Abstract 15201: Echocardiographic Epicardial Adipose Tissue Relates to Coronary Artery Plaque and Calcification: Comparisons with Abdominal Visceral Adipose Tissue
Background: Accumulation of abdominal visceral adipose tissue (VAT) is one of features of metabolic syndrome, and is associated with a risk of coronary artery disease (CAD). Epicardial adipose tissue (EAT) is an ectopic accumulation of VAT, and shares an embryological origin with abdominal VAT. Unlike abdominal VAT, EAT may affect directly on coronary artery, but the difference of pathological roles in EAT and abdominal VAT remains to be elucidated.
Methods: Consecutive 174 patients with suspected CAD who underwent both 64-slice computed tomography (CT) angiography and echocardiography were analyzed in this study. Cardiac and abdominal CT scans were performed to measure EAT and abdominal VAT. The presence of echocardiographic EAT was defined as more than 1.5 mm thickness of EAT.
Results: Out of 174 patients, 114 patients and 117 patients presented coronary calcification and coronary plaque visualized by CT angiography, respectively. Both EAT area (7.0 [4.6-10.7] cm2 vs. 5.2 [3.4-7.3] cm2, P<0.01) and abdominal VAT area (94 [61-137] cm2 vs. 78 [49-108] cm2, P<0.05) by CT were larger in patients with coronary plaque compared to those without it. Interestingly, EAT area by CT, but not abdominal VAT area, was significantly larger in patients with coronary calcification compared to those without it (EAT: 7.1 [4.4-10.5] cm2 vs. 5.5 [3.7-7.3] cm2, P<0.01). Next, as a non-invasive method, echocardiographic measurement of EAT thickness was examined. Echocardiographic EAT thickness showed significant correlation with EAT area by CT (R=0.453, P<0.01). The multivariable logistic regression analysis revealed that echocardiographic EAT (OR 3.276, 95% CI 1.195-8.986, P<0.05), but not abdominal VAT area, was a independent factor for coronary plaque after adjusting for age and other known risk factors. As for coronary calcification, HbA1c (OR 1.945, 95% CI 1.084-3.494, P<0.05) and echocardiographic EAT (OR 2.680, 95% CI 1.100-6.530, P<0.05), but not abdominal VAT area, were independent risk factors.
Conclusions: EAT and abdominal VAT may play differential pathological roles in CAD, and our data suggest that we should pay more attention to EAT when interpret CT or echocardiographic images for cardiovascular risk stratification.
Author Disclosures: M. Oikawa: None. T. Owada: None. H. Yamauchi: None. A. Yoshihisa: None. K. Nakazato: None. H. Suzuki: None. S. Saitoh: None. Y. Takeishi: None.
- © 2014 by American Heart Association, Inc.