scholarly journals Quantification of epicardial fat using 3D cine Dixon MRI

2020 ◽  
Author(s):  
Markus Henningsson ◽  
Martin Brundin ◽  
Tobias Scheffel ◽  
Carl Edin ◽  
Federica Viola ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Measurement Error ◽  
Single Phase ◽  
Image Quality Assessment ◽  
Epicardial Adipose Tissue ◽  
Interquartile Range ◽  
Epicardial Fat ◽  
Observer Variability ◽  
Inter Observer Variability ◽  
Significant Difference

Abstract Background: There is an increased interest in quantifying and characterizing epicardial fat which has been linked to various cardiovascular diseases such as coronary artery disease and atrial fibrillation. Recently, three-dimensional single-phase Dixon techniques have been used to depict the heart and to quantify the surrounding fat. The purpose of this study was to investigate the merits of a new high-resolution cine 3D Dixon technique for quantification of epicardial adipose tissue and compare it to single-phase 3D Dixon in patients with cardiovascular disease. Methods: Fifteen patients referred for clinical CMR examination of known or suspected heart disease were scanned on a 1.5T scanner using single-phase Dixon and cine Dixon. Epicardial fat was segmented by three readers and intra- and inter-observer variability was calculated per slice. Cine Dixon segmentation was performed in the same cardiac phase as single-phase Dixon. Subjective image quality assessment of water and fat images were performed by three readers using a 4-point Likert scale (1=severe; 2=significant; 3=mild; 4=no blurring of cardiac structures).Results: Intra-observer variability was excellent for cine Dixon images (ICC=0.96), and higher than single-phase Dixon (ICC=0.92). Inter-observer variability was good for cine Dixon (ICC=0.76) and moderate for single-phase Dixon (ICC=0.63). The intra-observer measurement error (mean ± standard deviation) per slice for cine was -0.02±0.51 ml (-0.08±0.4%), and for single-phase 0.39±0.72 ml (0.18±0.41%). Inter-observer measurement error for cine was 0.46±0.98 ml (0.11±0.46%) and for single-phase 0.42±1.53 ml (0.17±0.47%). Visual scoring of the water image yielded median of 2 (interquartile range = [Q3-Q1] 2-2) for cine and median of 3 (interquartile range = 3-2) for single-phase (P < 0.05) while no significant difference was found for the fat images, both techniques yielding a median of 3 and interquartile range of 3-2. Conclusion: Cine Dixon can be used to quantify epicardial fat with lower intra- and inter-observer variability compared to standard single-phase Dixon. The time-resolved information provided by the cine acquisition appears to support the delineation of the epicardial adipose tissue depot.

scholarly journals Quantification of Epicardial Fat using 3D Cine Dixon MRI

2020 ◽  
Author(s):  
Markus Henningsson ◽  
Martin Brundin ◽  
Tobias Scheffel ◽  
Carl Edin ◽  
Federica Viola ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Measurement Error ◽  
Single Phase ◽  
Image Quality Assessment ◽  
Epicardial Adipose Tissue ◽  
Interquartile Range ◽  
Epicardial Fat ◽  
Observer Variability ◽  
Inter Observer Variability ◽  
Significant Difference

Abstract Background There is an increased interest in quantifying and characterizing epicardial fat which has been linked to various cardiovascular diseases such as coronary artery disease and atrial fibrillation. Recently, three-dimensional single-phase Dixon techniques has been used to depict the heart and to quantify the surrounding fat. The purpose of this study was to investigate the merits of a new high-resolution cine 3D Dixon technique for quantification of epicardial adipose tissue and compare it to single-phase 3D Dixon in patients with cardiovascular disease.Methods Fifteen patients referred for clinical CMR examination of known or suspected heart disease were scanned on a 1.5T scanner using single-phase Dixon and cine Dixon. Epicardial fat was segmented by three readers and intra- and inter-observer variability was calculated per slice. Cine Dixon segmentation was performed in the same cardiac phase as single-phase Dixon. Subjective image quality assessment of water and fat images were performed by three readers using a 4-point Likert scale (1 = severe; 2 = significant; 3 = mild; 4 = no blurring of cardiac structures).Results Intra-observer variability was excellent for cine Dixon images (ICC = 0.96), and higher than single-phase Dixon (ICC = 0.92). Inter-observer variability was good for cine Dixon (ICC = 0.76) and moderate for single-phase Dixon (ICC = 0.63). The intra-observer measurement error (mean ± standard deviation) per slice for cine was − 0.02 ± 0.51 ml (-0.08 ± 0.4%), and for single-phase 0.39 ± 0.72 ml (0.18 ± 0.41%). Inter-observer measurement error for cine was 0.46 ± 0.98 ml (0.11 ± 0.46%) and for single-phase 0.42 ± 1.53 ml (0.17 ± 0.47%). Visual scoring of the water image yielded median of 2 (interquartile range = [Q3-Q1] 2–2) for cine and median of 3 (interquartile range = 3 − 2) for single-phase (P < 0.05) while no significant difference was found for the fat images, both techniques yielding a median of 3 and interquartile range of 3 − 2.Conclusion Cine Dixon can be used to quantify epicardial fat with lower intra- and inter-observer variability compared to standard single-phase Dixon. The time-resolved information provided by the cine acquisition appears to support the delineation of the epicardial adipose tissue depot.

