Abstract 13319: Epicardial Fat Volume Over 100ml is an Independent Risk Factor for Acute Coronary Syndrome.
Introduction: Epicardial fat is the visceral adipose tissue around the heart, and it may be a source of inflammatory cytokine. Although the relationship between increased epicardial fat volume (EFV) and coronary atherosclerosis has been reported previously, the minimum volume that represents a risk for acute coronary syndrome (ACS) has not been studied yet. We evaluated the epicardial fat volume in patients with ACS in order to fill this gap.
Methods: Eighty Japanese patients hospitalized for ACS were measured for EFV using 64-multislice CT by assigning Hounsfield Units, ranging from −190 to −30, to each fat area. The control group included 90 consecutive outpatients suspected of having coronary artery disease, whose coronary CT Results were normal. We also compared epicardial and subcutaneous adipose tissues, which were obtained from a patient undergoing coronary artery bypass surgery.
Results: EFV had increased in patients with ACS, compared with the control group (117±46 vs. 94±33 ml, p<0.001). ROC curve analysis determined a cut off value of 100.3ml with a sensitivity of 75% and a specificity of 60% for ACS (area under the curve: 0.692, 95% CI: 0.596 – 0.777, p < 0.001). The multivariate logistic analysis revealed that EFV > 100 ml was an independent risk factor for ACS. As seen on the histological slide, compared with subcutaneous adipose tissue, epicardial adipose tissue shows dense inflammatory cells infiltrates.
Conclusions: In conclusion, EFV >100ml is an independent risk factor for ACS in Japanese. This study supports the hypothesis that increased epicardial fat contributes to ACS, and that the epicardial fat inflammatory cells may affect the coronary arteries directly.
- © 2010 by American Heart Association, Inc.