Author + information
The prophylactic effect of postmenopausal hormone replacement therapy on coronary atherosclerosis remains controversial. We therefore examined the influence of a combined estrogen/progestin therapy on the progression of pericardial adipose tissue (PAT), which reflects the atherosclerotic burden of the coronary arteries and is very sensible to changes in lipid metabolism. In addition the extent of coronary calcifications (CAC) was determined.
We determined the extent of PAT and CAC in 255 women (age 57.0 ± 5.1 years, time after menopause 4.8 ± 2.5 years, group I) at the beginning of a hormone replacement therapy using multislice computed tomography. For quantification we determined the volume of PAT in ml and calculated the volume score for CAC. After an observation period of 3 years we determined the progression of PAT and CAC in a second scan. The results were compared to an age and risk factor adjusted group of postmenopausal women without hormone substitution (group II).
There was no significant difference in PAT volume (125 ± 51 ml vs. 139 ± 43 ml, n.s.), CAC volume score (64 ± 91 vs. 58 ± 82, n.s.), or risk factor distribution between both groups on study entry. In 53 women of group I and 50 women of group II coronary calcification could be excluded in initial scan, n.s. After a mean observation time of 34.7 ± 5.5 months we observed a significant difference between both groups regarding increase of PAT volume (43 ± 22 ml vs. 77 ± 36 ml, p < 0.01). A significant difference in the increase of CAC could not be observed (23 ± 23 vs. 26 ± 28, n.s.).
We observed a reduced progression of PAT in postmenopausal women under a combined estrogen/progestin therapy compared to a matched group of women without hormone substitution. Still we could not find a reduced progression of CAC, indicating that PAT might be more sensitive to short term changes of atherosclerotic burden.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: CT/Multimodality VI
Abstract Category: 20. Imaging: CT/Multimodality
Presentation Number: 1230-363
- 2013 American College of Cardiology Foundation