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Association of epicardial adipose tissue attenuation with coronary atherosclerosis in patients with a high risk of coronary artery disease

  • Zihou Liu
    Affiliations
    Department of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, PR China

    Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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  • Shunjun Wang
    Affiliations
    Department of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
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  • Yongqiang Wang
    Affiliations
    Department of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
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  • Ningbo Zhou
    Affiliations
    Department of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
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  • Jie Shu
    Affiliations
    Department of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
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  • Christof Stamm
    Affiliations
    Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany

    Deutsches Herzzentrum Berlin (DHZB), Berlin, Germany
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  • Meng Jiang
    Affiliations
    Department of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
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  • Fanyan Luo
    Correspondence
    Corresponding author. Department of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
    Affiliations
    Department of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
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      Highlights

      • Epicardial adipose tissue (EAT) attenuation and volume significantly correlated, but this relationship gradually diminished with increasing CAC scores
      • EAT attenuation was associated with CAD risk factors and the presence of CAD and CAC.
      • EAT attenuation was not associated with the presence of significant coronary lesions and triple-vessel plaques.
      • EAT attenuation was associated with CAC score, SIS and SSS.

      Abstract

      Background and aims

      Density may indicate some tissue characteristics and help reveal the role of epicardial adipose tissue (EAT) in coronary artery disease (CAD). Therefore, we assessed the association of EAT density with the coronary artery plaque burden in patients presenting with chest pain.

      Methods

      This retrospective cohort study comprised 614 patients (mean age 61 ± 9 years, 61% males) with a high cardiovascular disease risk, who underwent cardiac computed tomography angiography. Density was reflected as attenuation.

      Results

      EAT attenuation was significantly associated with EAT volume with a negative Pearson's correlation coefficient and gradually increased across coronary artery calcium (CAC) scores of 0, 1–100, 101–400 and > 400. EAT attenuation was tightly associated with CAD risk factors, including age, sex, BMI, total cholesterol, neutrophil to lymphocyte ratios and CAC score. The association between EAT attenuation and CAC score was strengthened after adjusting for multivariable indices (OR 1.21, 95% CI 1.05–1.40, p = 0.01) and further adjusting for EAT volume (OR 1.26 95% CI 1.06–1.51, p<0.01). However, EAT attenuation was associated only with CAD presence (OR 1.32, 95% CI 1.02–1.69, p<0.05), CAC presence (OR 1.28, 95% CI 1.02–1.60, p<0.05), segment involvement score (OR 1.19, 95% CI 1.01–1.40, p<0.05) and segment stenosis score (OR 1.19, 95% CI 1.01–1.40, p<0.05) in the EAT volume- and multivariable-adjusted model. Additionally, EAT attenuation was not associated with significant coronary artery lesions and triple-vessel plaques.

      Conclusions

      Higher EAT attenuation is associated with a higher risk of CAD.

      Graphical abstract

      Keywords

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