Key result
Epicardial adipose tissue volume was independently associated with left ventricular mass, but not with coronary microvascular function after adjusting for left ventricular mass and traditional risk factors.
Cohort (n=208)
Yes
Absolute Event Rate: 130.1% vs 114.2%
p-value: p=<0.001
Epicardial adipose tissue volume is associated with increased left ventricular mass independently of BMI, but does not independently predict coronary microvascular dysfunction when accounting for LV mass.
Caution against assuming EAT drives CMD beyond LV mass; leaves open causal roles in non-obstructive CAD.
PURPOSE: Epicardial adipose tissue (EAT) has been linked to coronary artery disease (CAD) and coronary microvascular dysfunction. However, its injurious effect may also impact the underlying myocardium. This study aimed to determine the impact of obesity on the quantitative relationship between left ventricular mass (LVM), EAT and coronary microvascular function. METHODS: A total of 208 (94 men, 45 %) patients evaluated for CAD but free of coronary obstructions underwent quantitative [(15)O]H2O hybrid positron emission tomography (PET)/CT imaging. Coronary microvascular resistance (CMVR) was calculated as the ratio of mean arterial pressure to hyperaemic myocardial blood flow. RESULTS: Obese patients [body mass index (BMI) > 25, n = 133, 64 % of total] had more EAT (125.3 ± 47.6 vs 93.5 ± 42.1 cc, p < 0.001), a higher LVM (130.1 ± 30.4 vs 114.2 ± 29.3 g, p < 0.001) and an increased CMVR (26.6 ± 9.1 vs 22.3 ± 8.6 mmHg×ml(-1)×min(-1)×g(-1), p < 0.01) as compared to nonobese patients. Male gender (β = 40.7, p < 0.001), BMI (β = 1.61, p < 0.001), smoking (β = 6.29, p = 0.03) and EAT volume (β = 0.10, p < 0.01) were identified as independent predictors of LVM. When grouped according to BMI status, EAT was only independently associated with LVM in nonobese patients. LVM, hypercholesterolaemia and coronary artery calcium score were independent predictors of CMVR. CONCLUSION: EAT volume is associated with LVM independently of BMI and might therefore be a better predictor of cardiovascular risk than BMI. However, EAT volume was not related to coronary microvascular function after adjustments for LVM and traditional risk factors.
No takes yet. Share an insight, caveat, or question.
Bakkum et al. (2015) conducted a cohort in Suspected coronary artery disease without obstructive CAD (n=208). Obesity (BMI ≥ 25) vs. Nonobese (BMI < 25) was evaluated on Left ventricular mass (LVM) in grams (p=<0.001). Epicardial adipose tissue volume was independently associated with left ventricular mass, but not with coronary microvascular function after adjusting for left ventricular mass and traditional risk factors.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: