| ǥ : Clinical award session
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ȣ - 490334 11 |
| Relation of Epicardial Adipose Tissue to Coronary Artery Disease Angiographic Severity and Cardiovascular Events |
| Department of Cardiology, Ajou University Medical Center, Suwon, Korea |
| Sung Gyun Ahn, Seong-ill Woo, Jung-Hyun Choi, Hong-Seok Lim, Soo-Jin Kang, Byung-Joo Choi, So-Yeon Choi, Myeong-Ho Yoon, Joon-Han Shin, Seung-Jea Tahk |
BACKGROUND: The aim of this study was to investigate the relationship of epicardial adipose tissue (EAT), which is frequently observed during transthoracic echocardiographic examination, to coronary artery disease (CAD) including cardiovascular events.
METHODS: We measured EAT thickness consecutively and prospectively in 495 patients (59 ± 11, 230 males) who underwent first the coronary angiography due to chest pain. High sensitivity C-reactive protein (hs-CRP) was obtained before a coronary angiography. On angiogram, each of stenosis segments was scored from 0 to 3 depending on the most severe diameter stenosis according to the following system: 0 = normal, 1 = stenosis between 1% and 49%, 2 = stenosis between 50% and 99%, 3 = total occlusion. A coronary atherosclerosis score was generated as the sum of the scores in all segments. EAT thickness was measured on the free wall of the right ventricle in the parasternal long-axis and short-axis views at the base level at end-diastole.
RESULTS: EAT thickness significantly increased in 281 CAD patients compared with in patients with normal coronary artery (47 ± 25 mm vs. 27 ± 25 mm, p < 0.001). EAT thickness had a correlation with coronary atherosclerosis score (r = 0.3, p < 0.001) and hs CRP level (r = 0.26, p < 0.001). EAT thickness also significantly increased in 260 patients presented as an acute coronary syndrome than in 164 patients with a stable angina (49 ± 26 vs. 37 ± 22 mm, p < 0.001) and other atypical clinical presentation (vs. 23 ± 21 mm, p < 0.001). Receiver operating curve analysis revealed a fair correlation with the presence of CAD (Area under the curve 0.74, 95 % confidence interval 0.699 to 0.778, p < 0.001). The best cut-off value of EAT thickness to predict CAD was 25 mm with 78% of sensitivity and 60% of specificity.
CONCLUSIONS: These results suggest that EAT could be a true visceral adipose tissue correlating with the extent and severity of coronary atherosclerosis as assessed by coronary angiography and cardiovascular events. The measurement of EAT thickness might be included for coronary artery disease work-up during the echocardiographic examination.
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