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. 2011 Mar;34(3):166-71.
doi: 10.1002/clc.20840. Epub 2011 Feb 1.

Relationship between epicardial fat measured by 64-multidetector computed tomography and coronary artery disease

Kohichiro Iwasaki  1 , Takeshi Matsumoto, Hitoshi Aono, Hiroshi Furukawa, Masanobu Samukawa
Affiliations

Relationship between epicardial fat measured by 64-multidetector computed tomography and coronary artery disease

Kohichiro Iwasaki et al. Clin Cardiol. 2011 Mar.

Abstract

Background: Epicardial fat (EF) is the visceral fat of the heart deposited under the visceral layer of the pericardium and has the same origin as abdominal visceral fat, which is shown to be strongly related to the development of coronary artery disease (CAD). We measured the volume of EF (EFV) by 64-multidetector computed tomography (MDCT) and studied the relationship between EFV and the severity of CAD.

Hypothesis: Epicardial fat volume increases steeply in patients with significant coronary artery stenosis and in those with severe coronary artery calcification.

Methods: We studied 197 patients with suspected CAD who underwent 64-MDCT and coronary angiography. Cross-sectional tomographic cardiac slices (3.0 mm thick) from base to apex (30 to 40 slices per heart) were traced semiautomatically and EFV was measured by assigning Hounsfield units ranging from -30 to -250 to fat.

Results: Epicardial fat volume was 99.4 ± 40.0 ml (range, 11.6 to 263.8 mL) and coronary artery calcium score (CACS) was 267.2 ± 605.1 (range, 0 to 3780). There was a significant relationship between EFV and CACS (r=0.210, P=0.003). Patients with EFV >100 had a CACS that was significantly higher than in those with EFV <100 (384.0 ± 782.0 vs 174.8 ± 395.6; P = 0.016). The incidence of significant CAD was significantly higher in patients with EFV >100 compared with those with EFV <100 (40.2% vs 22.7%; P=0.008). The EFV was significantly higher in patients with severe coronary artery stenosis and in those with severe coronary artery calcification (CACS >400).

Conclusions: Our results showed that EFV was associated with coronary atherosclerosis, and EFV increased steeply in patients with severe coronary artery stenosis and in those with severe coronary artery calcification.

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Figures

Figure 1
Figure 1
Representative case of EF showing (A) normal EF (EFV 21 mL), (B) moderately increased EF (EFV 98 mL), and (C) markedly increased EF (EFV 253 mL). Abbreviations: EF, epicardial fat; EFV, epicardial fat volume.
Figure 2
Figure 2
Relationship between EFV and CACS. Abbreviations: CACS, coronary artery calcification score; EFV, epicardial fat volume.
Figure 3
Figure 3
Results in groups 1 to 4 indicating (A) EFV and (B) incidence of patients with EFV >100 in each group. Abbreviations: EFV, epicardial fat volume.
Figure 4
Figure 4
Results in groups A to D indicating (A) EFV and (B) incidence of patients with EFV >100 in each group. Abbreviations: EFV, epicardial fat volume.
See this image and copyright information in PMC

Comment in

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