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Epicardial adipose tissue volume and coronary artery calcium to predict myocardial ischemia on positron emission tomography-computed tomography studies

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Journal of Nuclear Cardiology Aims and scope

Abstract

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 cm3, 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.

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Acknowledgment

The authors have indicated they have no financial conflicts of interest.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Emory University, 1365 Clifton Road, AT-504, Atlanta, GA, 30322, USA

    Matthew Janik MD, Gregory Hartlage MD, Nikolaos Alexopoulos MD, Zaur Mirzoyev MD, Dalton S. McLean MD & Paolo Raggi MD

  2. Department of Radiology, Emory University, Atlanta, GA, USA

    Chesnal D. Arepalli MD, Arthur E. Stillman MD, PhD & Paolo Raggi MD

  3. Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA

    Zhengjia Chen PhD

Authors
  1. Matthew Janik MD
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  2. Gregory Hartlage MD
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  3. Nikolaos Alexopoulos MD
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  4. Zaur Mirzoyev MD
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  5. Dalton S. McLean MD
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  6. Chesnal D. Arepalli MD
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  7. Zhengjia Chen PhD
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  8. Arthur E. Stillman MD, PhD
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  9. Paolo Raggi MD
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Corresponding author

Correspondence to Paolo Raggi MD.

Additional information

Dr. Nikolaos Alexopoulos was supported by a scholarship from the Hellenic Society of Cardiology.

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Janik, M., Hartlage, G., Alexopoulos, N. et al. Epicardial adipose tissue volume and coronary artery calcium to predict myocardial ischemia on positron emission tomography-computed tomography studies. J. Nucl. Cardiol. 17, 841–847 (2010). https://doi.org/10.1007/s12350-010-9235-1

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  • DOI: https://doi.org/10.1007/s12350-010-9235-1

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