Perivascular Fat Inflammation: From Atherosclerosis to COVID-19

Vascular inflammation is a critical factor in both atherosclerotic plaque formation and subsequent plaque rupture. The role of inflammation in atherosclerosis, while recognized for decades and supported by both epidemiological evidence and Mendelian randomization studies, has recently gained further prominence with clinical trials such as CANTOS and COLCOT, showing that reducing systemic inflammation improves clinical outcome. There is now an increased focus on targeting residual coronary inflammatory risk as a viable therapeutic target in cardiovascular drug development.

Currently, available tests for the detection of coronary artery inflammation are either non-specific for the cardiovascular system (e.g., plasma biomarkers) or expensive and not readily available (e.g., hybrid positron emission tomography imaging). Novel methods for the non-invasive quantification of coronary inflammation, through analysis of changes in perivascular adipose tissue attenuation (or radiodensity) in coronary computed tomography angiography, allow us to overcome many of the limitations of existing biomarkers and could be a valuable tool for the quantification of residual inflammatory risk, cardiovascular risk stratification and evaluating the treatment effect of novel anti-inflammatory therapies.

The biology of adipose tissue inflammation also offers unique insights into a variety of diseases, ranging from diabetes to COVID-19.

This field of scientific research has been pioneered by Professor Charalambos Antoniades, who is a Deputy Head of the Division of Cardiovascular Medicine at the University of Oxford and Chairman-Elect of the British Atherosclerosis Society. He will provide an overview of the field and its applicability to enable the design of precision cardiovascular trials.

Speakers

Cheerag Shirodaria, MD, MBA, Vice President Cardiovascular Medicine, Covance, Honorary Consultant Cardiologist, Oxford University Hospitals NHS Foundation Trust

Dr. Cheerag Shirodaria is Vice President of Cardiovascular Medicine and formerly Head of Medical Device & Diagnostic Solution at Covance. He remains on the Faculty at Oxford University Hospitals, where he is heavily involved in both clinical and academic coronary CT angiography programs.

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Dr. Charalambos Antoniades, Professor of Cardiovascular Medicine and Deputy Head of the Division of Cardiovascular Medicine at the University of Oxford

Dr. Charalambos Antoniades is Professor of Cardiovascular Medicine and Deputy Head of the Division of Cardiovascular Medicine at the University of Oxford, and a Consultant Cardiologist at Oxford University Hospitals in the UK. He is Chair of the British Atherosclerosis Society, Deputy Editor of Cardiovascular Research and Editor of the British Journal of Pharmacology. His research has pioneered our understanding of the relationship between adipose tissue and the cardiovascular system, with specific interest in the non-invasive imaging of inflammation. This knowledge has been applied in both translational and clinical research settings in a variety of disease states, ranging from cardiovascular disease to COVID-19. He is also founder and Chief Scientific Officer of Caristo Diagnostics.

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