ABSTRACT
Background: Distribution of body fat is known to be more independent and potent predictor of morbidity and
mortality than total body adipocity. Each visceral fat storage is anatomically and functionally different and according
to its closeness to an organ, it exerts a specific local function for each one. Epicardial adipose tissue (EAT) as a fat
depot is further implicated on coronary artery disease (CAD) because of proximity to the adventitia of major epicardial
coronary arteries. Epicardial fat volume (EFV) can be evaluated by MSCT even without contrast injection which helps
in prediction of the presence and the severity of CAD.
Objectives: To evaluate the relationship between epicardial fat volume and the severity of coronary artery disease
among patients presented by chest pain with low to intermediate pretest probability for CAD using Multi-Slice CT
coronary angiography.
Subjects and methods: The study included 100 patients, 94 males and 6 females with mean age 56.03 ± 10.24 years
who were referred to the MSCT coronary angiography unit in Zagazig University Hospital and Kobri Elkobba Military
Hospital during the period from January 2017 to August 2017. All patients were subjected to through history taking
including age, sex, family history of CAD, DM, HTN, smoking, complete clinical examination including BMI and
overweight was defined as ≥ 25 kg/m2, standard ECG, analysis of lipid profile, measurement of serum creatinine and
random blood glucose level as well as Multi-slice CT angiography.
Results: There was significant relationship between EFV and Proximal LAD and D1 lesions (p = 0.020) as regarding
segment involvement score (SIS) and segment stenosis score (SSS) by MSCT. Epicardial fat volume (EFV) was
125.34 ± 35.37 cm3 (range from 47.4 to 221.3 cm3 and the median value of EFV in our patients was 123.35 cm3) and
Coronary artery calcium score (CACS) was 157.69 ± 352.95 (range from 0 to 2212 and the median value was 29.55)
with significant relationship between EFV and Ca score (p = 0.009), highly significant relationship between EFV and
SIS score and SSS score (p < 0.001). There was significant relationship between EFV and sex (p = 0.002), highly
significant relationship between EFV and hypertension and diabetes mellitus (p < 0.001), no significant relationship
between EFV and smoking (p = 0.754) and family history of ischemic heart disease (p = 0.082), significant
relationship between EFV and age (p = 0.011), highly significant relationship between EFV and serum cholesterol,
LDL, serum triglycerides, LDL/HDL ratio, BMI and inversely proportional to HDL (p < 0.001).
Conclusion: we concluded in our study that EFV was associated with coronary atherosclerosis and EFV increased
steeply in patients with significant coronary artery stenosis and in those with severe coronary artery calcification as
revealed by MSCT angiography. Quantitation of EFV may be useful in addition to coronary artery calcium score as a
predictor to identify patients at risk for CAD.