Assessment of Pericardial Fat Volume and Carotid Intimal Thickness as Risk Factors for Developing Coronary Atherosclerosis Using Multi Detector Computed Tomography

Abstract

Background The real visceral fat deposit of the heart is epicardial adipose tissue, which exists directly on the epicardial surface of the myocardium and is totally confined within the pericardial sac. Because the coronary arteries and their major branches are embedded in fat, local contact between a metabolically active epicardial adipose tissue and the coronary vasculature was possible. Carotid artery increased intimal thickness is the initial step within the process of atherosclerosis, which is a major cause of coronary and arterial diseases. Aim of the Work To study the relation between pericardial fat volume measurements in Multi and detector computed tomography ‘MDCT’ with carotid intima-media thickness in duplex study for detecting the risk of developing coronary atherosclerosis. Patients and Methods This retrospective study was carried out at the Radiodiagnosis department; Ain Shams University Hospitals (ASUH) during the period from January 2021 to June 2021 on 30 patients; their ages ranged from 37 to 78 years old, with a mean age of 60 years. Patients were either self-referred or referred by a physician to follow up or investigate CAD. All patients underwent coronary CT angiography. They were evaluated for: (I) Coronary calcium score. (II) Pericardial fat volume. (III) Degree of atherosclerosis, then a carotid duplex study was performed to determine the carotid intimal thickness. Results we demonstrated that pericardial fat volume MDCT has a positive, significant, strong correlation with CAD (P. Value <0.001). In our study, a Post-hoc Bonferroni test was done regarding the obtained data and found a significant difference between (Moderate and Severe) versus all groups. This means a significant difference between the moderate group with minimal or mild, and a significant difference between the severe group with minimal or mild. So it could be considered as a screening test at an early stage for any patient with different degrees of CAD. Conclusion Multi-detector CT and Carotid duplex examination were both considered good non-invasive tools for evaluation of PAT volume (mean for unremarkable to minimal degree, volume of about 94 ± 14.73 cm3) and CIMT (mean for unremarkable to minimal degree, thickness of about 0.67 ± 0.06 mm). Both were found to be significant and positively proportionately correlated risk factors for coronary atherosclerosis, so it is suggested that both tests be used as an evaluating/screening tool for any patient with suspected or confirmed CAD to assess risk and severity.