Abstract 16292: Significance of Epcardial and Visceral Abdominal Adipose Tissue Evaluation as an Indicator of Non-Calcified Plaques in Patients With a Zero Coronary Artery Calcium Score
Background: Accumulation of epicardial and visceral abdominal adipose tissue is reported to be a marker of coronary atherosclerosis. However, significance of epicardial and visceral abdominal adipose tissue distribution in patients with early stage coronary atherosclerosis (e.g., a zero coronary artery calcium score) is not fully understood.
Objective: To evaluate the association of epicardial and visceral abdominal adipose tissue distribution with non-calcified coronary plaques (NCPs) in patients with a zero coronary artery calcium score (CACS).
Methods: We retrospectively studied 288 patients with a zero CACS who underwent coronary computed tomography angiography (CCTA) on 64-slice CT. Visceral abdominal adipose tissue area (VATA) was simultaneously measured in all patients. Epicardial adipose tissue volume (EATV) was calculated as the adipose tissue surrounding the myocardium and limited by pericardium on plain CT images. We detected all distinguishable NCPs with > 1 mm2 area located within the vessel wall (> 2 mm-diameter segments) using cross-sectional and multi-planar reconstruction CCTA images. Traditional risk factors and characteristics of patients including EATV and VATA were examined. The patients were divided into 4 groups by EATV and VATA; using a median EATV of 119 ml and a cut-off value (100 cm2) of VATA for Japanese abdominal obesity. We examined the prevalence of NCPs in all patients and in each group.
Results: Of the 288 patients (mean age; 61±10 years, 54% male), NCPs were detected in 85 patients (30%). Prevalence of NCPs was significantly higher in the high VATA group than the low VATA group (52/126, 42% vs. 33/162, 20%; p < 0.0001). In the low VATA groups, however, the high EATV group (> median value) had a higher prevalence of NCPs than the low EATV group (17/56, 30% vs. 16/106, 15%; p = 0.02). High EATV (> median value) was independently related to the presence of NCPs (odds ratio 3.1, 95% confidence interval 1.3-7.7, p = 0.01) after adjusting for age, gender, and traditional risk factors in the low VATA group.
Conclusions: Increased EATV is associated with early stage coronary atherosclerosis in less abdominal obesity. Combination of EATV and VATA assessment is a valuable indicator of NCPs in patients with a zero CACS.
- © 2013 by American Heart Association, Inc.