Key result
Indexed epicardial adipose tissue thickness ≥2.2 mm/m2 measured by echocardiography was independently associated with coronary artery disease (OR 5.40; 95% CI 2.17-13.55; p<0.001).
Why the study?
CT-measured epicardial adipose tissue volume correlates with CAD and QRISK3 has limitations, prompting assessment of whether echocardiographic epicardial adipose tissue thickness correlates with volume and predicts CAD independently of QRISK3.
Does epicardial adipose tissue thickness measured by echocardiography predict the presence of coronary artery disease independently of QRISK3 scores in patients evaluated for chest pain?
Cross-Sectional (n=97)
Does epicardial adipose tissue thickness measured by echocardiography predict the presence of coronary artery disease independently of QRISK3 scores in patients evaluated for chest pain?
Odds Ratio: 5.4 (95% CI 2.17–13.55)
p-value: p=<0.001
Epicardial adipose tissue thickness measured by simple 2D-echocardiography correlates strongly with CT-derived volume and serves as an independent predictor of coronary artery disease.
Indexed EAT thickness by echo was associated with CAD beyond QRISK3; hypothesis-generating and requires prospective validation before clinical use.
Background: Epicardial adipose tissue (EAT) mimics visceral fat which is associated with metabolic derangements and coronary artery disease (CAD). EAT volume (EAT-V) measured by CT scan had shown good correlation with CAD. QRISK3 score is a validated risk predictor of future cardiovascular events but has limitations. We assessed whether EAT thickness (EAT-T) measured by echocardiography, a simple and widely available tool, correlated with EAT-V, and whether EAT-T is a predictor of CAD independently of QRISK3 scores. Methods: We enrolled 97 patients who underwent CTA for evaluation of chest pain. EAT-T was measured by 2D-echocardiography in parasternal long axis (PLAX) and parasternal short axis (PSAX) views. We evaluated association of EAT-T with EAT-V and CAD (≥50% stenosis on CTA); and independent predictive value of EAT-T for CAD after adjusting for QRISK 3 scores. Results: EAT-T was significantly more in patients with CAD (PLAX: 4.82 ± 1.31 mm vs. 4.06 ± 1.25 mm, p=0.005). EAT-T correlated strongly with EAT-V (r=0.75, p<0.001). On receiver operating characteristic curve analysis, EAT-T (PLAX) ≥3.9 mm (area-under-curve: 0.68; 95% CI: 0.58-0.79, sensitivity 84%, specificity 55%) predicted the presence of CAD. On multivariate analysis after adjusting for QRISK 3 scores, EAT-T showed significant association with CAD with highest odds ratio for indexed EAT-T (EAT-T/body surface area) (PLAX) ≥2.2 mm/m2 (OR 5.40; 95% CI: 2.17-13.55.; p<0.001). Conclusion: EAT-T is a predictor of CAD independent of QRISK3 scores. An increased EAT-T detected CAD with >80% sensitivity. These findings need to be validated in larger prospective cohort studies.
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Naik et al. (2021) conducted a cross-sectional in Coronary Artery Disease (n=97). Epicardial adipose tissue thickness (EAT-T) was evaluated on Coronary artery disease (≥50% stenosis on CTA) (OR 5.40, 95% CI 2.17-13.55, p=<0.001). Indexed epicardial adipose tissue thickness ≥2.2 mm/m2 measured by echocardiography was independently associated with coronary artery disease (OR 5.40; 95% CI 2.17-13.55; p<0.001).
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