Document Detail

Epicardial adipose tissue volume and coronary artery calcium to predict myocardial ischemia on positron emission tomography-computed tomography studies.
MedLine Citation:
PMID:  20440592     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There appears to be an association of epicardial adipose tissue (EAT) with coronary artery disease (CAD) and its risk factors. EAT is assumed to influence CAD development by altering vasomotor tone and via toxic paracrine effects. The relationship of EAT to myocardial perfusion has not been studied.
METHODS: Quantification of EAT and CAC was performed on positron emission tomography/computed tomography (PET/CT) studies in 45 subjects (77% intermediate pre-test probability of CAD) with mild-moderate myocardial ischemia (5-14% perfusion defect, n = 23), severe ischemia (≥15% defect, n = 22) and a control group with no ischemia matched for CAD risk factors (n = 52).
RESULTS: EAT volume showed a better correlation with myocardial ischemia than total CAC (r = .47 vs r = .28, P < .01). EAT volume increased significantly from the control group to subjects with mild-moderate and severe ischemia (96.9, 124.5, and 143.9 cm(3), P < .01 for both ischemia groups vs controls). Total mean CAC was significantly higher in the severe ischemia group (676.3) than in control group (229.4) (P < .01). Multivariable logistic regression analyses showed that EAT volume was, but CAC was not, a significant predictor of ischemia after adjustment for age, sex, body mass index, and each other. EAT volume was a better predictor of ischemia than total CAC [area under the curve (AUC): .764 vs .6291, P = .04]. The combination of EAT + CAC (AUC = .7694) did not improve over EAT volume alone (P = .57).
CONCLUSIONS: In this study, EAT volume assessed by CT was an independent predictor of ischemia on PET, and outperformed CAC score in a CAD naïve population at intermediate pre-test probability of disease.
Matthew Janik; Gregory Hartlage; Nikolaos Alexopoulos; Zaur Mirzoyev; Dalton S McLean; Chesnal D Arepalli; Zhengjia Chen; Arthur E Stillman; Paolo Raggi
Publication Detail:
Type:  Journal Article     Date:  2010-05-04
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  17     ISSN:  1532-6551     ISO Abbreviation:  J Nucl Cardiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-16     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  841-7     Citation Subset:  IM    
Division of Cardiology, Department of Medicine, Emory University, 1365 Clifton Road, AT-504, Atlanta, GA 30322, USA.
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MeSH Terms
Adipose Tissue / pathology*
Calcium / metabolism*
Coronary Vessels / metabolism*
Middle Aged
Myocardial Ischemia / etiology,  radionuclide imaging*
Pericardium / pathology*
Positron-Emission Tomography / methods*
Risk Factors
Tomography, X-Ray Computed
Reg. No./Substance:

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