Perivascular Fat Attenuation Index by Computed Tomography as a Metric of Coronary Inflammation

We read with interest the study of Ohyama et al. that linked vasospastic angina with perivascular adipose tissue (PVAT) volume and inflammation. The role of PVAT in vascular disease pathogenesis is currently well-accepted and supported by both translational and clinical evidence. Nonetheless, the findings of Ohyama et al. are important because they highlight the role of PVAT in aspects of coronary pathophysiology beyond atherosclerosis. Evidence of coronary PVAT inflammation by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (^18FFDG PET/CT) imaging could be used in the diagnosis of vasospastic angina.

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