Epicardial adipose tissue: the genetics behind an emerging cardiovascular marker

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.A Sousa ◽  
M.G Serrao ◽  
M Temtem ◽  
A Pereira ◽  
M Santos ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Cardiovascular Risk ◽  
Genetic Risk ◽  
Epicardial Adipose Tissue ◽  
Genetic Risk Score ◽  
Renin Angiotensin System ◽  
Epicardial Fat ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Genetic Burden

Abstract Background Increasing evidence points epicardial adipose tissue (EAT) as an emerging cardiovascular risk marker. Whether genetic polymorphisms are associated with a higher EAT burden is still unknow. Genetic risk score (GRS) is an emerging method that attempts to establish correlation between single nucleotide polymorphisms (SNPs) and clinical phenotypes. Aim Evaluate the role of genetic burden and its association to EAT. Methods 996 patients (mean age 59±8, 78% male) were prospectively enrolled in a single center. EAT was measured on cardiac CT using a modified simplified method. Patients were divided into 2 groups (above vs. below the median EAT volume). We studied different polymorphisms across the following gene-regulated pathways: oxidation, renin-angiotensin system, cellular, diabetes/obesity and dyslipidemia pathways. Genotyping was performed by TaqMan allelic discrimination assay. A multiplicative genetic risk score (mGRS) was constructed and represents the genetic burden of the different polymorphisms studied. To evaluate the relation between genetics and EAT volume, we compared both groups by: global mGRS, gene cluster/axis mGRS and individual SNPs. Results Patients with above-median EAT volume were older, had higher body mass index (BMI) and higher prevalence of hypertension, diabetes and dyslipidemia (p&lt;0.05). Patients with higher EAT volumes presented a higher global mean GRS (p&lt;0.001), with the latter remaining an independent predictor for higher EAT volumes (OR 1.3, 95% CI 1.2–1.5), alongside age and BMI. In the analysis by gene clusters, patients with more epicardial fat consistently presented a higher polymorphism burden (translated by a higher mGRS level) across numerous pathways: oxidation, renin-angiotensin system, cellular, diabetes/obesity and dyslipidemia. After adjusting for confounders and other univariate predictors of higher fat volume, the following have emerged as independently related to higher EAT volumes: mGRS comprising the genes of different clusters, age and BMI. Amongst the 33 genes analyzed, only MTHFR677 polymorphisms (a gene with a critical role in regulating plasma homocysteine levels) emerged as significantly related to higher EAT volumes in our population (OR 1.4, 95% CI: 1.100–1.684, p=0.005). Conclusion Patients with a higher polymorphism burden in genes involved in the oxidation, renin-angiotensin, cellular, diabetes/obesity and dyslipidemia pathways present higher levels of epicardial fat. This potential association seems to be independent from the expected association between epicardial fat and cardiovascular risk factors. To our knowledge, this is the first time such genetic profiling has been done, casting further insight into this complex matter. Funding Acknowledgement Type of funding source: None

scholarly journals Investigation of Autosegmentation Techniques on T2-Weighted MRI for Off-line Dose Reconstruction in MR-Linac Adapt to Position Workflow for Head and Neck Cancers

2021 ◽  
Author(s):  
Brigid A McDonald ◽  
Carlos Cardenas ◽  
Nicolette O'Connell ◽  
Sara Ahmed ◽  
Mohamed A. Naser ◽  
...  
Keyword(s):  
Head And Neck ◽  
Execution Time ◽  
Organs At Risk ◽  
Ground Truth ◽  
Dice Similarity Coefficient ◽  
Observer Variability ◽  
Dose Reconstruction ◽  
Inter Observer Variability ◽  
Significant Difference ◽  
Delivered Dose

