Abstract 498: Cardiac 64-Multislice Computed Tomography Reveals an Association Between Epicardial Fat Volume and Acute Coronary Syndrome
Introduction: It has been reported that the presence of metabolically active adipose stores that surround epicardial coronary arteries contribute to the inflammatory burden. Inflammatory cytokines released from epicardial fat around coronary arteries may act locally on the coronary arteries. We assessed the hypothesis that epicardial fat volume (EFV) could be a predictor of acute coronary syndrome (ACS).
Methods: A protocol was devised to measure EFV using 64-multislice computed tomography (MSCT) in 50 Japanese patients hospitalized for ST elevated myocardial infarction or non-ST elevated myocardial infarction (mean age 67 ±12; 76 % men). All patients were underwent emergent coronary angioplasty. MSCT scan was performed in all patients within 1 week after admission. In MSCT analysis, cross sectional cardiac slices (3.0 mm thick) from base to apex were traced semi-automatically and EFV was measured by assigning Hounsfield units, ranging from −190 to −30, to each fat area. The actual EFV was then calculated by commercially available software. A control group, included 50 consecutive out patients (mean age 65 ±12; 62 % men) suspected for coronary artery disease, whose MSCT results were normal. Group data were compared using the Student unpaired t-test. Pearson’s correlation coefficients were calculated to assess the relation between EFV and other clinical parameters. Multivariate logistic regression was used to assess the significance of differences among ACS risk factors.
Results: EFV had increased in patients with ACS, compared with control group (116 ±45 ml vs 95 ±35 ml, p = 0.012), and correlated with body mass index, visceral fat area, high-density lipoprotein, and age. Multiple regression analysis showed EFV were significant independent variable for ACS (r = 0.227, p = 0.031).
Conclusions: The present study demonstrates that EFV is independent risk factor for ACS. Measurements of EFV may provide additional information for noninvasive assessment of ACS risk.