Epicardial Adipose Tissue and Coronary Artery Plaque Characteristics

Atherosclerosis. 2009; 208(1):311-316

Alexopoulos N, McLean DS, Janik M, Arepalli CD, Stillman AE, Raggi P

OBJECTIVE: Epicardial adipose tissue (EAT) has been implicated in the pathogenesis of coronary atherosclerosis. The association of EAT volume with type of coronary artery plaque on computed tomography angiography (CTA) is not known.

METHODS: Coronary artery calcium (CAC) scoring and EAT volume measurement were performed on 214 consecutive patients (mean age 54+/-14 years) referred for coronary CTA. CAC was performed on non-contrast images, while EAT volume, the severity of luminal stenoses, and plaque characterization were assessed using contrast-enhanced CTA images. EAT volume was also indexed to body surface area (EAT-i).

RESULTS: EAT volume correlated with age, height, body mass index (BMI), and CAC score. EAT volume increased significantly with the severity of luminal stenosis (p<0.001), and in patients with no plaques, calcified, mixed, and non-calcified plaques (62+/-33mL, 63+/-22mL, 98+/-47mL, and 99+/-36mL, respectively, p<0.001). The EAT volume was significantly larger in patients with mixed or non-calcified plaques compared to patients with calcified plaques or no plaques (all p<0.01 ). The trend remained significant after adjustment for traditional risk factors for coronary artery disease. In adjusted models EAT was an independent predictor of CAC [exp(B)=3.916, p<0.05], atherosclerotic plaques of any type [exp(B)=4.532, p<0.01], non-calcified plaques [exp(B)=3.849, p<0.01], and obstructive CAD [exp(B)=3.824, p<0.05]. The above results were unchanged after replacing EAT with EAT-i.

CONCLUSION: EAT volume was larger in the presence of obstructive CAD and non-calcified plaques. These data suggest that EAT is associated with the development of coronary atherosclerosis and potentially the most dangerous types of plaques.

PMID: 20031133

2 Responses

  1. Ronen Rubinshtein, MD  on December 31st, 2009

    Interesting paper on the relation between coronary plaques and epicardial fat tissue. The relation may be significant, and may also be related to the important role of the vasa-vasorum in the process of coronary atherosclerosis.

  2. kirschj  on January 4th, 2010

    Interesting paper. There are many studies like this one appearing in the literature as of lately. Two recent ones as a result of the MESA data:

    - The association of pericardial fat with incident coronary heart disease: the Multi-Ethnic Study of Atherosclerosis (MESA).
    Ding J, Hsu FC, Harris TB, Liu Y, Kritchevsky SB, Szklo M, Ouyang P, Espeland MA, Lohman KK, Criqui MH, Allison M, Bluemke DA, Carr JJ.
    Am J Clin Nutr. 2009 Sep;90(3):499-504.
    PMID: 19571212

    - The association of pericardial fat with calcified coronary plaque.
    Ding J, Kritchevsky SB, Harris TB, Burke GL, Detrano RC, Szklo M, Jeffrey Carr J.
    Obesity. 2008 Aug;16(8):1914-9.
    PMID: 18535554

    There is also a very nice review that just got published by Iacobellis, et al. See this post.


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