Association of hepatic steatosis with epicardial fat volume and coronary artery disease in symptomatic patients

• Published in: Radiologia medica Vol. 126; no. 5; pp. 652 - 660
• Main Authors: Ledda, Roberta Eufrasia, Milanese, Gianluca, Cademartiri, Filippo, Maffei, Erica, Benedetti, Giorgio, Goldoni, Matteo, Silva, Mario, Sverzellati, Nicola
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.05.2021; Springer Nature B.V
• Subjects: Adipose tissue; Adipose Tissue - diagnostic imaging; Adolescent; Adult; Aged; Aged, 80 and over; Cardiac Radiology; Cardiovascular disease; Computed Tomography Angiography; Coronary Angiography; Coronary artery disease; Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Demographic variables; Diagnostic Radiology; Fatty Liver - complications; Fatty Liver - diagnostic imaging; Female; Humans; Imaging; Interventional Radiology; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Pericardium - diagnostic imaging; Prediction models; Radiographic Image Interpretation, Computer-Assisted; Radiology; Registries; Regression analysis; Risk analysis; Risk Factors; Signs and symptoms; Ultrasound; Cardiac computed tomographic angiography; Hepatic steatosis; Coronary artery disease; Mean liver density; Epicardial fat volume
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-020-01321-9

Aims This study aims to investigate whether HS—when associated with an excessive amount of epicardial adipose tissue—correlates with CAD in subjects with symptoms suggestive of CVD. Methods and results CCTA images, demographic and clinical variables of 1.182 individuals were retrieved: semi-automated measurements for EFV, CAC, and MLD were obtained. Individuals were grouped into three categories according to the presence of CAD, resulting in absent (CAD 0 ), non-obstructive (CAD 1 ) or obstructive (CAD 2 ) disease-groups, and into two categories based on the presence of HS (with no HS, named HS − , and with HS, named HS + ). EFV was significantly higher in HS + than in HS − group ( p  < 0.001), whereas MLD was lower in CAD + than in CAD − subjects ( p  < 0.001). Two predictive models for CAD were tested: the former included clinical risk factors for CAD along with age, gender, EFV and MLD, whereas the latter did not include clinical variables. The logistic regression analysis of the second proposed model reliably discriminated CAD 0 from CAD 1 and CAD 2 (AUC of 0.712, range 0.682–0.742). Conclusion Lower MLD was associated with increased EFV, and MLD—as a marker of HS—discriminate symptomatic patients with CAD from whom without.