Mohammadzadeh Maryam, Mohammadzadeh Vahid, Shakiba Madjid, Motevalli Marzieh, Abedini Azadeh, Kadivar Sakineh, Entezari Pouya, Mohammadzadeh Ali
Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2018 Mar 1;21(3):95-100.
This study aimed to investigate the association between epicardial adipose tissue (EAT) and coronary artery disease (CAD) as well as cardiovascular risk factors.
Complete medical records of subjects were reviewed and cardiovascular risk factors were recorded. Epicardial fat volume (EFV) and epicardial fat thickness (EFT) were measured using digital volumetry of acquired images using a 256-slice CT-scanner. Calcium score was measured using Agatston method in non-contrast images. After contrast administration, bolus-tract images were obtained. Coronary arteries were assessed using reconstructed images in arterial phase of contrast-enhanced images. EFV and EFT measurements were compared to computed tomography angiography (CTA) findings of coronary arteries.
A total of 269 patients (Mean age: 55.5 ± 12.1, 44% female) were included. Higher means of EFT and EFV were associated with coronary artery stenosis. However, the correlation coefficients of the arterial stenosis with EFT and EFV were weak. EFV and EFT had a significant association with age (P < 0.001, P < 0.001 respectively), body mass index (BMI) (P < 0.001, P < 0.001 respectively) and hypertension (P < 0.016, P < 0.003 respectively). Diabetes mellitus (DM) and hyperlipidemia were not significantly associated with EFV (P = 0.069 and 0.639 respectively) and EFT (P = 0.103 and 0.366 respectively). EFV and EFT showed a weak correlation coefficient with calcium scoring (Spearman correlation coefficients: 0.26 and 0.22 respectively, both P < 0.001). In multivariate logistic regression models considering coronary stenosis as dependent variable and EFV, EFT and other CAD risk factors as independent variables, EFV and EFT did not show significant P values and were omitted from the model by other CAD risk factors.
Increased EFV and EFT are associated with CAD, age, BMI and hypertension. However, no remarkable association was found between them and calcium score, hyperlipidemia or DM. These variables could weakly predict CAD in univariate models but they are not independent predictive factors for CAD in multivariate models consisting of other CAD risk factors. Hence, EFT and EFV are not independent predictors for CADs when they are considered simultaneously with other CAD risk factors.
本研究旨在调查心外膜脂肪组织（EAT）与冠状动脉疾病（CAD）以及心血管危险因素之间的关联。
回顾受试者的完整病历并记录心血管危险因素。使用256层CT扫描仪对采集图像进行数字容积测量来测定心外膜脂肪体积（EFV）和心外膜脂肪厚度（EFT）。在非增强图像中使用阿加斯顿方法测量钙化积分。注射造影剂后，获取团注追踪图像。在造影增强图像的动脉期使用重建图像评估冠状动脉。将EFV和EFT测量结果与冠状动脉的计算机断层扫描血管造影（CTA）结果进行比较。
共纳入269例患者（平均年龄：55.5±12.1岁，44%为女性）。EFT和EFV的较高均值与冠状动脉狭窄相关。然而，动脉狭窄与EFT和EFV的相关系数较弱。EFV和EFT与年龄（分别为P<0.001，P<0.001）、体重指数（BMI）（分别为P<0.001，P<0.001）和高血压（分别为P<0.016，P<0.003）有显著关联。糖尿病（DM）和高脂血症与EFV（分别为P = 0.069和0.639）和EFT（分别为P = 0.103和0.366）无显著关联。EFV和EFT与钙化积分的相关系数较弱（Spearman相关系数分别为0.26和0.22，均P<0.001）。在以冠状动脉狭窄为因变量、EFV、EFT和其他CAD危险因素为自变量的多因素逻辑回归模型中，EFV和EFT未显示出显著的P值，并被其他CAD危险因素从模型中剔除。
EFV和EFT增加与CAD、年龄、BMI和高血压相关。然而，未发现它们与钙化积分、高脂血症或DM之间有显著关联。这些变量在单因素模型中对CAD的预测作用较弱，但在由其他CAD危险因素组成的多因素模型中它们不是CAD的独立预测因素。因此，当EFT和EFV与其他CAD危险因素同时考虑时，它们不是CAD的独立预测指标。
