Objective: An increment of abdominal visceral fat has been reported to be a coronary risk factor associated with metabolic syndrome. However, adipose tissue surrounding heart has not been fully determined as coronary risk factors. Accurate volumetric measurement of epicardial fat can be easily obtained by MDCT. We examined the relationship between epicardial fat volume and clinical parameters in patients with coronary artery disease (CAD).
Method: We evaluated epicardial fat volume by 64 detector row CT scanner in CAD patients (obese, 13; non-obese, 11 patients) who underwent elective coronary artery bypass graft surgery and in non-CAD patients who showed normal coronary arteries on angiography (obese, 3; non-obese, 11 patients). Epicardial fat volume was obtained as the sum of fat areas on short axis images. Obese patients were defined as over 25 in body mass index (BMI).
Result: Epicardial fat volume was significantly higher in patients with CAD than in those without CAD (40.6 ± 14.7 ml vs. 20.0 ± 14.7 ml, p < 0.05). Epicardial fat volume was not correlated to following coronary risk factors such as HbA1c, fasting plasma glucose, lipid and blood pressure except for BMI. Although there was no difference epicardial fat volume between in obese patients with CAD and in those without CAD (48.3 ± 27.9 ml vs. 41.2 ± 11.0 ml, NS), it was significantly higher in non-obese patients with CAD than in those without CAD (32.1 ± 9.2 ml vs. 14.2 ± 9.2 ml, p < 0.05).
Conclusions: The quantity of epicardial fat using MDCT is related with the presence of CAD. Especially in non-obese patients, epicardial fat may affect directly progression of CAD independent of pathophysiological process of metabolic syndrome.
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