Echocardiographic assessment of epicardial adipose tissue: A marker of coronary artery disease

Abstract

Recent studies have shown that epicardial adipose tissue (EAT) can be used as a cardiovascular risk evaluation tool. Coronary artery disease (CAD) assessment still to be a challenge with non-invasive explorations. Thus, we searched for a correlation between EAT and coronary artery disease. This is a prospective descriptive study that included 100 consecutive patients admitted to the cardiology department of the hospital of the internal security forces of Marsa and having consulted between November 2020 and April 2021 for symptoms that required coronary angiography. The mean age was 58 ± 12 years, with a masculine predominance (sex ratio = 6.14). Dyslipidemia and hypertension were the most common cardiovascular risk factors (86% and 57%, respectively). The median Gensini score was 8.5 [1–37] while the mean values of mean end-diastolic EAT (MEDE) and mean end-systolic EAT (MESE) were 3.3 ± 8 mm and 5.1 ± 1.3 mm, respectively. Thirty patients had a normal angiogram (Gensini score = 0, 30%), 29 patients had mild CAD (Gensini score = 1–19, 29%), and 41 patients had obstructive/severe CAD (Gensini score > 19, 41%). In univariate analysis, MEDE and MESE were significatively different between the tertiles of Gensini score (combined P < 0.001 for both). In bivariate analysis, there was a positive and moderate to strong significant correlation between EAT and Gensini score (MEDE: P < 0.001; r = 0.590, MESE: P < 0.001; r = 0.557). The analysis of receiver operating characteristic curve showed that a MEDE > 3.4 (sensibility = 80%, specificity = 72%) and a MESE > 5 (sensibility = 78%, specificity = 73%) can predict high Gensini score (OR = 11; 95% CI: 4.23–29; P < 0.001 and OR = 8; 95% CI: 3.21–20.4; P < 0.001, respectively). Echocardiographic measurement of the EAT is a useful non-invasive tool that can be used to predict obstructive CAD.