Purpose: In order to accurately accumulate delivered dose for head and neck cancer patients treated with the Adapt to Position workflow on the 1.5T magnetic resonance imaging (MRI)-linear accelerator (MR-linac), the low-resolution T2-weighted MRIs used for daily setup must be segmented to enable reconstruction of the delivered dose at each fraction. In this study, our goal is to evaluate various autosegmentation methods for head and neck organs at risk (OARs) on on-board setup MRIs from the MR-linac for off-line reconstruction of delivered dose. Methods: Seven OARs (parotid glands, submandibular glands, mandible, spinal cord, and brainstem) were contoured on 43 images by seven observers each. Ground truth contours were generated using a simultaneous truth and performance level estimation (STAPLE) algorithm. 20 autosegmentation methods were evaluated in ADMIRE: 1-9) atlas-based autosegmentation using a population atlas library (PAL) of 5/10/15 patients with STAPLE, patch fusion (PF), random forest (RF) for label fusion; 10-19) autosegmentation using images from a patient's 1-4 prior fractions (individualized patient prior (IPP)) using STAPLE/PF/RF; 20) deep learning (DL) (3D ResUNet trained on 43 ground truth structure sets plus 45 contoured by one observer). Execution time was measured for each method. Autosegmented structures were compared to ground truth structures using the Dice similarity coefficient, mean surface distance, Hausdorff distance, and Jaccard index. For each metric and OAR, performance was compared to the inter-observer variability using Dunn's test with control. Methods were compared pairwise using the Steel-Dwass test for each metric pooled across all OARs. Further dosimetric analysis was performed on three high-performing autosegmentation methods (DL, IPP with RF and 4 fractions (IPP_RF_4), IPP with 1 fraction (IPP_1)), and one low-performing (PAL with STAPLE and 5 atlases (PAL_ST_5)). For five patients, delivered doses from clinical plans were recalculated on setup images with ground truth and autosegmented structure sets. Differences in maximum and mean dose to each structure between the ground truth and autosegmented structures were calculated and correlated with geometric metrics. Results: DL and IPP methods performed best overall, all significantly outperforming inter-observer variability and with no significant difference between methods in pairwise comparison. PAL methods performed worst overall; most were not significantly different from the inter-observer variability or from each other. DL was the fastest method (33 seconds per case) and PAL methods the slowest (3.7 - 13.8 minutes per case). Execution time increased with number of prior fractions/atlases for IPP and PAL. For DL, IPP_1, and IPP_RF_4, the majority (95%) of dose differences were within 250 cGy from ground truth, but outlier differences up to 785 cGy occurred. Dose differences were much higher for PAL_ST_5, with outlier differences up to 1920 cGy. Dose differences showed weak but significant correlations with all geometric metrics (R2 between 0.030 and 0.314). Conclusions: The autosegmentation methods offering the best combination of performance and execution time are DL and IPP_1. Dose reconstruction on on-board T2-weighted MRIs is feasible with autosegmented structures with minimal dosimetric variation from ground truth, but contours should be visually inspected prior to dose reconstruction in an end-to-end dose accumulation workflow.

scholarly journals Plasma microRNA Profiling Reveals Novel Biomarkers of Epicardial Adipose Tissue: A Multidetector Computed Tomography Study

2019 ◽  
Vol 8 (6) ◽  
pp. 780 ◽  
Author(s):  
David de Gonzalo-Calvo ◽  
David Vilades ◽  
Pablo Martínez-Camblor ◽  
Àngela Vea ◽  
Andreu Ferrero-Gregori ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Adipose Tissue ◽  
Multidetector Computed Tomography ◽  
Epicardial Adipose Tissue ◽  
Significant Proportion ◽  
Epicardial Fat ◽  
P Value ◽  
Net Reclassification Improvement ◽  
Novel Biomarkers ◽  
Plasma Microrna

