Relationship Between Epicardial Fat Measured by 64‐Multidetector Computed Tomography and Coronary Artery Disease

Iwasaki, Kohichiro; Matsumoto, Takeshi; Aono, Hitoshi; Furukawa, Hiroshi; Samukawa, M

doi:10.1002/clc.20840

Cited by 78 publications

(52 citation statements)

References 22 publications

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“…Iwasaki et al also observed, on a univariate analysis, a higher EFV in patients with significant coronary stenosis (>50%) compared to patients without CAD. 16 Also, Ueno et al have shown that EFV is independently related to chronic total occlusions. 17 The Framingham Heart Study found an association between EAT and CCS in a cross-sectional analysis, but only when including the adipose tissue in addition to traditional risk factors.…”

Section: Discussionmentioning

confidence: 99%

Correlations Between Severity of Coronary Lesions and Epicardial Fat Volume in Patients with Coronary Artery Disease – a Multislice CT-based Study

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et al. 2016

Journal of Interdisciplinary Medicine

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Background: Epicardial fat has been recently identified as a major player in the development of the atherosclerotic process. Study aim: The aim of this study was to correlate the epicardial fat volume (EFV), determined by Multisclice CT, and the severity of the coronary lesions, expressed by the Coronary Calcium Score (CCS) and Syntax Score (SxS) in patients with established coronary artery disease (CAD). Material and methods: One-hundred-twentysix patients underwent Multisclice 64 CT assessment of coronary lesions and epicardial fat quantification. Calculation of CCS was performed on all the three coronary vessels and was followed by determination of SxS according to guidelines. The patients were divided into 2 groups: Group 1 -patients with CCS >400 (n = 26), and Group 2 -patients with CaS <400 (n = 100). Results: The mean age of the study population was 65.32 years for Group 1 and 54 years for Group 2 (p <0.0001). However, patients >65 years of age had a high CCS in a more significant extent than younger patients (50% in Group 1 vs. 17% in Group 2, p = 0.0115). Female gender was recorded in 48% of cases in Group 2 and in 19% of cases in Group 1 (p = 0.008). Several factors were identified in a higher extent in the group with high CCS as compared with the group with low CCS, such as the presence of significant stenosis (>50%) of the left anterior descending artery (LAD) (46% vs. 9%, p <0.0001), the presence of multi-vessel coronary disease (50% vs. 5%, p <0.0001) and a high SxS, above 23 (23% vs. 4%, p = 0.006). The epicardial fat volume was 117.81 ± 40.4 ml (95% CI: 97.98-138.2 ml) in Group 2 and 89.77 ± 37.7 ml (95% CI: 80.4-101.5 ml) in Group 1 (p = 0.0033). Conclusions: Epicardial fat volume could represent a new imaging-derived biomarker, useful for classification of the severity of coronary artery disease, increased values of EFV being associated with other biomarkers of disease severity, such as calcium score.

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Section: Discussionmentioning

confidence: 99%

Correlations Between Severity of Coronary Lesions and Epicardial Fat Volume in Patients with Coronary Artery Disease – a Multislice CT-based Study

Hodaş

Pop

Opincariu³

et al. 2016

Journal of Interdisciplinary Medicine

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“…Nowadays MDCT is preferred to echocardiography because volumetric EAT measurement by MDCT is found to be more reliable than echocardiographic thickness measurement [4]. Previous studies showed a strong correlation between EAT volume measured by MDCT and cardiometabolic risk factors [14], coronary calcium score [15], and CAD [16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…MDCT can provide more accurate measurements than other techniques because of its high temporal resolution [1], and MDCT measurements are reproducible [2,3]. It has also been shown that MDCT volumetric measurements are more reliable than echocardiographic thickness measurements [4].…”

Section: Introductionmentioning

confidence: 99%

The relationship between location-specific epicardial adipose tissue volume and coronary atherosclerotic plaque burden in type 2 diabetic patients

et al. 2017

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A b s t r a c tBackground and aim: Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot that plays an important role in the pathogenesis of coronary atherosclerosis. Due to its asymmetrical distribution, the relation between location-specific EAT measurements and coronary atherosclerosis remains unclear. Our study investigated the relationship between location-specific EAT volume and coronary atherosclerotic plaque burden that was detected by coronary computed tomography angiography (CCTA) in type 2 diabetic patients without coronary artery disease (CAD) history. Methods:A total of 157 consecutive diabetic patients who had undergone CCTA were included retrospectively. After evaluation of the CCTA images, the study population was divided into two groups according to the presence of coronary atherosclerosis. In both groups, total and left atrioventricular groove EAT volumes were measured. Results:Total and left atrioventricular groove EAT volumes were significantly associated with coronary atherosclerosis, but only left atrioventricular groove EAT volumes were an independent predictor for CAD. Also, total and left atrioventricular groove EAT volumes were positively correlated with C-reactive protein values (p = 0.0001/p = 0.0001) and the number of coronary atherosclerotic segments (p = 0.0001/p = 0.0001).

