Why the study?
Epicardial adipose tissue is related to coronary artery disease, but its role in hemodynamically significant CAD remains poorly understood.
Does epicardial adipose tissue (EAT) volume correlate with hemodynamically significant CAD in patients with known or suspected CAD?
Does epicardial adipose tissue (EAT) volume correlate with hemodynamically significant CAD in patients with known or suspected CAD?
EAT volume measured by CCTA is an independent predictor of hemodynamically significant CAD and improves diagnostic performance when added to obstructive CAD assessment.
EAT volume on CCTA may aid noninvasive detection of hemodynamically significant CAD; leaves open incremental value beyond CACs in prospective studies.
Background Epicardial adipose tissue (EAT) is directly related to coronary artery disease (CAD), but little is known about its role in hemodynamically significant CAD. Therefore, our goal is to explore the impact of EAT volume on hemodynamically significant CAD. Methods Patients who underwent coronary computed tomography angiography (CCTA) and received coronary angiography within 30 days were retrospectively included. Measurements of EAT volume and coronary artery calcium score (CACs) were performed on a semi-automatic software based on CCTA images, while quantitative flow ratio (QFR) was automatically calculated by the AngioPlus system according to coronary angiographic images. Results This study included 277 patients, 112 of whom had hemodynamically significant CAD and showed higher EAT volume. In multivariate analysis, EAT volume was independently and positively correlated with hemodynamically significant CAD [per standard deviation (SD) cm 3 ; odds ratio (OR), 2.78; 95% confidence interval (CI), 1.86–4.15; P < 0.001], but negatively associated with QFR min (per SD cm 3 ; β coefficient, −0.068; 95% CI, −0.109 to −0.027; P = 0.001) after adjustment for traditional risk factors and CACs. Receiver operating characteristics curve analysis demonstrated a significant improvement in predictive value for hemodynamically significant CAD with the addition of EAT volume to obstructive CAD alone (area under the curve, 0.950 vs. 0.891; P < 0.001). Conclusion In this study, we found that EAT volume correlated substantially and positively with the existence and severity of hemodynamically significant CAD in Chinese patients with known or suspected CAD, which was independent of traditional risk factors and CACs. In combination with obstructive CAD, EAT volume significantly improved diagnostic performance for hemodynamically significant CAD, suggesting that EAT could be a reliable noninvasive indicator of hemodynamically significant CAD.
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Jin et al. (2023) studied this question.
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