open access

Vol 76, No 6 (2018)
Original articles
Published online: 2018-02-02
Submitted: 2017-07-23
Accepted: 2018-02-01
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Clinical usefulness of epicardial adipose tissue in patients with high-intermediate pre-test probability for coronary artery disease

Regayip Zehir, Ahmet Güner, Mert Ilker Hayiroglu, Tugba Kemaloğlu Oz, Altug Osken, Huseyin Aksu, Sennur Unal Dayi, Gultekin Faik Hobikoğlu
DOI: 10.5603/KP.a2018.0054
·
Kardiol Pol 2018;76(6):1002-1008.

open access

Vol 76, No 6 (2018)
Original articles
Published online: 2018-02-02
Submitted: 2017-07-23
Accepted: 2018-02-01

Abstract

Background: Epicardial adipose tissue (EAT) is thought to be associated with the extension and severity of coronary artery disease (CAD), and echocardiographic measurement of EAT thickness is considered to be a possible cardiovascular risk indica­tor. The European Society of Cardiology Task Force recommends further non-invasive testing in patients with an intermediate pre-test probability (PTP) for the diagnosis of CAD.

Aim: We sought to evaluate the clinical usefulness of performing EAT measurements in patients with a high-intermediate PTP.

Methods: Patients referred to an outpatient clinic with stable chest pain symptoms, with PTP for CAD between 66% and 85%, were included in the study. Echocardiographic measurement of the EAT was identified as the echo-free space between the outer wall of the myocardium and the visceral layer of the pericardium. Single-photon emission computed tomography (SPECT) was performed in all patients. The diagnosis of CAD was based on the presence of reversible perfusion defects on SPECT.

Results: A total of 126 patients (76 men, 60.3%) with a mean age of 65.3 ± 9.1 years were recruited. The EAT thickness was 7.3 ± 0.7 mm in patients with positive SPECT and 6.2 ± 0.6 mm in patients with negative SPECT (p < 0.001). Multivariable analysis revealed higher rates of positive SPECT in patients with higher EAT (odds ratio [OR] 9.80; 95% confidence interval [CI] 3.72–25.79; p < 0.001), and receiver operating characteristic curve analysis showed that the greatest specificity was obtained when the cut-off value of EAT thickness was 6.75 mm (sensitivity 76%; specificity 74%).

Conclusions: In patients with high-intermediate PTP, EAT is a useful measurement that may assist in risk stratification.

Abstract

Background: Epicardial adipose tissue (EAT) is thought to be associated with the extension and severity of coronary artery disease (CAD), and echocardiographic measurement of EAT thickness is considered to be a possible cardiovascular risk indica­tor. The European Society of Cardiology Task Force recommends further non-invasive testing in patients with an intermediate pre-test probability (PTP) for the diagnosis of CAD.

Aim: We sought to evaluate the clinical usefulness of performing EAT measurements in patients with a high-intermediate PTP.

Methods: Patients referred to an outpatient clinic with stable chest pain symptoms, with PTP for CAD between 66% and 85%, were included in the study. Echocardiographic measurement of the EAT was identified as the echo-free space between the outer wall of the myocardium and the visceral layer of the pericardium. Single-photon emission computed tomography (SPECT) was performed in all patients. The diagnosis of CAD was based on the presence of reversible perfusion defects on SPECT.

Results: A total of 126 patients (76 men, 60.3%) with a mean age of 65.3 ± 9.1 years were recruited. The EAT thickness was 7.3 ± 0.7 mm in patients with positive SPECT and 6.2 ± 0.6 mm in patients with negative SPECT (p < 0.001). Multivariable analysis revealed higher rates of positive SPECT in patients with higher EAT (odds ratio [OR] 9.80; 95% confidence interval [CI] 3.72–25.79; p < 0.001), and receiver operating characteristic curve analysis showed that the greatest specificity was obtained when the cut-off value of EAT thickness was 6.75 mm (sensitivity 76%; specificity 74%).

Conclusions: In patients with high-intermediate PTP, EAT is a useful measurement that may assist in risk stratification.

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Keywords

echocardiography, epicardial adipose tissue, pre-test probability, single-photon emission computed tomography

About this article
Title

Clinical usefulness of epicardial adipose tissue in patients with high-intermediate pre-test probability for coronary artery disease

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 76, No 6 (2018)

Pages

1002-1008

Published online

2018-02-02

DOI

10.5603/KP.a2018.0054

Bibliographic record

Kardiol Pol 2018;76(6):1002-1008.

Keywords

echocardiography
epicardial adipose tissue
pre-test probability
single-photon emission computed tomography

Authors

Regayip Zehir
Ahmet Güner
Mert Ilker Hayiroglu
Tugba Kemaloğlu Oz
Altug Osken
Huseyin Aksu
Sennur Unal Dayi
Gultekin Faik Hobikoğlu

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