Toyohashi Heart Center, 21-1 Gobudori, Oyama-cho, Toyohashi 441-8530, Japan.
Eur Heart J Cardiovasc Imaging. 2012 May;13(5):408-15. doi: 10.1093/ehjci/jes022. Epub 2012 Jan 30.
Epicardial fat volume (EFV) has been implicated in coronary artery disease. Relationship between EFV and coronary plaque vulnerability has not been elucidated. The aim of this study was to investigate the association of EFV with coronary plaque vulnerability by using optical coherence tomography (OCT).
We enrolled 117 patients who underwent multislice computed tomography (MSCT) and OCT. EFV was quantified on MSCT. Patients were categorized according to tertiles of EFV: low tertile, EFV < 104.1 cm(3); mid-tertile, 104.1 cm(3)≤ EFV ≤ 130.7 cm(3); high tertile, EFV > 130.7 cm(3). A total of 180 vessels and 221 plaques were assessed with OCT to detect a thin-capped fibroatheroma (TCFA). TCFA was defined as a plaque with necrotic lipid pools ≥ 2 quadrants and minimum fibrous cap thickness measuring <65 μm. Patients with low computed tomographic attenuation and positive remodelling were frequently observed and patients with OCT-derived TCFA were more common in the high tertile EFV. EFV was associated with a maximal lipid arc (103.4 ± 28.2 cm(3) in 0 quadrant, 120.2 ± 35.2 cm(3) in 1-2 quadrants, and 131.5 ± 41.1 cm(3) in >2 quadrants; P= 0.01) and inversely correlated with a minimum fibrous cap thickness of the patients (r = -0.400, P<0.01). In multivariate analysis, the high tertile of EFV remained an independent predictor for patients with OCT-derived TCFA [odds ratio (OR) 2.92; 95% confidence interval (CI) 1.13-7.55; P= 0.027] and acute coronary syndrome (ACS) patients (OR 2.89; 95% CI 1.14-7.29; P= 0.025).
EFV was associated with coronary plaque vulnerability and high EFV was an independent predictor of ACS in patients with coronary artery disease.
心外膜脂肪体积（EFV）与冠状动脉疾病有关。EFV 与冠状动脉斑块易损性之间的关系尚未阐明。本研究旨在通过光学相干断层扫描（OCT）研究 EFV 与冠状动脉斑块易损性的关系。
我们纳入了 117 名接受多层计算机断层扫描（MSCT）和 OCT 的患者。EFV 在 MSCT 上进行量化。患者根据 EFV 的三分位数进行分类：低三分位，EFV<104.1cm³；中三分位，104.1cm³≤EFV≤130.7cm³；高三分位，EFV>130.7cm³。总共对 180 个血管和 221 个斑块进行了 OCT 评估，以检测薄帽纤维粥样瘤（TCFA）。TCFA 定义为斑块中坏死脂质池≥2 个象限，最小纤维帽厚度<65μm。低 CT 衰减和阳性重塑的患者经常被观察到，高 EFV 组中 OCT 检测到的 TCFA 更为常见。EFV 与最大脂质弧（0 象限 103.4±28.2cm³，1-2 象限 120.2±35.2cm³，>2 象限 131.5±41.1cm³；P=0.01）相关，与患者的最小纤维帽厚度呈负相关（r=-0.400，P<0.01）。多变量分析显示，EFV 的高三分位仍然是 OCT 检测到 TCFA 的患者（比值比 2.92；95%置信区间 1.13-7.55；P=0.027）和急性冠状动脉综合征（ACS）患者（比值比 2.89；95%置信区间 1.14-7.29；P=0.025）的独立预测因素。
EFV 与冠状动脉斑块易损性有关，EFV 升高是冠状动脉疾病患者 ACS 的独立预测因素。
