Incremental diagnostic value of epicardial adipose tissue for the detection of functionally relevant coronary artery disease. Issue 1 (September 2015)

• Record Type: Journal Article
• Authors: Romijn, M.A.; Danad, I.; Bakkum, M.J.; Stuijfzand, W.J.; Tulevski, I.I.; Somsen, G.A.; Lammertsma, A.A.; van Kuijk, C.; van de Ven, P.M.; Min, J.K.; Leipsic, J.; van Rossum, A.C.; Raijmakers, P.G.; Knaapen, P.
• Is Part Of: Atherosclerosis. Volume 242:Issue 1(2015)
• Page Start: 161
• Page End: 166
• Publication Date: 2015-09
• Subjects: Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2015.07.005
• Languages: English
• ISSNs: 0021-9150

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Background and Aim</title> <p id="abspara0010">To determine the incremental diagnostic value of epicardial adipose tissue (EAT) volume in addition to the coronary artery calcium (CAC) score for detecting hemodynamic significant coronary artery disease (CAD).</p> </sec> <sec> <title id="sectitle0020">Methods and Results</title> <p id="abspara0015">122 patients (mean age 61 ± 10 years, 61% male) without a previous cardiac history underwent a non-contrast CT scan for calcium scoring and EAT volume measurements. Subsequently all patients underwent invasive coronary angiography (ICA) in conjunction with fractional flow reserve (FFR) measurements. A stenosis >90% and/or a FFR ≤0.80 were considered significant. Mean EAT volume and CACscore were 128 ± 51 cm<sup>3</sup> and 418 ± 704, respectively. The correlation between EAT volume and the CACscore was poor (r = 0.11, p = 0.24). Male gender (odds ratio [OR] 2.86, p = 0.01), CACscore ([cut-off value 100] OR 3.31, p = 0.003, and EAT volume ([cut-off value 92 cm<sup>3</sup>] OR 4.28, p = 0.01) were associated with flow-limiting disease. The multivariate model revealed that only male gender (OR 2.50, p = 0.045), CAC score (OR 3.60, p = 0.005), and EAT volume (OR 4.95, p = 0.02) were independent predictors of myocardial ischemia. Using the cut-off values of 100 (CAC score) and 92 cm<sup>3</sup> (EAT volume), sensitivity, specificity, negative predictive value, positive predictive value, and accuracy for detecting functionally relevant CAD as indicated by FFR were 71, 57, 77, 50 and 63% and 91, 29, 85, 44 and 52% for the CACscore and EAT volume, respectively. Adding EAT volume to the CAC score and cardiovascular risk factors did not enhance diagnostic performance for the detection of significant CAD (p = 0.57).</p> </sec> <sec> <title id="sectitle0025">Conclusion</title> <p id="abspara0020">EAT volume measurements have no diagnostic value beyond calcium scoring and cardiovascular risk factors in the detection of hemodynamic significant CAD.</p> </sec> </abstract>