Association of Epicardial Fat Volume with Coronary Artery Ectasia and Coronary Artery Disease

Abstract

Epicardial fat may play an important role in the pathogenesis of coronary artery disease (CAD). We investigated the relationship between coronary artery ectasia (CAE) and epicardial fat volume (EFV). This retrospective study included 506 patients with CAE (group 1), 500 with CAD (group 2), and 500 patients with normal coronaries as controls (group 3). The pericardium was traced manually from the edge of the pulmonary trunk to the last measured by computed tomography slice containing images of the heart to obtain a region of interest. EFV was significantly higher in patients with CAD than in those with CAE (87.94 ± 22.18 vs 61.33 ± 12.75 mL; P < .001). Patients with normal coronaries had EFV of 56.62 ± 9.82 mL. Multivariate logistic regression analysis showed that male gender [Odds ratio (OR) (95% confidence interval (CI)): 1.220 (1.015–1.682), P = .042], diabetes [OR (95% CI): 1.036 (1.008–1.057); P = .002], and smoking [OR (95% CI): 3.043 (1.022–9.462); P = .005] were significantly associated with CAE. The receiver operating characteristic (ROC) curve showed that EFV had strongest diagnostic value for detecting CAD rather than CAE [AUC .502 P = .074 (95% CI: .311–.784)]. This study demonstrated that EFV is an independent predictor for CAE and CAD. However, sensitivity and specificity for detecting CAE is low when compared with CAD.

Epicardial Adipose Tissue Hyperinflammation Might be the Broken Thread in Coronary Artery Ectasia Pathogenesis

“…3 Not only did Subhan et al strengthen the observation by Çetin et al 2 but they also included a large population (n = 500) of CAD patients. 1 A recently published meta-analysis (21 studies encompassing 4975 patients) underscored that greater EAT volume and thickness was associated with increasing CAD severity, regardless of imaging modality used (CCT or TTE). 4 Furthermore, impaired adipokine secretion, such as increased resistin 5 and decreased adiponectin release, 6,7 has also been suggested in CAE cases compared with healthy controls, while the role of EAT-mediated inflammation is highly suspected in the etiopathogenesis of the disease.…”

“…We read with interest the study by Subhan et al 1 investigating the association between epicardial adipose tissue (EAT) and isolated coronary artery ectasia (iCAE). They found that epicardial fat volume, as assessed by cardiac computed tomography (CCT), independently predicted iCAE and coronary artery disease (CAD).…”

“…3 Not only did Subhan et al strengthen the observation by Çetin et al 2 but they also included a large population (n = 500) of CAD patients. 1 A recently published meta-analysis (21 studies encompassing 4975 patients) underscored that greater EAT volume and thickness was associated with increasing CAD severity, regardless of imaging modality used (CCT or TTE). 4…”