title: Cardiac 64-multislice computed tomography reveals increased epicardial fat volume in patients with acute coronary syndrome.
abstract: Inflammatory cytokines released from epicardial fat around coronary arteries may modulate the coronary arteries and promote coronary atherosclerosis. We assessed the hypothesis that epicardial fat volume (EFV) is increased in patients with acute coronary syndrome (ACS). EFV was measured in 80 Japanese patients hospitalized for ACS using 64-multislice computed tomography. The ACS group included 51 patients with ST-segment elevated myocardial infarction and 29 patients with non-ST-segment elevated myocardial infarction. All patients underwent emergency coronary angioplasty and 64-multislice computed tomographic scanning during hospitalization. The control group included 90 consecutive outpatients with suspected ACS whose coronary computed tomographic results were normal. EFV was larger in patients with ACS than in the control group (117 ± 47 vs 95 ± 33 ml, p <0.001). Multivariate regression analysis showed that EFV was associated with age, body mass index, and visceral fat area in the control group. However, these correlations did not appear in the ACS group. Multivariate logistic regression analysis showed that EFV >100 ml was independently associated with ACS (odds ratio 2.84, 95% confidence interval 1.17 to 6.87, p = 0.021). Receiver operator characteristic analysis determined a cut-off value of 100.3 ml with a sensitivity of 75% and a specificity of 60% for ACS (area under the curve 0.692, 95% confidence interval 0.596 to 0.777, p <0.001). Compared to subcutaneous adipose tissue, epicardial adipose tissue showed inflammatory cell infiltrates on a micrograph. In conclusion, the present study demonstrated significantly increased EFV in patients with ACS. A large amount of epicardial fat may be a risk factor for ACS.
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan. haraken@med.nagoya-u.ac.jp
authors.forename: Ken
authors.initials: K
authors.lastname: Harada
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Amano
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Uetani
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Tokuda
authors.forename: Katsuhide
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Yusaku
authors.initials: Y
authors.lastname: Shimbo
authors.forename: Ayako
authors.initials: A
authors.lastname: Kunimura
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kumagai
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Yoshida
authors.forename: Bunichi
authors.initials: B
authors.lastname: Kato
authors.forename: Masataka
authors.initials: M
authors.lastname: Kato
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Marui
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Matsubara
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology; D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D050154:Adiposity; D000368:Aged; D050197:Atherosclerosis / Q000150:complications* / Q000000981:diagnostic imaging; D015992:Body Mass Index; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*