Abstract 11945: Relation of Epicardial and Visceral Fat to Coronary Plaque Characteristics in Nonobese Japanese With Severe Coronary Artery Disease: Analysis by Integrated Backscatter Intravascular Ultrasound
Background: Metabolic syndrome (MS) and epicardial fat volume (EFV) are associated with coronary artery disease (CAD). In Japanese, the number of MS risk factors increases when the visceral fat area (VFA) at the navel level exceeds 100 cm2. EFV was also recently shown to correlate with CAD severity even in nonobese individuals. The role of EFV in the pathogenesis of severe CAD in nonobese patients has remained unclear, however. Objective: To examine the relation between EFV or VFA and coronary plaque characteristics in nonobese Japanese with severe CAD.
Methods: Sixty-one consecutive nonobese (BMI, 22.3 ± 2.2 kg/m2) patients (age, 67.2 ± 9.5 years; 70% men) who underwent percutaneous coronary intervention (PCI) and integrated backscatter intravascular ultrasound (IB-IVUS) were enrolled. They included 29 patients with acute coronary syndrome and 32 with angina pectoris. Conventional and IB-IVUS images obtained with a 40-MHz intravascular catheter were subjected to 3D analysis to obtain the total, fibrous, lipid, and calcified plaque volumes. Effects of PCI on plaque data were minimized by assessment of 10-mm vessel lengths proximal to the culprit lesions. EFV and abdominal VFA were measured by 64-slice CT.
Results: EFV was correlated with VFA (r = 0.59, P ≤ 0.01) but not with total plaque volume or plaque characteristics. Patients were divided into two groups based on VFA (≤ or ≥100 cm2). In large-VFA patients, EFV was higher than that in small-VFA patients (127.5 vs. 87.8 ml, P ≤ 0.001) and was correlated with the percentage of lipid plaque (r = 0.47, P = 0.03). Multiple regression analysis revealed an independent association between EFV and the percentage of lipid plaque in large-VFA patients (Table).
Conclusion: The percentage of lipid plaque was correlated with EFV in nonobese CAD patients with a VFA of ≥100 cm2 who underwent PCI. Epicardial fat may thus play a role in the development of lipid-rich plaque in nonobese patients with severe CAD and an accumulation of visceral fat.
- © 2013 by American Heart Association, Inc.