Abstract 17781: Relationship Between Epicardial Adipose Tissue and Coronary Arterial Remodeling as Assessed by Intravascular Ultrasound in Patients with Coronary Artery Disease

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Background: Recently, the interest in epicardial adipose tissue (EAT) is rapidly growing. Several study suggest that EAT induces inflammation of the artery wall by secretion of pro-inflammatory proteins and plays a role in the pathogenesis of coronary artery disease. However, there is no information regarding the impact of EAT on coronary arterial remodeling and plaque vulnerability. Objectives: The aim of this study was to evaluate the relationship between EAT and intravascular ultrasound (IVUS) findings, mainly remodeling, in patients with coronary artery disease. Methods: One hundred and eight consecutive patients with de novo lesions located in native coronary artery were studied. The EAT thickness on the right ventricle was measured using transthoracic echocardiography, and arterial remodeling of culprit lesion was assessed by preinterventional IVUS. The remodeling index (RI) was calculated as lesion divided by the reference external elastic membrane cross-sectional area, Positive remodeling (PR) was defined as RI>1.05, intermediate remodeling (IR) as between 0.95 and 1.05, and negative remodeling (NR) as <0.95. IVUS findings included plaque characteristics-lipid rich, mixed and calcified plaque and plaque eccentricity. Results: There was significant relationship between EAT thickness and RI(r= 0.36, p=0.0001). Higher EAT thickness (≥10mm, n=55) were associated with higher BMI(25.2±3.6 kg/m 2 vs. 23.9±2.8 kg/m 2 , p=0.04), plasma triglyceride level (189.1±103.8 mg/dl vs. 146.1±80.9 mg/dl, p=0.02), and plasma urinary acid level(6.8±1.5mg/dl vs. 5.9±1.5 mg/dl, p=0.02). PR and more lipid rich and mixed plaque were observed in patients with higher EAT thickness than lower EAT thickness (PR ;43.6% vs. 18.9%,p=0.02. lipid rich and mixed plaque; 89% vs.66%,p=0.004). Multivariate analysis showed high EAT thickness was independent factor affecting coronary positive remodeling (OR3.05,p=0.02).There was no significant association EAT thickness and plaque eccentricity. Conclusion; High EAT thickness was significantly correlated with the coronary positive remodeling and non calcified plaque characteristics.