Epicardial Fat Volume Assessed by Multi-Detector Computed Tomography and Its Relationship With the Severity of Coronary Artery Disease

Background: Epicardial adipose tissue is defined as the adipose tissue located between the outer wall of the myocardium and the visceral layer of the pericardium. Epicardial adipose tissue can be measured by echocardiography and more precisely by computed tomography (CT). The present study aimed to investigate the relationship between epicardial fat volume (EFV) assessed by multi-detector CT and the severity of coronary artery disease (CAD). Methods: This cross-sectional study was conducted on 140 patients with a low-to-intermediate pretest probability of CAD referred for multi-detector CT coronary angiography. EFV was quantified during the non-contrast phase of the imaging protocol, and the severity of CAD was assessed in terms of segment involvement and segment stenosis scores during the contrast phase. Results: The study population included 105 men (75%) at a mean age of 56 +/- 10.27 years. Risk factors of atherosclerosis were analyzed among the patients. Body mass index ranged between 24 kg/m(2) and 30.9 kg/m(2), hypertension was detected in 77.5%, diabetes mellitus was reported in 55%, and 67.5% were smokers. While 17.5% of the studied patients had normal coronaries, 37.5% had single-vessel disease and 45% had multi-vessel disease. A significant relationship existed between EFV and the coronary artery calcium score (P=0.011). Highly significant relationships were also detected between EFV and both segment involvement and segment stenosis scores (P=0.001 and P=0.003, respectively). Patients with normal coronary arteries had a lower EFV than those with coronary lesions (a highly significant relationship, P=0.004), whether with single-vessel or with multi vessel disease. Conclusions: EFV increased in patients with either significant coronary artery stenosis or coronary calcification. Risk factors of atherosclerosis showed direct relationships with EFV.