Effects of Eicosapentaenoic Acid Treatment on Epicardial and Abdominal Visceral Adipose Tissue Volumes in Patients with Coronary Artery Disease

AIM: Epicardial adipose tissue (EAT) is a pathogenic fat depot that may be associated with coronary atherosclerosis and cardiovascular events. Because eicosapentaenoic acid (EPA) has been reported to exert cardiovascular protective effects, we aimed to assess the effects of EPA on the volume of visceral adipose tissue, including EAT and abdominal visceral adipose tissue (AVAT), using multislice computed tomography (CT). METHODS: In 30 patients with coronary artery diseases (9 women; mean age, 67.2 ± 5.4 years), EAT and AVAT volumes were compared between the control group (n=15, conventional therapy) and the EPA group (n=15, conventional therapy plus purified EPA 1800 mg/day) during a six-month period. EAT was defined as any pixel that had CT attenuation of -150 to -30 Hounsfield units (HU) within the pericardial sac. RESULTS: After the six-month follow-up, the serum EPA level increased from 59.9 ± 18.8 to 177.2 ± 3.3 μg/mL in the EPA group (p<0.01), but no increase was noted in the control group. Similarly, the EPA/arachidonic acid (AA) ratio increased from 0.39 ± 0.12 to 1.22 ± 0.28 in the EPA group (p<0.01), with no significant increase in the control group. The AVAT and EAT volumes decreased in the EPA group but were unchanged in the control group (AVAT, -11.6 ± 17.0 vs. +8.8 ± 13.6 cm(2), p<0.01; EAT, -7.3 ± 8.3 vs. +8.7 ± 8.8 cm(3), p<0.01). Moreover, the change in the AVAT volume negatively correlated with the change in EPA (r=-0.58, p<0.01) and EPA/AA levels (r=-0.53, p<0.01). A similar negative correlation in these parameters was also observed for the EAT volume. CONCLUSIONS: Oral intake of purified EPA appears to be associated with reductions in EAT and AVAT volumes.