Clinical Utility of Measuring Epicardial Adipose Tissue Thickness with Echocardiography Using a High-Frequency Linear Probe in Patients with Coronary Artery Disease.
BACKGROUND
The relationship between epicardial adipose tissue (EAT) and coronary artery disease (CAD) has recently attracted a great deal of attention in the medical community. The objective of this study was to determine whether measuring EAT thickness in the anterior interventricular groove (AIG) using echocardiography is feasible and whether this index can be a marker of CAD.


METHODS
A total of 311 patients (mean age, 67 ± 11 years; 208 men) who underwent coronary angiography between December 2011 and December 2013 were prospectively enrolled. EAT-AIG thickness and EAT thickness on the free wall of the right ventricle (RV) were measured in systole using a high-frequency linear probe. Seventy-one patients who underwent multidetector-row computed tomography were enrolled to validate the method for measuring EAT thickness using echocardiography. Subjects were divided into two groups, those with and without significant coronary stenosis, on the basis of findings on coronary angiography (≥ 75% luminal narrowing).


RESULTS
EAT-AIG thickness measured using echocardiography was validated by computed tomography. EAT-AIG thickness was strongly correlated with EAT volume (r = 0.714, P < .001). The CAD group had thicker EAT-AIG than the non-CAD group (8.3 ± 3.0 vs 6.3 ± 2.5 mm, P < .001). EAT-RV thickness was greater in the CAD group than in the non-CAD group (5.0 ± 2.1 vs 4.4 ± 2.3 mm, P = .009) as well. The area under the curve on receiver operating characteristic curve analysis of EAT-AIG thickness for predicting CAD was 0.704, which was higher than the EAT-RV thickness.


CONCLUSIONS
Measuring EAT thickness using echocardiography with a high-frequency linear probe was validated with computed tomography. EAT-AIG was thicker in the CAD group than in the non-CAD group, as was EAT-RV thickness. This noninvasive index may have potential as a diagnostic marker for predicting coronary atherosclerosis.
Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan; Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
Yukina
Y
Hirata
Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan; Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan. Electronic address: yamadah@tokushima-u.ac.jp.
Hirotsugu
H
Yamada
Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan; Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
Kenya
K
Kusunose
Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan; Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
Takashi
T
Iwase
Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan; Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
Susumu
S
Nishio
Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan; Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
Shuji
S
Hayashi
Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan; Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
Mika
M
Bando
Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan; Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
Rie
R
Amano
Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan; Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
Koji
K
Yamaguchi
Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan; Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
Takeshi
T
Soeki
Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan; Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
Tetsuzo
T
Wakatsuki
Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan; Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.
Masataka
M
Sata
D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D050154:Adiposity; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010496:Pericardium / Q000000981:diagnostic imaging*; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D017678:Sex Distribution
Anterior interventricular groove; Computed tomography; Coronary artery disease; Echocardiography; Epicardial adipose tissue