Is there any association between epicardial adipose tissue compartment and coronary artery disease?
█ Original article
Drobni Zsófia Dóra1, Kolossváry Márton1, Karády Júlia1, Jermendy Ádám1, Littvay Levente2, Tárnoki Ádám Domonkos3, Tárnoki Dávid László3, Voros Szilard4, Jermendy György5, Merkely Béla1, Maurovich-Horvat Pál1
1MTA-SE Lendület Kardiovaszkuláris Képalkotó Kutatócsoport, Semmelweis Egyetem, Városmajori Szív- és Érgyógyászati Klinika, Budapest
2Közép-Európai Egyetem, Budapest
3Semmelweis Egyetem, Radiológiai Klinika, Budapest
4Global Genomics Group; Atlanta, GA, USA; 5Bajcsy-Zsilinszky Kórház, Budapest
Various fat compartments might have an important role in the pathophysiology of atherosclerosis. Previous studies demonstrated an association between abdominal adipose tissue compartments and increased cardiovascular risk however the role of epicardial adipose tissue (EAT) is still unclear. It has been suggested that increased EAT quantity increases the risk of coronary artery disease (CAD). Our aim was to assess the relationship between the volume of EAT and the presence of CAD in subjects with negative cardiovascular medical history.
We included 195 subjects (age: 56.1±9.4 years, female 64.1%) from the BUDAPEST-GLOBAL study. All subjects underwent coronary CT angiography (CTA) and were classified into groups with and without CAD (CAD-positive: n=106 and CAD-negative: n=89, respectively), based on the presence or absence of any plaque in coronary CTA. We measured the EAT volume on a native cardiac scan and the abdominal adipose tissue areas on a single CT-slice acquired at the L3/L4 level.
Subjects from the CAD-positive group were older, had a larger waist circumference, EAT volume and abdominal adipose tissue areas than subjects from the CAD-negative group. There were fewer females in the CAD-positive group, and in this group the presence of hypertension, dyslipidemia and diabetes were more frequent. Considering the lipid and glucose levels, we observed a significant difference only in the serum triglyceride levels. Age (OR: 1.1 p<0.001), hypertension (OR: 3.3 p<0.05), female sex (OR: 0.1 p<0.001) and the volume of EAT in 10 cm3 clusters (OR: 1.3 p=0.001) were independent predictors for CAD. A 10 cm3 increment in the volume of EAT increases the risk of CAD with 30%. Female sex was a protective factor therefore male sex is a positive predictive factor.
Since EAT shows a significant association with the presence of CAD, it is reasonable to consider the quantity of EAT in risk assessments to improve the accuracy of CAD risk prediction.