Objective Aortic stenosis (AS) shares pathophysiological similarities with atherosclerosis including active inflammation. CT attenuation of perivascular adipose tissue provides a measure of vascular inflammation that is linked to prognosis and has the potential to be applied to the aortic valve. We investigated perivascular adipose tissue attenuation around the aortic valve in patients with AS. Methods CT attenuation was measured in the perivascular adipose tissue extending 3 mm radially and 10 mm longitudinally around the aortic valve in patients with and without AS. Associations between perivascular adipose tissue attenuation and AS disease severity, activity and progression were investigated. Results Perivascular adipose tissue attenuation around the aortic valve demonstrated good intraobserver and interobserver repeatability (interobserver: intraclass correlation coefficient 0.977 (95% CI: 0.94, 0.99)) but was similar between patients with AS (n=120) and control subjects (n=80) (−62.4 (−68.7, −56.5) Hounsfield units (HU) vs −61.2 (−65.3, −55.6) HU, p=0.099). There were no differences between perivascular adipose tissue attenuation in patients with mild (−60.2 (−66.9, −55.1) HU), moderate (−62.8 (−69.6, −56.80) HU) or severe (−62.3 (−69.3, −55.4) HU) AS (all p>0.05), and perivascular adipose tissue attenuation did not demonstrate an association with AS severity as assessed by echocardiography or CT calcium scoring, nor with disease activity assessed by 18F-sodium fluoride positron emission tomography. Moreover, there was no association between baseline aortic valve perivascular adipose tissue attenuation and subsequent AS progression (annualised change in peak velocity: r=0.072, p=0.458). Similar results were found using five other image analysis methods. Conclusions CT-derived aortic valve perivascular adipose tissue attenuation is not associated with AS disease severity, activity or progression suggesting that it has no value in the investigation and management of patients with AS. Data are available upon reasonable request. The data underlying this article will be shared on reasonable request to the corresponding author.

中文翻译：

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主动脉瓣狭窄患者主动脉瓣血管周围脂肪组织计算机断层扫描衰减

目的 主动脉瓣狭窄（AS）与动脉粥样硬化具有相似的病理生理学相似性，包括活动性炎症。血管周围脂肪组织的 CT 衰减提供了与预后相关的血管炎症的测量，并且有可能应用于主动脉瓣。我们研究了 AS 患者主动脉瓣周围血管周围脂肪组织的衰减情况。方法 对患有和不患有 AS 的患者的主动脉瓣周围径向延伸 3 mm 和纵向延伸 10 mm 的血管周围脂肪组织进行 CT 衰减测量。研究了血管周围脂肪组织衰减与 AS 疾病严重程度、活动性和进展之间的关联。结果 主动脉瓣周围血管周围脂肪组织衰减表现出良好的观察者内和观察者间重复性（观察者间：组内相关系数 0.977 (95% CI: 0.94, 0.99)），但 AS 患者 (n=120) 和对照受试者 (n= 80）（−62.4（−68.7，−56.5）亨斯菲尔德单位（HU）与−61.2（−65.3，−55.6）HU，p=0.099）。轻度（−60.2（−66.9，−55.1）HU）、中度（−62.8（−69.6，−56.80）HU）或重度（−62.3（−69.3，−55.4）患者的血管周围脂肪组织衰减没有差异) HU) AS（全部 p>0.05）和血管周围脂肪组织衰减并未显示与通过超声心动图或 CT 钙评分评估的 AS 严重程度相关，也与通过 18F-氟化钠正电子发射断层扫描评估的疾病活动性相关。此外，基线主动脉瓣血管周围脂肪组织衰减与随后的 AS 进展之间没有关联（峰值速度的年化变化：r=0.072，p=0.458）。使用其他五种图像分析方法也发现了类似的结果。结论 CT 衍生的主动脉瓣血管周围脂肪组织衰减与 AS 疾病的严重程度、活动性或进展无关，表明它在 AS 患者的调查和治疗中没有价值。数据可根据合理要求提供。本文所依据的数据将根据合理请求分享给通讯作者。