Does epicardial adipose tissue volume provide information about the presence and localization of coronary artery disease?

Abstract

Objective: This study is important for the determination of branches and segments of the first atherosclerotic coronary artery. The objective was to examine the role of epicardial adipose tissue (EAT) volume in estimating the presence and localization of plaque of coronary arteries.

Methods: Our study is a retrospective study, consisting of 50 male (mean age: 45.5 ± 12 yrs) and 58 female (mean age: 52.5 ± 11.6 yrs). A total of 108 consecutive patients underwent coronary computerized tomography (CT) angiography. Each coronary artery segment was assessed for the presence of atherosclerotic plaque. According to the plaque-involved vessel, patients were grouped as without plaque; plaque-involved left anterior descending artery (LAD), right coronary artery (RCA), or circumflex artery (Cx); and mixed (two or more vessels).

Results: The differences in mean values between the two groups were compared using the independent samples t test. Mann-Whitney U test was used for the comparison of continuous variables among groups. While EAT volume was found to be higher in the group with plaque, the difference between the two groups was statistically significant (88.6 ± 9.2 cm(3), 67.4 ± 7.2 cm(3), respectively, p=0.001). EAT volume was 67.3 ± 7.1 cm(3) in the without plaque group, 97.7 ± 22.8 cm(3) in LAD, 79.7 ± 10.1 cm(3) in RCA, 70.7 ± 8.9 cm(3) in Cx, and 101.9 ± 18.6 cm(3) in mixed vessels. In the intragroup comparison, the EAT volume of plaque-involved LAD and mixed vessels was significantly higher than in the other groups. The EAT volume of plaque-involved RCA was significantly higher (p=0.015) than in plaque-involved Cx.

Conclusion: Increased EAT volume is directly proportional to the presence of coronary artery plaques, especially in LAD and with more than one artery.

Figure 1

a-d. Demonstration of semi-automated detection of epicardial adipose tissue on axial images of a 40-year-old male, with the pink painted regions representing epicardial adipose tissue (a, b, and c) and 3D reconstruction (d). Calcified plaques were observed in the proximal segment of the LAD (A) (white arrow)