title: The impact of epicardial fat volume on coronary plaque vulnerability: insight from optical coherence tomography analysis.
abstract: OBJECTIVE
  Epicardial fat volume (EFV) has been implicated in coronary artery disease. Relationship between EFV and coronary plaque vulnerability has not been elucidated. The aim of this study was to investigate the association of EFV with coronary plaque vulnerability by using optical coherence tomography (OCT).
  
  
  RESULTS
  We enrolled 117 patients who underwent multislice computed tomography (MSCT) and OCT. EFV was quantified on MSCT. Patients were categorized according to tertiles of EFV: low tertile, EFV < 104.1 cm(3); mid-tertile, 104.1 cm(3)≤ EFV ≤ 130.7 cm(3); high tertile, EFV > 130.7 cm(3). A total of 180 vessels and 221 plaques were assessed with OCT to detect a thin-capped fibroatheroma (TCFA). TCFA was defined as a plaque with necrotic lipid pools ≥ 2 quadrants and minimum fibrous cap thickness measuring <65 μm. Patients with low computed tomographic attenuation and positive remodelling were frequently observed and patients with OCT-derived TCFA were more common in the high tertile EFV. EFV was associated with a maximal lipid arc (103.4 ± 28.2 cm(3) in 0 quadrant, 120.2 ± 35.2 cm(3) in 1-2 quadrants, and 131.5 ± 41.1 cm(3) in >2 quadrants; P= 0.01) and inversely correlated with a minimum fibrous cap thickness of the patients (r = -0.400, P<0.01). In multivariate analysis, the high tertile of EFV remained an independent predictor for patients with OCT-derived TCFA [odds ratio (OR) 2.92; 95% confidence interval (CI) 1.13-7.55; P= 0.027] and acute coronary syndrome (ACS) patients (OR 2.89; 95% CI 1.14-7.29; P= 0.025).
  
  
  CONCLUSIONS
  EFV was associated with coronary plaque vulnerability and high EFV was an independent predictor of ACS in patients with coronary artery disease.
authors.affiliation: Toyohashi Heart Center, 21-1 Gobudori, Oyama-cho, Toyohashi 441-8530, Japan. tito@heart-center.or.jp
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ito
authors.forename: Kenya
authors.initials: K
authors.lastname: Nasu
authors.forename: Mitsuyasu
authors.initials: M
authors.lastname: Terashima
authors.forename: Mariko
authors.initials: M
authors.lastname: Ehara
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kinoshita
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ito
authors.forename: Masashi
authors.initials: M
authors.lastname: Kimura
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Tanaka
authors.forename: Maoto
authors.initials: M
authors.lastname: Habara
authors.forename: Etsuo
authors.initials: E
authors.lastname: Tsuchikane
authors.forename: Takahiko
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D050154:Adiposity; D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D016001:Confidence Intervals; D017023:Coronary Angiography / Q000295:instrumentation; D001026:Coronary Artery Bypass / Q000295:instrumentation; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000295:instrumentation*; D015999:Multivariate Analysis; D016017:Odds Ratio; D010496:Pericardium / Q000473:pathology*; D011237:Predictive Value of Tests; D018570:Risk Assessment; D013223:Statistics as Topic; D041623:Tomography, Optical Coherence / Q000295:instrumentation*