Abstract 14087: Increased Regional Epicardial Fat Volume is Associated with Reversible Myocardial Ischemia in Patients with Suspected Coronary Artery Disease
Background: Epicardial adipose tissue is a source of pro-inflammatory cytokines and has been linked to the development of coronary artery disease. No systematic assessment of the relationship between local epicardial fat volume (EFV) and reversible and irreversible myocardial perfusion defects exist to date.
Methods: We analyzed EFV in patients being evaluated for coronary artery disease with SPECT myocardial perfusion imaging combined with computed tomography (CT) for attenuation correction. Low dose CT without contrast was performed in 396 consecutive patients undergoing nuclear perfusion imaging for evaluation of coronary artery disease. Regional thickness, cross-sectional areas and total EFV was extrapolated from areas of tissue between the visceral myocardium and pericardium.
Results: 295 patients had normal myocardial perfusion scans and 101 had abnormal perfusion scans. Mean EFV in normal, ischemic and infarcted hearts were 99.8±82.3 cm3, 156.4±121.9 cm3 and 96.3±102.1 cm3, respectively (p<0.001). Reversible perfusion defects on nuclear imaging scans were associated with increased local EFV compared to patients with normal perfusion in the distribution of the right (69.2±51.5 vs. 46.6±32.0 cm3; p=0.03) and left anterior descending coronary artery (87.1±76.4 vs. 46.7±40.6 cm3; p=0.005).
Conclusions: Our results demonstrate increased regional accumulation of epicardial fat in patients with active myocardial ischemia compared to patients with myocardial scar or normal perfusion on nuclear perfusion scans. These findings suggest an interaction between myocardial ischemia and metabolic pathways leading to accumulation of epicardial adipose tissue. Our analysis suggests a potential role for cardiac CT to improve risk stratification in patients with suspected coronary artery disease.
- © 2011 by American Heart Association, Inc.