Abstract 497: Relationship of Extrapericardial Fat With Coronary Atherosclerosis on Multi-row Detector Cardiac Computed Tomography
Background: Prior studies have suggested that the proximity of fat surrounding the heart was responsible for the deposition of plaque into the coronary arteries. In this study, we looked at the associations between epicardial fat and extrapericardial fat to Coronary Artery Calcium (CAC) and to the number of segments with plaque using 64 Slice multidetector computed tomography (MDCT).
Methods and Procedures: Patients who had undergone a contrast enhanced MDCT and had sufficient imaged range (images 15 mm above and 30 mm below the take off of the left main coronary artery) were studied. Measurements of epicardial fat and total intrathoracic fat volumes were quantified, and extrapericardial fat was extrapolated from the subtraction of the latter volumes. CAC scores as well as number of segments with plaque on CTA were used as surrogates for atherosclerotic burden.
Results: In our cohort of 144 patients, 107 (74%) were males, 80 (56%) had dyslipidemia, 59 (40%) had hypertension, 8 (5.6%) currently smoke, and 74 (51.4%) had a family history of CAD. Both total intrathoracic and extrapericardiall fat were significantly associated with at least a 3 fold increasing CAC burden as well elevated plaque burden after adjusting for demographics and traditional risk factors. Epicardial Fat showed only a non-significant trend with coronary atherosclerotic plaque burden (p < 0.095) in a ordinal logistic regression model. (See Table 1⇓)
Conclusions: While both extrapericardial fat and total fat were associated with number of plaque segments and CAC, epicardial fat volume by itself was not. This suggests adipocyte proximity might not be the main predictor of atherosclerosis.