Epicardial adipose tissue (EAT) constitutes a novel parameter for cardiometabolic risk assessment and a target for therapy. Here, we evaluated for the first time the plasma microRNA (miRNA) profile as a source of biomarkers for epicardial fat volume (EFV). miRNAs were profiled in plasma samples from 180 patients whose EFV was quantified using multidetector computed tomography. In the screening study, 54 deregulated miRNAs were identified in patients with high EFV levels (highest tertile) compared with matched patients with low EFV levels (lowest tertile). After filtering, 12 miRNAs were selected for subsequent validation. In the validation study, miR-15b-3p, miR-22-3p, miR-148a-3p miR-148b-3p and miR-590-5p were directly associated with EFV, even after adjustment for confounding factors (p value < 0.05 for all models). The addition of miRNA combinations to a model based on clinical variables improved the discrimination (area under the receiver-operating-characteristic curve (AUC) from 0.721 to 0.787). miRNAs correctly reclassified a significant proportion of patients with an integrated discrimination improvement (IDI) index of 0.101 and a net reclassification improvement (NRI) index of 0.650. Decision tree models used miRNA combinations to improve their classification accuracy. These results were reproduced using two proposed clinical cutoffs for epicardial fat burden. Internal validation corroborated the robustness of the models. In conclusion, plasma miRNAs constitute novel biomarkers of epicardial fat burden.

Arrhythmogenic Evidence for Epicardial Adipose Tissue: Heart Rate Variability and Turbulence are Influenced by Epicardial Fat Thickness

2014 ◽  
Vol 38 (1) ◽  
pp. 99-106 ◽  
Author(s):  
AKİF SERHAT BALCIOĞLU ◽  
DAVRAN ÇİÇEK ◽  
SİNAN AKINCI ◽  
HALİL OLCAY ELDEM ◽  
UĞUR ABBAS BAL ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Adipose Tissue ◽  
Epicardial Adipose Tissue ◽  
Epicardial Fat ◽  
Epicardial Fat Thickness ◽  
Fat Thickness

scholarly journals Association of Epicardial Adipose Tissue with Essential Hypertension: A Meta-Analysis

2021 ◽  
Author(s):  
Xinyu Zou ◽  
Yingrui Li ◽  
Qiang She ◽  
Bin Liu
Keyword(s):  
Cardiovascular Disease ◽  
Adipose Tissue ◽  
Essential Hypertension ◽  
Odds Ratio ◽  
Observational Studies ◽  
Epicardial Adipose Tissue ◽  
Meta Analysis ◽  
Hypertensive Patients ◽  
New Information ◽  
Significant Difference

Abstract Background and aims: Increased epicardial adipose tissue (EAT) has been proposed as a risk factor for essential hypertension (EH). The aim of this study was to investigate the association of EAT with EH.Methods and results: PubMed, EMBASE, and Cochrane databases were systematically reviewed to identify relevant studies assessing the association of EAT thickness (EAT-t) and volume (EAT-v) with EH. There were 39 observational studies and 8,983 subjects included in the meta-analysis. The analysis indicated that hypertensive patients had a higher mean of EAT-t (SMD=0.64, 95% CI: 0.44-0.83, p<0.001) and EAT-v (SMD: 0.69, 95% CI:0.34-0.1.05, p<0.001) than normotensive individuals. Accordingly, we calculated pooled odds ratio (OR) and 95% confidence intervals (CI) for the association of EAT with EH, and the results showed that EAT-t (OR: 1.59, 95% CI: 1.09–2.33, P<0.001) and EAT-v (OR: 1.82, 95% CI: 1.33–2.19, P<0.001) were associated with essential hypertension. Additionally, higher mean of EAT-t (SMD=0.85, 95% CI=0.49-0.1.21, p<0.001) and EAT-v (SMD=0.83, 95% CI=0.31-1.34, p=0.002) were found in non-dipper hypertensive patients than those in dipper patients, but we didn’t find significant difference in EAT-t among patients with different grades of hypertension. We also investigated the association of EAT with complications in hypertensive patients, and the results showed that EAT was increased in patients with arteriosclerotic cardiovascular disease (ASCVD) or cardiac hypertrophy and dysfunction than those without. Conclusions: The increase in EAT was associated with the occurrence and complications of EH. The findings provide new information regarding the occurrence and complications of EH.

scholarly journals CT-derived characterization of pericoronary, paracardial and epicardial adipose tissue and its association with myocardial ischemia as assessed by adenosine stress CMR perfusion imaging

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
M Goeller ◽  
H Duncker ◽  
D Dey ◽  
M Moshage ◽  
D Bittner ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Myocardial Ischemia ◽  
Perfusion Imaging ◽  
Epicardial Adipose Tissue ◽  
Adenosine Stress ◽  
Single Centre ◽  
Ct Attenuation ◽  
Significant Difference ◽  
Single Centre Study ◽  
Stress Cmr

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Kaltenbach scholarship of the german heart foundation Background  Increased attenuation of pericoronary adipose tissue (PCAT) around the right coronary artery (RCA) is a new imaging biomarker to detect coronary inflammation derived from routine coronary CT angiography (CTA) and has been shown to be associated with cardiac mortality. Increased volume of epicardial adipose tissue (EAT) has been reported be associated with myocardial ischemia. Purpose  We aimed to investigate for the first time a potential association between CTA-derived PCAT measures and myocardial ischemia as assessed by adenosine stress CMR perfusion imaging.  Methods In this single-centre study 109 stable individuals (mean age of 62 ± 11 years, 77% males) with coronary artery disease underwent CTA followed by adenosine stress CMR perfusion imaging to detect myocardial ischemia. PCAT CT attenuation (HU) and PCAT volume (cm³) was measured around the RCA (10 to 50 mm from RCA ostium), the proximal 40 mm of the left anterior descending artery (LAD) and the circumflex artery (LCX) using semi-automated software. Per patient PCAT CT attenuation was calculated as followed: (PCAT attenuation of RCA + LAD + LCX)/3). Non-contrast CT data sets were used for coronary calcium scoring and the quantification of EAT (located between the myocardial surface and the pericardium) and paracardial adipose tissue (PAT; intrathoracic and outside of the pericardium).  Results  Between patients with evidence of significant myocardial ischemia as assessed by adenosine stress CMR (n = 35) and patients without myocardial ischemia (n = 74) there was no significant difference in the PCAT CT attenuation of RCA (-85.3 vs. -85.7  HU, p = 0.87), LAD (-84.8 vs. -85.7 HU, p = 0.66) and LCX (-82.8 vs. -83.2 HU, p = 0.79) as well as in the per patient PCAT CT attenuation (-84.2 vs. -84.9 HU, p = 0.76). Neither did patients with myocardial ischemia within the RCA territory show increased RCA PCAT CT attenuation (-87.7 vs. -85.3 HU, p = 0.40); nor was such a relationship found for the territory of the LAD (-80.6 vs.  85.8 HU, p = 0.11) or LCX (-83.1 vs. -83.0 HU, p = 0.99). The CT attenuation of EAT (-77.9 vs. -78.7 HU, p = 0.65) and PAT (-89.9 vs. -90.0 HU, p = 0.93) did not differ significantly between patients with myocardial ischemia compared to patients without myocardial ischemia. Between patients with myocardial ischemia and patients without myocardial ischemia there was no significant difference in the volumes of EAT (118.1 vs. 110.6 cm³, p = 0.55), PAT (279.5 vs. 240.9 cm³, p = 0.20) and the per patient PCAT volume (1021.9 vs. 1015.5 cm³, p = 0.90). In logistic regression analysis the volume and CT attenuation of the different intrathoracic fat compartments PCAT, EAT and PAT were not independently associated with the presence of myocardial ischemia (n.s.).  Conclusions In this single-centre study CTA-derived quantified CT attenuation and volume of PCAT, EAT and PAT were not associated with myocardial ischemia as assessed by adenosine stress CMR perfusion imaging.

scholarly journals Increased epicardial adipose tissue volume is associated with PR interval prolongation

2015 ◽  
Vol 38 (1) ◽  
pp. 45 ◽  
Author(s):  
Wei-Chin Hung ◽  
Wei-Hua Tang ◽  
Chao-Ping Wang ◽  
Li-Fen Lu ◽  
Fu-Mei Chung ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Epicardial Adipose Tissue ◽  
Epicardial Fat ◽  
Interval Prolongation ◽  
Pr Interval ◽  
Qrs Duration ◽  
Adipose Tissue Volume ◽  
Artery Disease ◽  
Visceral Adipose ◽  
The Relationship

Purpose: Epicardial fat is visceral adipose tissue that possesses inflammatory properties. Inflammation and obesity are associated with cardiovascular disease and arrhythmogenesis, but little is known about the relationship between epicardial fat and PR-Interval prolongation. The purpose of this study was to investigate the association between epicardial adipose tissue (EAT) volume and PR-interval prolongation as assessed by computed tomography (CT) and Twelve-lead ECGs. Methods: Patients (n=287) were referred for 64-slice CT for exclusion of coronary artery disease and EAT volumes were determined. Twelve-lead ECGs were obtained from each subject and were evaluated by two independent readers. Results: Patients with significant PR interval prolongation had higher median EAT volume than patients with normal PR interval. Statistically significant correlations were observed between the EAT volume and the PR interval (p = 0.183, p = 0.003), and QRS duration (p = 0.144, p = 0.018). Multivariate and trend analyses confirmed that EAT volume was independently associated with the presence of PR interval prolongation. The receiver operator characteristics curve of EAT volume showed that an EAT volume >144.4 cm³ was associated with PR interval prolongation. Conclusion: This study indicates that EAT volume is highly associated with PR interval prolongation. Whether epicardial fat plays a role in the pathogenesis of PR interval prolongation requires future investigation.

