Relationship of epicardial fat volume to coronary plaque, severe coronary stenosis, and high-risk coronary plaque features assessed by coronary CT angiography.

BACKGROUND Associations of epicardial fat volume (EFV) measured on noncontrast cardiac CT (NCT) include coronary plaque, myocardial ischemia, and adverse cardiac events. OBJECTIVES This study aimed to define the relationship of EFV to coronary plaque type, severe coronary stenosis, and the presence of high-risk plaque features (HRPFs). METHODS We retrospectively evaluated 402 consecutive patients, with no prior history of coronary artery disease, who underwent same day NCT and coronary CT angiography (CTA). EFV was measured on NCT with the use of validated, semiautomated software. The coronary arteries were evaluated for coronary plaque type (calcified [CP], noncalcified [NCP], or partially calcified [PCP]) and coronary stenosis severity ≥70% with the use of coronary CTA. For patients with NCP and PCP, 2 high-risk plaque features were evaluated: low-attenuation plaque and positive remodeling. RESULTS There were 402 patients with a median age of 66 years (range, 23-92 years) of whom 226 (56%) were men. The EFV was greater in patients with CP (112 ± 55 cm(3) vs 89 ± 39 cm(3)), PCP (110 ± 57 cm(3) vs 98 ± 45 cm(3)), and NCP (115 ± 44 cm(3) vs EFV 100 ± 52 cm(3)). In the 192 patients with PCP or NCP, on multivariable analysis, after adjusting for conventional cardiovascular risk factors, EFV was an independent predictor of ≥70% coronary artery stenosis (odds ratio [OR], 3.0; 95% CI, 1.3-6.6; P = 0.008), any high-risk plaque features (OR, 1.7; 95% CI, 0.9-3.4; P = 0.04), and low attention plaque (OR, 2.4; 95% CI, 1.1-5.1; P = 0.02) but not of positive remodeling. CONCLUSIONS EFV is greater in patients with CP, PCP, and NCP. In patients with NCP and PCP, EFV is significantly associated with severe coronary stenosis, high-risk plaque features, and low attenuation plaque.

[1]  Damini Dey,et al.  Interscan reproducibility of computer-aided epicardial and thoracic fat measurement from noncontrast cardiac CT. , 2011, Journal of cardiovascular computed tomography.

[2]  R. Seibel,et al.  Association of pericoronary fat volume with atherosclerotic plaque burden in the underlying coronary artery: a segment analysis. , 2010, Atherosclerosis.

[3]  D. Dey,et al.  Epicardial fat volume and concurrent presence of both myocardial ischemia and obstructive coronary artery disease. , 2012, Atherosclerosis.

[4]  M. Kimura,et al.  The impact of epicardial fat volume on coronary plaque vulnerability: insight from optical coherence tomography analysis. , 2012, European heart journal cardiovascular Imaging.

[5]  Hirofumi Anno,et al.  Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. , 2009, Journal of the American College of Cardiology.

[6]  Mohamed Marwan,et al.  Assessment of coronary artery remodelling by dual-source CT: a head-to-head comparison with intravascular ultrasound , 2011, Heart.

[7]  H. Furukawa,et al.  Relationship Between Epicardial Fat Measured by 64‐Multidetector Computed Tomography and Coronary Artery Disease , 2011, Clinical cardiology.

[8]  D. Dey,et al.  Image quality and artifacts in coronary CT angiography with dual-source CT: initial clinical experience. , 2008, Journal of cardiovascular computed tomography.

[9]  S. Achenbach,et al.  Characterization of culprit lesions in acute coronary syndromes using coronary dual-source CT angiography. , 2010, Atherosclerosis.

[10]  Hirofumi Anno,et al.  Multislice computed tomographic characteristics of coronary lesions in acute coronary syndromes. , 2007, Journal of the American College of Cardiology.

[11]  I. Kakadiaris,et al.  Computer-aided non-contrast CT-based quantification of pericardial and thoracic fat and their associations with coronary calcium and Metabolic Syndrome. , 2010, Atherosclerosis.

[12]  R. Detrano,et al.  Quantification of coronary artery calcium using ultrafast computed tomography. , 1990, Journal of the American College of Cardiology.

[13]  T. Murohara,et al.  Cardiac 64-multislice computed tomography reveals increased epicardial fat volume in patients with acute coronary syndrome. , 2011, The American journal of cardiology.

[14]  Fabian Bamberg,et al.  Association of pericardial fat and coronary high-risk lesions as determined by cardiac CT. , 2012, Atherosclerosis.

[15]  Arik Wolak,et al.  Algorithm for radiation dose reduction with helical dual source coronary computed tomography angiography in clinical practice. , 2008, Journal of cardiovascular computed tomography.

[16]  Mathias Prokop,et al.  Relation of epicardial and pericoronary fat to coronary atherosclerosis and coronary artery calcium in patients undergoing coronary angiography. , 2008, The American journal of cardiology.

[17]  F. Shih,et al.  Association of epicardial adipose tissue with coronary atherosclerosis is region-specific and independent of conventional risk factors and intra-abdominal adiposity. , 2011, Atherosclerosis.

[18]  D. Dey,et al.  Automated Quantitation of Pericardiac Fat From Noncontrast CT , 2008, Investigative radiology.

[19]  A. Stillman,et al.  Epicardial adipose tissue and coronary artery plaque characteristics. , 2010, Atherosclerosis.

[20]  Piotr J. Slomka,et al.  Increased pericardial fat volume measured from noncontrast CT predicts myocardial ischemia by SPECT. , 2010, JACC. Cardiovascular imaging.

[21]  Dieter Ropers,et al.  In vivo CT detection of lipid-rich coronary artery atherosclerotic plaques using quantitative histogram analysis: a head to head comparison with IVUS. , 2011, Atherosclerosis.

[22]  M. Jinzaki,et al.  Increased epicardial fat volume quantified by 64-multidetector computed tomography is associated with coronary atherosclerosis and totally occlusive lesions. , 2009, Circulation journal : official journal of the Japanese Circulation Society.

[23]  Damini Dey,et al.  Pericardial fat burden on ECG-gated noncontrast CT in asymptomatic patients who subsequently experience adverse cardiovascular events. , 2010, JACC. Cardiovascular imaging.

[24]  A Cederblad,et al.  Determination of total adipose tissue and body fat in women by computed tomography, 40K, and tritium. , 1986, The American journal of physiology.

[25]  S. Achenbach,et al.  Diagnostic accuracy of image postprocessing methods for the detection of coronary artery stenoses by using multidetector CT. , 2007, Radiology.

[26]  Kazuo Awai,et al.  Association between epicardial adipose tissue volume and characteristics of non-calcified plaques assessed by coronary computed tomographic angiography. , 2012, International journal of cardiology.

[27]  Hiroto Utsunomiya,et al.  Characterization of noncalcified coronary plaques and identification of culprit lesions in patients with acute coronary syndrome by 64-slice computed tomography. , 2009, JACC. Cardiovascular imaging.

[28]  L. Sjöström,et al.  Total and visceral adipose-tissue volumes derived from measurements with computed tomography in adult men and women: predictive equations. , 1988, The American journal of clinical nutrition.

[29]  R. Detrano,et al.  The Association of Pericardial Fat With Calcified Coronary Plaque , 2008, Obesity.

[30]  D. Dey,et al.  Moving beyond binary grading of coronary arterial stenoses on coronary computed tomographic angiography: insights for the imager and referring clinician. , 2008, JACC. Cardiovascular imaging.

[31]  S. Yamashita,et al.  Abdominal fat: standardized technique for measurement at CT. , 1999, Radiology.