Can epicardial and pericardial adipose tissue volume predict the presence and severity of coronary artery disease?

Abstract

Purpose Excessive accumulation of free fatty acids in the coronary arteries can lead to coronary artery disease (CAD). Quantification of epicardial adipose tissue (EAT) and pericardial adipose tissue (PAT) is beneficial to understand its relationship with CAD, hypertension (HT), and diabetes. Material and methods This retrospective study included 54 patients who underwent CT coronary angiogram using a multidetector row CT scanner. The EAT and PAT volumes from cardiac images were quantified using Image J software. The severity of CAD was graded using the CAD-RADS score. Results Twenty-nine patients had no CAD, 21 patients had significant CAD, and 4 patients had insignificant CAD. Out of 21 patients with significant CAD, 14 had involvement of multiple coronary arteries. The EAT and PAT volumes were higher in patients with HT, DM, CAD-present group and significant-CAD-present group, but this was not statistically significant except the PAT volume with respect to diabetes. Significant correlation was found between EAT volume and calcium score ( p = 0.035) and between EAT volume and total cholesterol level ( p = 0.017). Significant differences in the EAT volumes were found in different CAD-RADS categories in the right coronary artery (RCA). From the threshold values, it was observed that CAD can develop in LAD even at lower of EAT and PAT volumes. Conclusions Quantification of EAT and PAT volumes is beneficial in understanding its relationship with the presence and severity of coronary artery disease and its risk factors.

Epicardial fat volume and its association with cardiac arrhythmias in CT coronary angiography

“…An explanation could be the composition of our patient population that might have had an influence on regression analysis for Agatston score and CAD-RADS score. The distribution of gender -a larger male population -and the number of patients with diabetes -a less diabetic population in our study -are pre viously found influencing factors of Agatston score and differ substantially from the study of Panda et al [14,[20][21][22]. Most likely reason is that the mean Agatston score in our population is about half that found in the compared study by Panda et al As discovered by Mahabadi et al the association of epicardial fat volume on the progression of coronary calcification is more emphasised in subjects with low body mass index and decreases with the degree of adiposity [23].…”

“…Recently, epicardial fat volume has been studied with contradictory data: On the one hand, Panda et al . found a positive correlation between epicardial fat volume and Agatston score [ 14 ]. This was not the case in our collective of 96 patients, which nearly doubles the patient number in the mentioned study ( n = 54) but is still a relatively small patient population.…”

“…The distribution of gender – a larger male population – and the number of patients with diabetes – a less diabetic population in our study – are pre-viously found influencing factors of Agatston score and differ substantially from the study of Panda et al . [ 14 , 20 - 22 ]. Most likely reason is that the mean Agatston score in our population is about half that found in the compared study by Panda et al .…”

“…First, the area below the visceral layer of the pericardium was marked with a circle-shaped brush tool in the image analysis software, leaving a mask for the content of the visceral pericardial sac. Afterwards, another mask was created in a different layer using a threshold value of –200 to –30 Hounsfield units to mark all fat-isodense areas within the DICOM image dataset [ 14 , 18 ]. Lastly, a logic operations tool was applied to subtract both layers from each other, leaving the fat-isodense areas within the first mentioned mask marked in a different colour, i.e.…”

“…There are different studies examining the correlation between epicardial fat volume and severity of CAD but the results differ significantly [ 11 , 12 ]. Only a few studies to date have examined the relationship between epicardial fat volume and coronary artery disease – the reporting and data system (CAD-RADS) score in particular [ 13 , 14 ]. The aim of the present study was therefore to measure epicardial fat volume and investigate its correlation with CAD-RADS score and the occurrence of cardiac tachyarrhythmia in patients with acute chest pain.…”