Epicardial adipose tissue volume as a predictor for coronary artery disease in diabetic, impaired fasting glucose, and non-diabetic patients presenting with chest pain

Versteylen, Mathijs O.; Takx, Richard A.P.; Joosen, Ivo A.; Nelemans, Patricia J.; Das, Marco; Crijns, Harry J.G.M.; Hofstra, Leonard; Leiner, Tim

doi:10.1093/ehjci/jes024

Cited by 41 publications

(34 citation statements)

References 32 publications

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“…Results from studies in type 2 diabetes and mixed populations (diabetes and non-diabetes) are conflicting. In the studies reporting an association between epicardial adipose tissue and coronary artery disease, including high risk plaque characteristics and CAC [13][14][15], it remains uncertain if the associations demonstrated are truly independent from traditional risk factors. We report a lack of association between cardiac adipose tissue and CAC score in persons with type 2 diabetes free of cardiovascular disease in line with results from a study in a mixed population (34% had diabetes) with suspected or known coronary artery disease (referred for clinically indicated invasive coronary angiography) [16].…”

Section: Cardiac Adipose Tissue and Coronary Atherosclerosismentioning

confidence: 99%

“…Due to the proximity of the structures, cardiac adipose tissue could through paracrine signalling promote calcification or impair the myocardial microcirculatory function [7,10]. Knowledge of these associations in persons with diabetes, who are known to have higher amounts of cardiac adipose tissue and higher risk of cardiovascular disease compared to persons without diabetes, is sparse [6,[11][12][13][14][15][16]. A study in patients with systolic heart failure demonstrated an association between epicardial adipose tissue thickness and cardiac sympathetic denervation, implying that cardiac adipose tissue could affect autonomic nerve function [17].…”

mentioning

confidence: 99%

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Relation of cardiac adipose tissue to coronary calcification and myocardial microvascular function in type 1 and type 2 diabetes

Zobel

Christensen

Winther

et al. 2020

Cardiovasc Diabetol

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Background: Cardiac adipose tissue may have local paracrine effects on epicardial arteries and the underlying myocardium, promoting calcification and affecting myocardial microcirculation. We explored whether the total amount of cardiac adipose tissue was associated with coronary artery calcium score (CAC) and myocardial flow reserve in persons with type 1 or type 2 diabetes and healthy controls. Methods:We studied three groups: (1) 30 controls, (2) 60 persons with type 1 diabetes and (3) 60 persons with type 2 diabetes. The three groups were matched for sex and age. The three groups derived from retrospective analysis of two clinical studies. All underwent cardiac 82 Rb positron emission tomography/computed tomography (PET/CT) scanning. Cardiac adipose tissue volume (the sum of epicardial and pericardial fat), CAC, and myocardial flow reserve (ratio of pharmacological stress flow and rest flow) were evaluated using semiautomatic software. We applied linear regression to assess the association between cardiac adipose tissue, CAC and myocardial flow reserve.

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Section: Cardiac Adipose Tissue and Coronary Atherosclerosismentioning

confidence: 99%

mentioning

confidence: 99%

Relation of cardiac adipose tissue to coronary calcification and myocardial microvascular function in type 1 and type 2 diabetes

Zobel

Christensen

Winther

et al. 2020

Cardiovasc Diabetol

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“…23, 24 Furthermore, the majority of clinical studies reporting significant associations of EFV with CAD were derived from community-based patient samples with low risk profiles. Thus, there is conflicting evidence whether EFV indeed is an independent risk factor for CAD.…”

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confidence: 99%

Lack of Association Between Epicardial Fat Volume and Extent of Coronary Artery Calcification, Severity of Coronary Artery Disease, or Presence of Myocardial Perfusion Abnormalities in a Diverse, Symptomatic Patient Population

Tanami

Jinzaki

Kishi

et al. 2015

Circ: Cardiovascular Imaging

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Background Epicardial fat may play a role in the pathogenesis of coronary artery disease (CAD). We explored the relationship of epicardial fat volume (EFV) with the presence and severity of CAD or myocardial perfusion abnormalities in a diverse, symptomatic patient population. Methods and Results Patients (n=380) with known or suspected CAD who underwent 320-detector row CT angiography, nuclear stress perfusion imaging, and clinically driven invasive coronary angiography for the CORE320 international study were included. EFV was defined as adipose tissue within the pericardial borders as assessed by CT utilizing semi-automatic software. We used linear and logistic regression models to assess the relationship of EFV with coronary calcium score, stenosis severity by quantitative coronary angiography (QCA), and myocardial perfusion abnormalities by SPECT. Median EFV among patients (median age 62.6 years) was 102 cm3 [interquartile range 53]. Calcium score ≥ 1 was present in 83% of patients with 59% having ≥ 1 coronary artery stenosis of ≥ 50% by QCA, and 49% having abnormal myocardial perfusion results by SPECT. There were no significant associations between EFV and CACS, presence severity of ≥ 50% stenosis by QCA, or abnormal myocardial perfusion by SPECT. Conclusions In a diverse population of symptomatic patients referred for invasive coronary angiography, we did not find associations of epicardial fat volume with the presence and severity of coronary artery disease or with myocardial perfusion abnormalities. The clinical significance of quantifying epicardial fat volume remains uncertain but may relate to the pathophysiology of acute coronary events rather than the presence of atherosclerotic disease.

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“…In this study, highest values of EFT were found in patients with extremely high intra-abdominal fat and insulin resistance. In a recent study, an association has been found with the EAT volume and presence and extent of CAD in diabetic or non-diabetic patients (27).…”

Section: Metabolic Syndromementioning

confidence: 92%

Epicardial adipose tissue: a review of physiology, pathophysiology, and clinical applications

Şengül¹,

Özveren²

2013

Anadolu Kardiyol Derg

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Visceral fat tissue is an important predictor of cardio-metabolic diseases, carrying more risk than general fat accumulation. Epicardial fat, a particular form of visceral fat deposited around the heart, is considered an important cardiovascular risk predictor, in view of producing and releasing several adipo-cytokines. There is growing evidence about the physiological and metabolic importance of epicardial fat. Epicardial fat thickness and volume have both strong correlation between obesity, impaired fasting glucose, insulin resistance, metabolic syndrome, hypertension, diabetes mellitus, and atherosclerosis. Epicardial fat can be assessed by transthoracic echocardiography, cardiac magnetic resonance imaging, and computed tomography. In this article, we reviewed the anatomy, physiology, function, and the methods of assessment of epicardial fat tissue. We also have tried to discuss its relationship to metabolic syndrome and coronary atherosclerosis in the lights of recent findings. (

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Epicardial adipose tissue volume as a predictor for coronary artery disease in diabetic, impaired fasting glucose, and non-diabetic patients presenting with chest pain

Abstract: The EAT volume is associated with CAD in DM2, IFG, and control patients. However, EAT is not an independent predictor for CAD in patients presenting with stable chest pain.

Cited by 41 publications

References 32 publications

Relation of cardiac adipose tissue to coronary calcification and myocardial microvascular function in type 1 and type 2 diabetes

Relation of cardiac adipose tissue to coronary calcification and myocardial microvascular function in type 1 and type 2 diabetes

Lack of Association Between Epicardial Fat Volume and Extent of Coronary Artery Calcification, Severity of Coronary Artery Disease, or Presence of Myocardial Perfusion Abnormalities in a Diverse, Symptomatic Patient Population

Epicardial adipose tissue: a review of physiology, pathophysiology, and clinical applications

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