Relationship between epicardial adipose tissue and coronary artery stenoses on computed tomography in patients scheduled for carotid artery revascularization. Issue 5 (May 2022)

• Record Type: Journal Article
• Authors: Sato, Yoshihiro; Kawai, Hideki; Hoshino, Meiko; Matsumoto, Shoji; Hayakawa, Motoharu; Sadato, Akiyo; Sarai, Masayoshi; Motoyama, Sadako; Takahashi, Hiroshi; Naruse, Hiroyuki; Ishii, Junnichi; Toyama, Hiroshi; Ozaki, Yukio; Nakahara, Ichiro; Hirose, Yuichi; Izawa, Hideo
• Is Part Of: Journal of cardiology. Volume 79:Issue 5(2022)
• Page Start: 588
• Page End: 595
• Publication Date: 2022-05
• Subjects: Epicardial adipose tissue -- Carotid artery disease -- Coronary computed tomography; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2021.12.008
• Languages: English
• ISSNs: 0914-5087

Abstract

Highlights: Ischemic stroke and coronary artery disease share common pathological mechanisms. Half of the patients with carotid stenoses also have coronary artery diseases. Coronary artery disease is the major cause of death after an ischemic stroke. Epicardial adipose tissue (EAT) was associated with coronary artery stenoses. EAT may have a specific role in the coronary atherosclerosis. Abstract: Background: We aimed to clarify the relationship between epicardial adipose tissue (EAT) volume and the presence of severe stenoses (SS) on coronary computed tomography angiography (CTA) for risk stratification of the patients with carotid artery stenoses. Methods: We prospectively performed CTA for 125 consecutive patients (72.4 ± 8.1 years, 85% men) without a history of coronary artery disease (CAD), who were scheduled for carotid artery revascularization from 2014 to 2020. SS was defined as ≥70% luminal stenosis on CTA. EAT was quantified automatically as the total volume of tissue with -190 to -30 HU. Results: Of 125 patients, 76 had SS. Between the patients with and without SS, there were significant differences in coronary artery calcium score (CACS), left ventricular ejection fraction (LVEF), dyslipidemia, and EAT, despite no differences in carotid echocardiography findings. After adjustment for age, gender, and dyslipidemia, EAT was an independent factor associated with SS ( p =0.011), as well as CACS and LVEF. The addition of EAT to a baseline model including age, gender, dyslipidemia, LVEF, and CACS achieved both net reclassification improvement (0.505, p =0.003) and integrated discrimination improvement (0.059, p =0.003). Conclusions: In patients with carotid stenoses, EAT is associated with CAD and is useful for additional risk stratification. Epicardial fat may have a specific role in the development of CAD in patients with suspected systemic atherosclerosis. Graphical Abstract: Two representative cases (the same as Figure 1) and histogram with the distribution of epicardial adipose tissue (EAT) volumes according to the presence of severe stenoses (SS). LAD, left anterior descending artery; LCX, left circumflex artery; RCA, right coronary artery Image, graphical abstract .