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KMID : 1149520200040010023
Cardiovasclar Imaging Asia
2020 Volume.4 No. 1 p.23 ~ p.29
Relationship Between Epicardial Fat Volume and Coronary Microvascular Dysfunction in Patients with Chest Pain and Unobstructed Coronary Arteries
Quah Jing Xian

Sargent Stephanie
Nel Karen
Anstey Christopher M.
Stanton Tony
Greaves Kim
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 (¥â=?0.002, p=0.012). Multivariable linear regression analysis using MBFR as a continuous outcome variable revealed age (¥â=?0.012, p=0.011) and CACS (¥â=?0.003, p=0.023) to be associated with MBFR. EFV was not associated with MBFR (¥â=?0.0007, p=0.538). Model repetition with MBFR as a dichotomous variable (MBFR ¡Ã2 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
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