementation.
心血管疾病仍然是全球主要的死亡原因，炎症现已被认为是动脉粥样硬化和其他心脏代谢疾病的核心驱动因素。最近的进展已将血管周围脂肪组织从一个被动的结构元件重新定位为一个活跃的内分泌和免疫调节器官，现在它是心血管和代谢研究的一个关键焦点。评估血管周围脂肪组织炎症最有前景的工具之一是脂肪衰减指数，这是一种源自冠状动脉计算机断层扫描血管造影的非侵入性成像生物标志物。本综述探讨了脂肪衰减指数在冠状动脉疾病以及全身性炎症或代谢疾病（银屑病、系统性红斑狼疮、炎症性肠病、肥胖症、2型糖尿病和非阻塞性冠状动脉综合征）中用于心血管风险分层和治疗监测的转化潜力。我们总结了将血管周围脂肪组织功能障碍与血管炎症和不良心血管结局联系起来的证据。回顾脂肪衰减指数的临床研究突出了其检测亚临床炎症和监测治疗反应的能力。随着研究的进展，测量方案和成像阈值的标准化对于常规临床应用至关重要。