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“…In this issue of Clinical Cardiology, Iwasaki et al reported on the relationship between EAT, the calcium score, and the severity of coronary atherosclerosis. 3 They studied 197 patients who underwent CT calcium scoring and 64-slice CT coronary angiography. In all of these patients they carefully measured the volume of EAT using a dedicated off-line postprocessing program.…”

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confidence: 99%

“…124 cm 3 . The volume of EAT accounts for approximately 15% to 20% of the total cardiac volume and covers approximately 80% of the total cardiac surface.…”

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Epicardial Adipose Tissue: An Emerging Role for the Development of Coronary Atherosclerosis

Feyter

2011

Clinical Cardiology

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There is a growing body of evidence that epicardial adipose tissue (EAT) plays an enhancing role in the development of coronary atherosclerosis. 1,2 Pericardial fat is deposited around the heart at two locations, as epicardial and paracardial adipose tissue separated from each other by the parietal pericardium. Paracardial adipose tissue originates from the primitive thoracic mesenchyme and is supplied by the pericardiophrenic artery, a branch of the internal thoracic artery. EAT is defined as adipose tissue situated within the pericardium. EAT originates from the splanchnopleuric mesoderm (such as the mesenteric and omental fat deposits), and the vascular supply is from coronary arteries. Conceptually, EAT is more interesting than paracardial adipose tissue because of the close anatomic relationship between EAT and the myocardium. EAT also includes pericoronary fat situated around the coronary arteries, which may even be more appealing due to its very close proximity to the coronary arteries, suggesting a role for the development of coronary atherosclerosis. So far there is no general consensus as to which of these fat deposits should be studied, but most reports are about EAT, and few also report about the peri-coronary fat deposits. 1,2 EAT is metabolically active visceral fat, and the quantity of EAT is correlated with the metabolic syndrome (a waist circumference, hypertriglyceridemia, and hyperglycemia), cardio-metabolic risk factors, and coronary atherosclerosis. 2 EAT is distributed asymmetrically around the heart, and the fat is deposited mainly at the atrioventricular and interventricular grooves, around the major coronary arteries and free wall of the right ventricle, and the apex of the left ventricle. EAT can be measured by magnetic resonance imaging or echocardiography, but recently computed tomography (CT) has emerged as a robust, 3-dimensional, high-resolution imaging technique that reliably identifies EAT. CT allows quantification of EAT by manually tracing the pericardium on cross-sectional CT images. Within the traced region, the adipose tissue is identified by voxels that have a range of −190 to −30 HU. Automated computer-assisted methods allow quantification of epicardial fat tissue measurements.The measurements are presented as regional fat thickness (mm), as cross-sectional area (cm 2 ), and as a volume (cm 3 ). EAT volume is reported as ranging from 68 toThe author has no funding, financial relationships, or conflicts of interest to disclose. 124 cm 3 . The volume of EAT accounts for approximately 15% to 20% of the total cardiac volume and covers approximately 80% of the total cardiac surface. EAT accounts for roughly 1% of the total body fat mass. EAT volume is higher in patients with a high body mass index (BMI) than in patients with a low BMI. The mean EAT thickness measured at several sites, including the free right ventricular wall, left ventricular anterior wall, and grooves was 5.3 ± 1.6 mm. 1 The measurement of regional fat thickness around the coronary arteries is useful because ...

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Relationship Between Epicardial Fat Measured by 64‐Multidetector Computed Tomography and Coronary Artery Disease

Cited by 78 publications

References 22 publications

Correlations Between Severity of Coronary Lesions and Epicardial Fat Volume in Patients with Coronary Artery Disease – a Multislice CT-based Study

Correlations Between Severity of Coronary Lesions and Epicardial Fat Volume in Patients with Coronary Artery Disease – a Multislice CT-based Study

The relationship between location-specific epicardial adipose tissue volume and coronary atherosclerotic plaque burden in type 2 diabetic patients

Epicardial Adipose Tissue: An Emerging Role for the Development of Coronary Atherosclerosis

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