Relation between Epicardial Adipose Tissue Thickness Assessed by Multidetector Computed Tomography and Significance of Coronary Artery Disease

Abstract

Objective: To evaluate the relation between epicardial adipose tissue (EAT) thickness and also pericoronary fat assessed by Multidetector Computed Tomography (MDCT) with both calcium score and significance of coronary artery disease. Background: Epicardial adipose tissue (the visceral fat of the heart present under the visceral layer of the pericardium) has the same origin of abdominal visceral fat, which is known to be strongly related to the development of coronary artery atherosclerosis. Multidetector CT (MDCT) provides an accurate and reproducible quantification of EAT due to its high spatial and temporal resolution. Patients and Methods: The current study included 70 patients with low-intermediate probability of coronary artery disease. All patients were subjected to 256 Multidetectors CT to assess EAT thickness, the mean thickness of the pericoronary fat surrounding the three coronary arteries and coronary calcium score. Also coronary CT angiography was done and patients were then divided into 3 groups according to significance of coronary atherosclerosis: Group 1: No atherosclerosis (20 patients), Group 2: Non obstructive atherosclerosis (luminal narrowing less than 50% in diameter) (25 patients), Group3: Obstructive atherosclerosis (luminal narrowing ≥ 50%) (25 patients). Results: The mean EAT thickness and the mean pericoronary fat thickness were significantly higher in patients with obstructive coronary artery disease (CAD) with stenosis > 50% (group 3) compared to other groups with normal coronaries or non obstructive (CAD). ROC curve was used to define the best cut off value of the thickness of both EAT and pericoronary fat in predicting the obstructive CAD group which was ≥7.2 and 12.6 mm for epicardial and pericoronary fat respectively. Also there is a How to cite this paper: Samy, N.I., Fakhry, M. and Farid, W.

Evaluation of epicardial adipose tissue by coronary multi-detector computed tomography: an independent predictor of obstructive coronary artery disease

“…In a study conducted by Gać et al [13], it was indicated that positive correlation was noted between significant CAD, EAT thickness and PCFT in 80 suspected patients by coronary CT angiography. Other studies had similar results as our data regarding correlation of EAT thickness and PCFT and obstructive CAD [14,15]. However, You et al [16] reported that there was no correlation between PCFT and CAD severity.…”

The relation between pericoronary fat thickness and density quantified by coronary computed tomography angiography with coronary artery disease severity

“…They found a substantial correlation between EATT, calcium score and the Significance of coronary artery disease, with greater values in group III than in groups I and II. 18 , 7 , 19 …”

“…This is consistent with Demircelik et al, 7 who discovered that PCFT cut-off value ≥ 13.8 mm and EAT ≥6.8mm predict CAD obstruction. In addition, Samy et al 18 reported that the predicted EAT and PCFT values for obstructive CAD were ≥7.2 and 12.6 mm, respectively.…”

Coronary Artery Disease Severity has a Strong Association with Epicardial Adipose Tissue Thickness

“…CAD is major source of worldwide mortality and morbidity 6 .CAD is multifactor condition 6 .Visceral obesity is an independent risk factor for CAD 6 . EAT is a visceral fat that has been found to be associated with coronary artery plaques and calcification 6 . Irrespective of cardiovascular risk factors EAT leads to lethal and non-lethal coronary artery events in population 7 .…”