Department of Cardiology, Faculty of Medicine (for girls), Al-Azhar University, Cairo, Nasr city, 11651, Egypt.
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
High Blood Press Cardiovasc Prev. 2023 Sep;30(5):427-434. doi: 10.1007/s40292-023-00590-5. Epub 2023 Sep 19.
Epicardial adipose tissue may have an important role in the pathogenesis of coronary artery disease (CAD).
We aimed to study the association between epicardial fat volume (EFV) and presence of obstructive as well as multivessel CAD.
A total of 87 adult subjects with suspected CAD who underwent both quantified by multidetector computerized tomography (MDCT) and Invasive Coronary Angiography (ICA) were enrolled in this observational study. EVF was measured by MDCT by calculating the sum of cross- sectional areas of fat multiplied by slice thickness. EFV measurement and its association with the presence of obstructive CAD (defined as coronary artery stenosis > 70%) was evaluated.
Overall, 89.6% patients had obstructive CAD with higher EFV as compared to 10.3% patients with non-obstructive CAD (57 ± 20.14 cm vs. 44 ± 7.4 cm; P < 0.001). Furthermore, EFV was significantly increased in group II as compared with group I (74 ± 24.3 ml vs. 53 ± 16.2 ml; P < 0.003). On the hand, the coronary calcium score (CAC) was insignificantly increased in group II as compared with group I (486.1 vs. 211.2; P = 0.10). Multivariate analysis revealed that, EFV might be an independent risk factor for not only the presence of obstructive CAD (odds ratio [OR], 1.062; 95% CI 1.018- 1.108; P < 0.005) but also in predicting multivessel disease affection.
Our results demonstrated that, EFV was significantly increased not only with obstructive CAD, independent of other traditional risk factors and CAC score, but also it can be considered a good predictor of multivessel disease occurrence.
心外膜脂肪组织可能在冠状动脉疾病（CAD）的发病机制中起重要作用。
我们旨在研究心外膜脂肪体积（EFV）与阻塞性和多支 CAD 存在之间的关系。
这项观察性研究共纳入 87 名疑似 CAD 的成年患者，这些患者均接受了多排计算机断层扫描（MDCT）和血管造影检查。EFV 通过 MDCT 测量，方法是计算脂肪横截面积乘以切片厚度的总和。评估 EFV 测量值及其与阻塞性 CAD（定义为冠状动脉狭窄>70%）存在的关系。
总体而言，89.6%的患者存在阻塞性 CAD，EFV 高于 10.3%的非阻塞性 CAD 患者（57±20.14cm vs. 44±7.4cm；P<0.001）。此外，与组 I 相比，组 II 的 EFV 显著增加（74±24.3ml vs. 53±16.2ml；P<0.003）。另一方面，与组 I 相比，组 II 的冠状动脉钙评分（CAC）无显著增加（486.1 vs. 211.2；P=0.10）。多变量分析显示，EFV 不仅是存在阻塞性 CAD 的独立危险因素（比值比[OR]，1.062；95%置信区间 1.018-1.108；P<0.005），而且还可以预测多支血管疾病的发生。
我们的结果表明，EFV 不仅在存在阻塞性 CAD 时显著增加，而且独立于其他传统危险因素和 CAC 评分，而且可以被认为是多支血管疾病发生的良好预测指标。
