Background : While relatively little is known about epicardial fat���s physiologic and metabolic roles, it has been implicated in the development of epicardial coronary atheroscleorsis. The objective of this study was to evaluate the relationship of echocardiographic epicardial fat to the presence and severity of coronary artery disease in clinical setting.
Methods : 203 consecutive patients who underwent echocardiography and diagnostic coronary angiography were studied. Epicardial fat thickness on the free wall of right ventricle was measured at end-diastole from parasternal long-axis views of three cardiac cycles. Angiograms were analyzed for the presence, extent and severity of coronary artery disease using Gensini���s score. Blood sampling was done to measure lipid profiles and inflammatory markers including high sensitive C-reactive protein (hsCRP) and monocyte counts.
Results : According to the quartile of epicardial fat thickness, we divided the patients into two groups (Group I, fat thickness <7.6 mm; Group II, ���7.6 mm). There were no significant differences in the baseline characteristics except abdominal circumference (p=0.023). A significant correlation revealed between epicardial fat thickness and age (r=0.332, p<0.001), C-reactive protein (r=0.182, p=0.009), body-mass index (r=0.142, p-0.044) and abdominal circumference (r=0.229, p=0.001). The epicardial fat thickness was significantly correlated with the presence of coronary artery disease and Gensini���s score (p=0.003 and p=0.014). Multivariate analysis showed that age (OR 5.29, p=0.003), epicardial fat thickness (OR 10.53, p=0.004), diabetes (OR 8.06, p=0.006) and smoking (OR 14.65, p=0.015) were independent factors affecting coronary artery disease.
Conclusions : Epicardial fat thickness was associated with the presence and severity of coronary artery disease.