Association of epicardial adipose tissue with coronary atherosclerosis is region-specific and independent of conventional risk factors and intra-abdominal adiposity.
OBJECTIVE
To elucidate which measurement of epicardial adipose tissue (EAT) best reflects its atherogenic risk, we examined the associations between different EAT measurements and various atherosclerotic parameters of the entire coronary tree and individual coronary arteries.


METHODS
This study included 224 consecutive patients underwent multidetector computed tomography before diagnostic coronary angiography. Regional thickness, cross-sectional areas, and total volume of EAT were measured. Four atherosclerotic parameters, including severity score, extent score, calcium volume score, and number of coronary arteries with ≥50% luminal stenosis, of the entire coronary tree and individual coronary arteries were assessed.


RESULTS
Both total EAT volume and thickness of EAT in the left atrioventricular groove were unanimously associated with the presence of coronary atherosclerosis dichotomously defined by the 4 scoring systems. However, only EAT thickness in the left atrioventricular groove, but not total EAT volume, was significantly associated with all 4 parameters of coronary atherosclerosis in a dose-dependent manner, even after adjustments for conventional risk factors, body-mass index, waist circumference, C-reactive protein, and intra-abdominal visceral fat area. Using the receiver-operating-characteristic analysis, 12.2mm was the optimal cutoff point for left atrioventricular groove thickness to predict the presence of significant coronary stenosis (≥50% diameter stenosis). Among the three coronary arteries, left atrioventricular groove thickness was most strongly correlated with ≥50% diameter stenosis in the embedded left circumflex artery by multivariate regression model.


CONCLUSIONS
Thickness of EAT in the left atrioventricular groove provides a more accurate assessment of its atherogenic risk and is therefore a better coronary risk factor than total EAT volume.
Wang
Tzung-Dau
TD
Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Lee
Wen-Jeng
WJ
Shih
Fuh-Yuan
FY
Huang
Chien-Hua
CH
Chen
Wen-Jone
WJ
Lee
Yuan-Teh
YT
Shih
Tiffany Ting-Fang
TT
Chen
Ming-Fong
MF
D000273:Adipose Tissue / Q000473:pathology*; D050154:Adiposity; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000473:pathology; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000473:pathology*; D012372:ROC Curve; D012306:Risk; D012307:Risk Factors