The Role of Inflammation in Epicardial Adipose Tissue in Heart Diseases

2018 ◽  
Vol 24 (3) ◽  
pp. 297-309 ◽  
Author(s):  
Zdenek Matloch ◽  
Anna Cinkajzlova ◽  
Milos Mraz ◽  
Martin Haluzik
Keyword(s):  
Adipose Tissue ◽  
Epicardial Adipose Tissue ◽  
Heart Diseases ◽  
Left Ventricular ◽  
Epicardial Fat ◽  
Cellular Interactions ◽  
Endocrine Organ ◽  
Adipose Tissue Depot ◽  
Electrocardiographic Abnormalities

Epicardial adipose tissue is not only a specific adipose tissue depot but also an active endocrine organ producing numerous substances with an important role in the development of obesity-related heart diseases. It is located between myocardium and visceral pericardium and consists predominantly of adipocytes, immunocompetent cells, ganglia and interconnecting nerve branches. Several studies documented a positive correlation between pericardial and epicardial fat and left ventricular hypertrophy and septal thickening, leading to diastolic dysfunction, electrocardiographic abnormalities and facilitating cardiac failure. The cellular cross-talks between epicardial fat and myocardium may include both the vasocrine and the paracrine mechanisms. Adipokines secreted from epicardial adipose tissue, vascular and stromal cells diffuse into interstitial fluid crossing the adventitia, media and intima and modulate cardiac function and cardiomyocyte phenotype and survival. In this article, we review the significance of epicardial adipose tissue and its association with cardiovascular diseases, cellular interactions between epicardial fat and myocardium, secretions of adipokines and inflammatory mediators and a potential of epicardial fat as a therapeutic target for the prevention of obesity-related heart diseases.

Abstract 12678: Clinical Utility of Echocardiographic Epicardial Adipose Tissue Thickness Measured Using a High-frequency Linear Probe in Patients With Coronary Artery Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yukia Hirata ◽  
Hirotsugu Yamada ◽  
Kenya Kusunose ◽  
Susumu Nishio ◽  
Mika Bando ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Adipose Tissue ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
High Frequency ◽  
Epicardial Adipose Tissue ◽  
Linear Probe ◽  
Significant Difference ◽  
Artery Disease

Introduction: Epicardial adipose tissue(EAT), which is thought to be an ectopic adipose tissue, has been paid attention in association with coronary artery disease (CAD). Hypothesis: We hypothesized that EAT in anterior interventricular groove (AIG) obtained by echocardiography can be an additional marker over classical risk factors for prediction of CAD. Methods: We enrolled 311 patients (mean age 67±11 yrs, 208 men) who underwent coronary angiography between December 2011 and December 2013 at our hospital. We measured EAT thickness on the AIG and right ventricular free wall (EAT-RV) using high-frequency linear probe. Subjects were divided into 2 groups with and without significant coronary stenosis (≧75%) from coronary angiography. The performance of clinical risk factors (including age, male gender, body mass index (BMI), diabetes mellitus, hypertension, dyslipidemia, and smoking) plus various combinations of EAT thickness measurements for predicting CAD was assessed using the area under the curve (AUC) in ROC analysis. Results: The EAT-AIG thickness was significantly greater in the CAD group than that in the non-CAD group (8.3±3.0 vs. 6.3±2.5 mm, p<0.001), and there as also significant difference in the EAT-RV between the two groups (5.0±2.1 vs. 4.4±2.3 mm, p=0.009). Adding the EAT-AIG thickness over classical risk factors improved prediction of presence CAD (AUC 0.692 vs. 0.788, p<0.001), while the EAT-RV did not (AUC 0.692 vs. 0.704, p=0.343). Conclusions: Echocardiographic EAT-AIG thickness was greater in the CAD group than the non-CAD group. This non-invasive index may have clinical potential as a maker for predicting coronary atherosclerosis.

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