title: Epicardial adipose tissue thickness is associated with myocardial infarction and impaired coronary perfusion.
abstract: OBJECTIVE
  Epicardial adipose tissue (EAT) is associated with the presence, severity and extent of atherosclerotic coronary artery disease (CAD) in addition to subclinical atherosclerosis. We investigated if EAT thickness is related to acute myocardial infarction in patients with CAD. We also searched for the association between EAT thickness and objective coronary flow and myocardial perfusion parameters such as Thrombolysis in Myocardial Infarction Frame count (TFC) and myocardial blush grade (MBG).
  
  
  METHODS
  Two-hundred consecutive patients with stable angina pectoris or acute coronary syndrome who were admitted to Ufuk University Faculty of Medicine, Dr Rıdvan Ege Hospital cardiology department were included in this observational, cross-sectional study. EAT thickness was evaluated by conventional transthoracic echocardiography. Coronary angiography was performed to determine the coronary involvement and perfusion.
  
  
  RESULTS
  Mean EAT thicknesses were 5.4±1.9 mm, 6.3±1.8 mm, and 8.5±1.4 mm in the stable angina pectoris (SAP), unstable angina pectoris (USAP) and acute myocardial infarction groups, respectively (p<0.001). With increasing EAT thickness, TFC increases whereas mean MBG values decrease (for EAT thickness <5 mm, 5-7 mm, >7 mm; mean TFC: 21.6±2.2, 25.3±3.3 and 35.2±7.7; and MBG values: 2.98±0.14, 2.83±0.57 and 1.7±1.16, respectively; both p<0.001). Cut-off EAT value to predict AMI was identified as 7.8 mm (ROC analysis AUC:0.876; p<0.001, 95% CI:0.822-0.927). Sensitivity and specificity of EAT cut-off value 7.8 mm to predict AMI were 81.8% and 82.5% respectively.
  
  
  CONCLUSIONS
  Increased EAT is associated with AMI and it may prove beneficial for choosing patients who would need more aggressive approach in terms of risk reduction using echocardiography which is a relatively cheap and readily available tool as a follow-up parameter.
authors: Department of Cardiology, Faculty of Medicine, Ufuk University; Ankara-Turkey. aslitanindi@gmail.com.
authors: Aslı
authors: A
authors: Tanındı
authors: Sinan Altan
authors: SA
authors: Kocaman
authors: Aycan Fahri
authors: AF
authors: Erkan
authors: Murat
authors: M
authors: Uğurlu
authors: Aslıhan
authors: A
authors: Alhan
authors: Hasan Fehmi
authors: HF
authors: Töre
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000473:pathology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000473:pathology*; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index