title: Increased epicardial adipose tissue in patients with slow coronary flow phenomenon.
abstract: BACKGROUND
  Slow coronary flow (SCF) is an angiographic finding characterised by delayed opacification of epicardial coronary arteries without obstructive coronary disease. Epicardial adipose tissue (EAT), localised beneath the visceral pericardium, is a metabolically active endocrine and paracrine organ with possible interactions within the heart. EAT and low-grade inflammation play major roles in the atherosclerotic vascular processes and may be important in other coronary pathologies such as SCF.
  
  
  OBJECTIVE
  To investigate whether EAT and C-reactive protein (CRP) are increased in patients with isolated SCF compared to normal subjects.
  
  
  METHODS
  The present study was cross-sectional and observational, consisting of 66 individuals who underwent coronary angiography with a suspicion of coronary artery disease and who had angiographically normal coronary arteries of varying coronary flow rates. The relationship between EAT, CRP and SCF phenomenon was investigated. Thirty-three patients with isolated SCF (mean age: 56 ± 10 years) and 33 age- and gender-matched control participants with normal coronary flow (NCF), but without SCF, (mean age: 55 ± 10 years) were included in the study.
  
  
  RESULTS
  EAT thickness was significantly increased in the SCF group compared to the NCF group (7.1 ± 2.7 vs. 4.7 ± 1.9 mm, p < 0.001). Body mass index (BMI, p < 0.001) and the percentage of isolated SCF (p = 0.002) were significantly higher in patients with increased EAT thickness. CRP was not related to SCF. When we performed multiple logistic regression analysis, only increased EAT thickness was related to the presence of SCF (OR 1.720, 95% CI 1.175-2.516, p = 0.005) independent of BMI and CRP.
  
  
  CONCLUSIONS
  This study revealed, for the first time, a significant increase in EAT thickness in patients with SCF compared to NCF. We believe that further studies are needed to clarify the role of adipose tissue in patients with SCF.
authors.affiliation: Department of Cardiology, Rize University Medical Faculty, Rize, Turkey.
authors.forename: Turan
authors.initials: T
authors.lastname: Erdogan
authors.forename: Aytun
authors.initials: A
authors.lastname: Canga
authors.forename: Sinan Altan
authors.initials: SA
authors.lastname: Kocaman
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cetin
authors.forename: Murtaza Emre
authors.initials: ME
authors.lastname: Durakoglugil
authors.forename: Yuksel
authors.initials: Y
authors.lastname: Cicek
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Ugurlu
authors.forename: Sahin
authors.initials: S
authors.lastname: Bozok
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D017023:Coronary Angiography; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging* / Q000378:metabolism; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000378:metabolism; D012044:Regression Analysis
chemical_list: D002097:C-Reactive Protein