Ct Evaluation of Association Between Pericardial Fat Volume and Coronary Artery Disease

Abstract

BACKGROUNDPericardial fat is the adipose tissue surrounding the heart. It releases inflammatory cytokines in a local fashion and affect only the adjacent structures, which are coronary arteries. Multiple studies have tried to establish the association of pericardial fat volume and calcium scoring with the incidence of coronary artery disease with contradicting results. We hope to provide additional evidence towards this already existing dispute and to comment whether pericardial fat volume measurement should be done as a routine diagnostic tool and consider it as a marker for ischaemic heart disease.The objective of this study is to evaluate the association between pericardial fat volume and coronary artery disease using dual source computed tomography (DSCT), to evaluate the pericardial fat volume differences between patients with coronary artery disease and normal controls, to assess the relationship between pericardial fat volume and coronary calcium score and between different degrees of coronary artery stenosis. MATERIALS AND METHODSWe included 117 DSCT coronary angiography studies, of which 62 cases were males and 55 were females; 74 scans showed positive findings of coronary artery disease and 43 cases were normal. Both the presence of coronary calcium score and/or coronary artery stenosis was taken into consideration as positive radiological findings of coronary artery disease. The scans were taken using Siemens Somatom definition flash DSCT with 100 kVp, 0.75 mm slice thickness and mAs according to the patient's BMI. The scans were obtained in diastolic phase with the patient in supine position. Contrast agent used was Visipaque. Pericardial fat volume was measured in Siemens Somatom Syngo volume analysis software. The area of interest was taken as the areas of pericardial fat around the main coronary arteries and the threshold HU was kept between -30 and -190 HU. Coronary artery stenosis was assessed visually by two experienced radiologists and categorised to mild (< 50%), moderate (50% -75%) and severe (>75%). Coronary artery calcium score (Agatston score) was calculated using Siemens calcium score analysis software by an experienced radiologist. Each coronary artery was selected and the sum of all the calcium score of all the arteries were taken as total coronary calcium score. The data was written in excel format. All the statistics was done in SPSS 16.0 software. RESULTSThe retrospective analysis of 117 CT coronary angiography scans revealed 74 (63.24%) cases with positive findings for coronary artery disease either having coronary calcification or coronary artery stenosis. The mean of pericardial fat volume for normal cases was 76.84 ± 35.79 cm 3 and the positive cases with the evidence of coronary artery disease were 92.95 ± 35.84 cm 3 . Significant differences were observed between the pericardial fat volume of normal subjects and subjects with the evidence of coronary artery disease in student t-test (P= 0.023). Pericardial fat volume was observed to have no significant difference betw...

Evaluation of the Relationship Between Epicardial Fat Tissue Area and Coronary Atherosclerosis

“…In addition to the known causes of atherosclerosis, epicardial adipose tissue has also been reported in recent years to cause atherosclerosis and coronary artery disease. Today, it has been proven that pericardial adipose tissue secretes more inflammatory cytokines than subcutaneous adipose tissue, and inflammation caused by these cytokines is one of the causes of coronary artery disease 13 .…”

“…In many studies in the literature using epicardial fat volume, pericardial fat volume and epicardial adipose tissue thickness, a strong positive correlation was found between coronary artery stenosis and ischemic lesions and the amount of adipose tissue 13,15,19,21 . In the study conducted by Du et al, pericardial fat volume was found to be higher in patients with significant stenosis and ischemic lesions compared to those without 22 .…”