title: Relationship between epicardial fat measured by 64-multidetector computed tomography and coronary artery disease.
abstract: BACKGROUND
  Epicardial fat (EF) is the visceral fat of the heart deposited under the visceral layer of the pericardium and has the same origin as abdominal visceral fat, which is shown to be strongly related to the development of coronary artery disease (CAD). We measured the volume of EF (EFV) by 64-multidetector computed tomography (MDCT) and studied the relationship between EFV and the severity of CAD.
  
  
  OBJECTIVE
  Epicardial fat volume increases steeply in patients with significant coronary artery stenosis and in those with severe coronary artery calcification.
  
  
  METHODS
  We studied 197 patients with suspected CAD who underwent 64-MDCT and coronary angiography. Cross-sectional tomographic cardiac slices (3.0 mm thick) from base to apex (30 to 40 slices per heart) were traced semiautomatically and EFV was measured by assigning Hounsfield units ranging from -30 to -250 to fat.
  
  
  RESULTS
  Epicardial fat volume was 99.4 ± 40.0 ml (range, 11.6 to 263.8 mL) and coronary artery calcium score (CACS) was 267.2 ± 605.1 (range, 0 to 3780). There was a significant relationship between EFV and CACS (r=0.210, P=0.003). Patients with EFV >100 had a CACS that was significantly higher than in those with EFV <100 (384.0 ± 782.0 vs 174.8 ± 395.6; P = 0.016). The incidence of significant CAD was significantly higher in patients with EFV >100 compared with those with EFV <100 (40.2% vs 22.7%; P=0.008). The EFV was significantly higher in patients with severe coronary artery stenosis and in those with severe coronary artery calcification (CACS >400).
  
  
  CONCLUSIONS
  Our results showed that EFV was associated with coronary atherosclerosis, and EFV increased steeply in patients with severe coronary artery stenosis and in those with severe coronary artery calcification.
authors.affiliation: Department of Cardiology, Okayama Central Hospital, Okayama, Japan. kiwasaki@kyokuto.or.jp
authors.forename: Kohichiro
authors.initials: K
authors.lastname: Iwasaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Aono
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furukawa
authors.forename: Masanobu
authors.initials: M
authors.lastname: Samukawa
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000473:pathology*; D000368:Aged; D002114:Calcinosis; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D023921:Coronary Stenosis / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed