Epicardial and pericardial fat volume correlate with the severity of coronary artery stenosis.

Naser Aslanabadi,Rezvanyeh Salehi,Alireza Javadrashid,Behrouz Khodadad,Hossein Montazerghaem,Elgar Enamzadeh,Mohammadkazem Tarzamani

doi:10.15171/jcvtr.2014.018

Abstract

Introduction: Epicardial fat volume (EFV) has been reported to correlate with the severity of coronary artery disease (CAD). Pericardial fat volume (PFV) has recently been reported to be strongly associated with CAD severity and presence. We aimed to investigate the relationship between EFV and PFV with severity of coronary artery stenosis in patients undergoing 64-slice multi-slice computed tomography (MSCT). Methods: One hundred and fifty one patients undergoing MSCT for suspected CAD were enrolled. Non-enhanced images were acquired to assess calcium score. Contrast enhanced images were used to quantify EFV, PFV and severity of luminal stenosis. Results: Coronary artery stenosis was mild in 25 cases (16.6%), moderate in 58 cases (38.4%) and severe in 68 cases (45%). With increase in severity of coronary artery stenosis, there was significant increase in PFV, EFV as well as epicardial fat thickness in right ventricle free wall in basal view and epicardial fat thickness in left ventricle posterior wall in mid and apical view. There was significant linear correlation between PFV with coronary calcification score (r=0.18, P=0.02), between coronary artery stenosis severity and PFV (r=0.75, P<0.001), EFV (r=0.79, P<0.001), apical epicardial fat thickness in right ventricle free wall (r=0.29, P<0.001), Mid (r=0.28, P<0.001) and basal (r=0.23, P=0.004) epicardial fat thickness in left ventricle posterior wall. Conclusion: PFV, EFV and regional epicardial thickness are correlated with severity of CAD and could be used as a reliable marker in predicting CAD severity.

Highlights

Epicardial fat volume (EFV) has been reported to correlate with the severity of coronary artery disease (CAD)
Pericardial fat volume (PFV) is another marker that can be quantified from non-contrast computed tomography (CT) scans performed for coronary calcium scoring
multi-slice computed tomography (MSCT) is capable of simultaneous demonstration of coronary calcium score, obstructive versus non-obstructive coronary lesions and amount of Epicardial adipose tissue (EAT) and epicardial fat volume (EFV)

Summary

Introduction

Epicardial fat volume (EFV) has been reported to correlate with the severity of coronary artery disease (CAD). There is increasing evidence that regional visceral fat accumulation may contribute with unfavorable metabolic effects and cardiovascular risk factors.[1,2,3] The adverse cardiovascular effects of obesity are mainly due to systemic and local accumulation of visceral fat pad with metabolically releasing of chemokines and cytokines.[4,5] EAT as a fat depot is further implicated on coronary artery disease (CAD) because of proximity to the adventitia of major epicardial coronary arteries.[6,7] EAT can be measured with simple echocardiography on free wall of right ventricle with correlation with presence of atherosclerotic CAD on conventional coronary angiography.[8] Other imaging modalities for measurement of EAT are magnetic resonance imaging (MRI) and multi-slice computed tomography (MSCT).[9,10,11] With recent developments in MRI and MSCT more comprehensive developments in measurements of EAT have become possible.[1] Pericardial fat volume (PFV) is another marker that can be quantified from non-contrast computed tomography (CT) scans performed for coronary calcium scoring. In this study we aim to evaluate the correlation between epicardial and PFV using MSCT with severity of the coronary artery stenosis

Objectives

Methods

Results

Conclusion