Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Atherosclerosis. 2010 Nov;213(1):279-87. doi: 10.1016/j.atherosclerosis.2010.07.055. Epub 2010 Aug 10.
To elucidate which measurement of epicardial adipose tissue (EAT) best reflects its atherogenic risk, we examined the associations between different EAT measurements and various atherosclerotic parameters of the entire coronary tree and individual coronary arteries.
This study included 224 consecutive patients underwent multidetector computed tomography before diagnostic coronary angiography. Regional thickness, cross-sectional areas, and total volume of EAT were measured. Four atherosclerotic parameters, including severity score, extent score, calcium volume score, and number of coronary arteries with ≥50% luminal stenosis, of the entire coronary tree and individual coronary arteries were assessed.
Both total EAT volume and thickness of EAT in the left atrioventricular groove were unanimously associated with the presence of coronary atherosclerosis dichotomously defined by the 4 scoring systems. However, only EAT thickness in the left atrioventricular groove, but not total EAT volume, was significantly associated with all 4 parameters of coronary atherosclerosis in a dose-dependent manner, even after adjustments for conventional risk factors, body-mass index, waist circumference, C-reactive protein, and intra-abdominal visceral fat area. Using the receiver-operating-characteristic analysis, 12.2mm was the optimal cutoff point for left atrioventricular groove thickness to predict the presence of significant coronary stenosis (≥50% diameter stenosis). Among the three coronary arteries, left atrioventricular groove thickness was most strongly correlated with ≥50% diameter stenosis in the embedded left circumflex artery by multivariate regression model.
Thickness of EAT in the left atrioventricular groove provides a more accurate assessment of its atherogenic risk and is therefore a better coronary risk factor than total EAT volume.
为了阐明哪种心外膜脂肪组织（EAT）测量方法最能反映其动脉粥样硬化风险，我们研究了不同 EAT 测量方法与整个冠状动脉树和各个冠状动脉的不同动脉粥样硬化参数之间的相关性。
本研究纳入了 224 例在诊断性冠状动脉造影前接受多层螺旋 CT 检查的连续患者。测量了 EAT 的局部厚度、横截面积和总体积。评估了整个冠状动脉树和各个冠状动脉的 4 个动脉粥样硬化参数，包括严重程度评分、程度评分、钙体积评分和≥50%管腔狭窄的冠状动脉数量。
EAT 总体积和左房室沟 EAT 厚度均与 4 种评分系统定义的冠状动脉粥样硬化的存在呈一致相关。然而，只有左房室沟 EAT 厚度，而不是 EAT 总体积，与所有 4 个冠状动脉粥样硬化参数呈剂量依赖性相关，即使在调整了传统危险因素、体重指数、腰围、C 反应蛋白和腹腔内脏脂肪面积后。使用受试者工作特征曲线分析，左房室沟厚度 12.2mm 是预测存在显著冠状动脉狭窄（≥50%管腔狭窄）的最佳截断点。在三支冠状动脉中，左房室沟厚度与多变量回归模型中嵌入的左旋支≥50%管腔狭窄的相关性最强。
左房室沟 EAT 厚度能更准确地评估其动脉粥样硬化风险，因此比 EAT 总体积更能准确反映冠状动脉风险。
