Cardiovasc Imaging Asia.  2020 Jan;4(1):23-29. 10.22468/cvia.2019.00178.

Relationship Between Epicardial Fat Volume and Coronary Microvascular Dysfunction in Patients with Chest Pain and Unobstructed Coronary Arteries

Affiliations
  • 1Department of Cardiology, Sunshine Coast Hospital and Health Services, Queensland, Australia. jingxian.quah@health.qld.gov.au
  • 2Department of Cardiology, Poole Hospital NHS Foundation Trust, Bournemouth University, Dorset, UK.
  • 3Department of Intensive Care, Sunshine Coast Hospital and Health Services, Queensland, Australia.

Abstract


OBJECTIVE
Epicardial fat (EF) is metabolically active adipose tissue positioned between the epicardial surface of the heart and the pericardium. We investigated whether there is a relationship between EF and Coronary Microvascular Dysfunction (CMD) in patients presenting with chest pain and unobstructed coronary arteries.
MATERIALS AND METHODS
This study recruited patients referred to cardiology clinics for assessment of chest pain who subsequently underwent assessment via CT coronary angiogram (CTA). Myocardial blood flow reserve (MBFR) was assessed using myocardial contrast echocardiography. Epicardial fat volume (EFV) was measured by tracing serial slices on CTA with corresponding Hounsfield units of −195 to −45.
RESULTS
We recruited 134 participants with a mean age of 59.2 (9.8) years. CMD was present in 54 (40%) patients, and the measured mean EFV was 128 mm3 (96, 168). Fortythree patients (32%) had a coronary artery calcium score (CACS) of 0, 64 (48%) had a CACS of 1-100, 18 (13%) had a CACS of 101-400, and 9 (7%) had a CACS >400. Univariate regression analysis showed that EFV and MBFR had a correlation coefficient of R=−0.22, with a significant regression slope (β=−0.002, p=0.012). Multivariable linear regression analysis using MBFR as a continuous outcome variable revealed age (β=−0.012, p=0.011) and CACS (β=−0.003, p=0.023) to be associated with MBFR. EFV was not associated with MBFR (β=−0.0007, p=0.538). Model repetition with MBFR as a dichotomous variable (MBFR ≥2 or <2) revealed no association with EFV.
CONCLUSION
No relationship was found between EFV and MBFR when traditional cardiovascular risk factors and calcium score.

Keyword

Inflammation; Endothelium, vascular

MeSH Terms

Adipose Tissue
Calcium
Cardiology
Chest Pain*
Coronary Vessels*
Echocardiography
Endothelium, Vascular
Heart
Humans
Inflammation
Linear Models
Pericardium
Risk Factors
Thorax*
Calcium
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