Coronary artery diseaseImpact of Location of Epicardial Adipose Tissue, Measured by Coronary Artery Calcium-Scoring Computed Tomography on Obstructive Coronary Artery Disease
Section snippets
Methods
The study was approved by our Institutional Review Board, and the requirement for informed consent was waived. From January 2007 to June 2010, 219 consecutive subjects receiving CAC-scoring CT and CTCA in 1 session for clinical suspicion of CAD were listed on the intuitional Radiological Information System. We applied exclusion criteria of (1) poor image quality of CTCA (5 subjects), (2) previous cardiac surgery (2 subjects), and (3) incomplete clinical risk factors (4 subjects). Finally, 208
Results
The clinical characteristics of the subjects are listed in Table 1. The age, male gender, waist circumference, high-density lipoprotein cholesterol, statin use, diabetes mellitus, smoking habits, hypertension, and Agatston score were significantly greater in the O-CAD group than in the NO-CAD group, except for BMI, low-density lipoprotein cholesterol, and triglycerides. A variety of CT measurements of EAT are listed in Table 2. There were no significant differences in the total EAT volume
Discussion
In this study, we systematically investigated the role of EAT thickness at different locations and total EAT volume in association with obstructive CAD. We found that left AVG EAT thickness, instead of total EAT volume, was the most important EAT adiposity predictor of obstructive CAD, independent of clinical risk factors and Agatston score. Although EAT volume is generally accepted as a contributor of coronary atherosclerosis, several studies have failed to show a distinct association of EAT
Acknowledgment
The authors wish to thank research assistants Yin-Fan Lai, MS, Hui-Chu Chang, BS, You-Yin Lin, BS, and Chin-Yin Tsai, BS for data management.
References (30)
- et al.
Mapping epicardial fat with multi-detector computed tomography to facilitate percutaneous transepicardial arrhythmia ablation
Eur J Radiol
(2006) - et al.
Quantification of epicardial and peri-coronary fat using cardiac computed tomography; reproducibility and relation with obesity and metabolic syndrome in patients suspected of coronary artery disease
Atherosclerosis
(2008) - et al.
Relation of epicardial and pericoronary fat to coronary atherosclerosis and coronary artery calcium in patients undergoing coronary angiography
Am J Cardiol
(2008) - et al.
Association of epicardial adipose tissue with coronary atherosclerosis is region-specific and independent of conventional risk factors and intra-abdominal adiposity
Atherosclerosis
(2010) - et al.
Prognostic value of cardiac computed tomography angiography: a systematic review and meta-analysis
J Am Coll Cardiol
(2011) - et al.
Relation of epicardial adipose tissue to coronary atherosclerosis
Am J Cardiol
(2008) - et al.
Quantification of coronary artery calcium using ultrafast computed tomography
J Am Coll Cardiol
(1990) - et al.
SCCT guidelines for the interpretation and reporting of coronary computed tomographic angiography
J Cardiovasc Comput Tomogr
(2009) - et al.
Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study
J Am Coll Cardiol
(2008) - et al.
Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial
J Am Coll Cardiol
(2008)
Safety and accuracy of multidetector row computed tomography for early assessment of residual stenosis of the infarct-related artery and the number of diseased vessels after acute myocardial infarction
Am Heart J
Comparing culprit lesions in ST-segment elevation and non-ST-segment elevation acute coronary syndrome with 64-slice multidetector computed tomography
Eur J Radiol
Relationship between coronary artery disease and epicardial adipose tissue quantification at cardiac CT: comparison between automatic volumetric measurement and manual bidimensional estimation
Acad Radiol
Epicardial adipose tissue and coronary artery plaque characteristics
Atherosclerosis
Extension of coronary artery disease is associated with increased IL-6 and decreased adiponectin gene expression in epicardial adipose tissue
Cytokine
Cited by (22)
Epicardial fat tissue, coronary arterial calcification and mortality in patients with advanced chronic kidney disease and hemodialysis
2021, NefrologiaCitation Excerpt :Mediastinal adipose tissue (MAT) is deposited outside the parietal fascia of the pericardium. The distinction between the different locations of fat deposits is important, since pericardial fat has specific metabolic characteristics and different blood drainage.13–17 The quantification of EAT is not standardized, the studies are heterogeneous in terms of radiological technique and the location of the fat, and there is no consensus on the reference ranges.13,18
Atherosclerotic plaque metabolism in high cardiovascular risk subjects – A subclinical atherosclerosis imaging study with <sup>18</sup>F-NaF PET-CT
2017, AtherosclerosisCitation Excerpt :To our knowledge, we report for the first time a positive correlation between 18F-NaF uptake and thoracic fat volume. There are data linking the volume and distribution of epicardial fat to obstructive coronary heart disease [19–21], CV clinical outcomes [22], myocardial ischemia [23] and also coronary plaque vulnerability [24]. Hypothetically, as 18F-NaF marks micro-calcification in metabolically active plaques, possibly unstable, it might as well correlate with thoracic fat volume, which is associated with atherosclerosis and pro-inflammatory state.
Relation Between Epicardial Adipose and Aortic Valve and Mitral Annular Calcium Determined by Computed Tomography in Subjects Aged ≥65 Years
2016, American Journal of CardiologyCitation Excerpt :There are a few publications which revealed an association between EAT thickness particularly at the LAVG and CAD. Studies by Wang and Wu et al concluded that EAT measured at the LAVG, rather than epicardial fat volume, provides a more accurate assessment of atherogenic risk and is a predictor of obstructive CAD.29–31 The association of LAVG EAT with atherosclerosis was not restricted to the left circumflex artery territory, but it related to the extent of disease in the entire coronary tree.
Clinical Utility of Measuring Epicardial Adipose Tissue Thickness with Echocardiography Using a High-Frequency Linear Probe in Patients with Coronary Artery Disease
2015, Journal of the American Society of EchocardiographyVisceral adipose tissue as a source of inflammation and promoter of atherosclerosis
2014, AtherosclerosisCitation Excerpt :Notably, a few contrasting results have also been published: in one study the association was demonstrated only in patients with low body mass index [35]; other investigators who used echocardiography to measure EAT thickness failed to show any association with coronary artery disease [36], and in a Japanese study EAT was associated with coronary artery disease only in men but not in women [37]. Some have questioned whether the total volume of EAT or the volume of fat surrounding a specific coronary artery, for instance fat surrounding the left anterior descending coronary artery in the interventricular groove, is more closely associated with the development of coronary atherosclerosis [31,38]. In most studies, both pericardial [39–42] and epicardial [27,33,43] adipose tissue have been associated with the presence and extent of markers of atherosclerosis such as coronary artery calcium, although a few failed to show an association [44,45].
Usefulness of screening left atrioventricular groove epicardial adipose tissue thickness
2013, American Journal of Cardiology
This study was supported by grant NSC97-2314-B-010-045-MY3 from the National Science Council (Taiwan, R.O.C.) and the grants VGHKS101-020 and VGHKS100-074 from the Kaohsiung Veterans General Hospital (Taiwan, R.O.C.).
See page 948 for disclosure information.