Association of Epicardial Adipose Tissue With Left Ventricular Strain and MR Myocardial Perfusion in Patients With Known Coronary Artery Disease

Abstract

BackgroundEpicardial adipose tissue (EAT) may have a paracrine effect on coronary microcirculation and myocardium. However, it is unclear whether EAT is linked to cardiac function and perfusion.PurposeTo investigate the association of EAT with left ventricular (LV) strain and myocardial perfusion in patients with coronary artery disease (CAD).Study TypeRetrospective.PopulationA total of 78 patients with CAD and 20 healthy controls. The patients were further divided into high (n = 39) and low EAT volume (n = 39) groups according to median EAT volume.Field Strength/SequenceA 1.5 T, balanced steady‐state free precession, inversion recovery prepared echo‐planar, and segmented‐turbo fast low‐angle shot (FLASH) phase‐sensitive inversion recovery (PSIR) sequences.AssessmentEAT volume was measured by manually tracing the epicardial border and the visceral layer of pericardium on the short‐axis cine stacks. LV strain parameters included global radial (GRS), circumferential (GCS), and longitudinal peak strain (GLS). Perfusion indices included upslope, perfusion index, time‐to‐maximum signal intensity (TTM), and maximum signal intensity (MaxSI).Statistical TestsOne‐way analysis of variance or Kruskal–Wallis rank tests, Chi‐squared or Fisher exact tests. Multivariate linear regression analyses. A P value < 0.05 was considered statistically significant.ResultsThe parameters of GRS GCS, GLS, upslope, perfusion index, and MaxSI were significantly lower in the patients when compared to the controls. Moreover, the high EAT volume group presented significantly longer TTM values and lower GRS, GCS, GLS, upslope, perfusion index, and MaxSI than the low EAT volume group. Multivariate linear regression analyses demonstrated that EAT was independently associated with GRS, GCS, GLS, upslope, perfusion index, TTM, and MaxSI in patients. EAT and upslope were independently associated with GRS, while EAT and perfusion index were both independently associated with GCS and GLS.Data ConclusionEAT was associated with parameters of LV function and perfusion, and myocardial perfusion was independently associated with LV strain in patients with CAD.Evidence Level3.Technical EfficacyStage 3.

Epicardial Adipose Tissue Thickness and Preserved Ejection Fraction Heart Failure

“…Adiponectin gene expression and thus concentration decreases significantly in epicardial adipocytes as coronary artery atherosclerosis progresses [40]. Epicardial AT expansion is inversely related to perfusion of LV sub-endocardial layers and LV global longitudinal strain in patients with CAD; sub-endocardial layer perfusion and LV strain are directly related [41]. Analysis of macrophage polarization markers reveals increased low-grade inflammation in EAT biopsies from patients with CAD [42].…”