Epicardial Adipose Tissue as a Predictor of Coronary Artery Disease in Asymptomatic Subjects

• Published in: The American journal of cardiology Vol. 110; no. 4; pp. 534 - 538
• Main Authors: Bachar, Gil N., MD, Dicker, Dror, MD, Kornowski, Ran, MD, Atar, Eli, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.08.2012; Elsevier; Elsevier Limited
• Subjects: Adipose Tissue - diagnostic imaging; Adipose Tissue - pathology; Adult; Aged; Biological and medical sciences; Blood Glucose - metabolism; Blood Pressure; Body fat; Body Mass Index; Calcium - analysis; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Cholesterol; Coronary Artery Disease - diagnosis; Coronary heart disease; Coronary vessels; Coronary Vessels - chemistry; Female; Heart; Heart rate; Humans; Male; Medical imaging; Medical sciences; Middle Aged; Multidetector Computed Tomography; Pericardium - diagnostic imaging; Pericardium - pathology; Predictive Value of Tests; Retrospective Studies; Risk Factors; Severity of Illness Index; Studies; Human; Adipose tissue; Predictor; Cardiovascular disease; Asymptomatic; Circulatory system; Cardiology; Predictive factor; Coronary heart disease; Epicardial
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2012.04.024

This study sought to elucidate the relation between epicardial adipose tissue (EAT) thickness measured by multidetector computed tomography and presence of coronary artery atherosclerosis. Recent studies have suggested that fat disposition in visceral organs and epicardial tissue could serve as a predictor of coronary artery disease (CAD). The sample included 190 asymptomatic subjects with ≥1 cardiovascular risk factor who were referred for cardiac computed tomographic angiography. Body mass index, blood pressure, fasting glucose level, and lipid profile were measured. Multidetector computed tomographic results were analyzed for atherosclerosis burden, calcium Agatston score, and EAT thickness: mean EAT values were 3.54 ± 1.59 mm in patients with atherosclerosis and 1.85 ± 1.28 mm in patients without atherosclerosis (p <0.001). On receiver operating characteristic analysis, an EAT value ≥2.4 mm predicted the presence of significant (>50% diameter) coronary artery stenosis. There was a significant difference in EAT values between patients with and without metabolic syndrome (2.58 ± 1.63 vs 2.04 ± 1.46 mm, p <0.05) and between patients with a calcium score >400 and <400 (3.38 ± 1.58 vs 2.02 ± 1.42 mm, p <0.0001). In conclusion, asymptomatic patients with CAD have significantly more EAT than patients without CAD. An EAT thickness of 2.4 mm is the optimal cutoff for prediction of presence of significant CAD.