Epicardial adipose tissue thickness by echocardiography is a marker for the presence and severity of coronary artery disease
Introduction
Visceral adiposity is fat deposition around internal organs. It is metabolically active and is an important risk factor for developing the metabolic syndrome (MS) [1], [2], [3], [4]. Epicardial adipose tissue (EAT) is a component of visceral adiposity and mediates cardiac function and atherosclerosis via expression of several bioactive molecules [5], [6]. Transthoracic echocardiography enables non-invasive assessment of EAT [4], [7]. Several studies have addressed the association between EAT thickness and the severity of coronary artery disease (CAD) with conflicting results [8], [9], [10]. Thus, we aimed to test the hypothesis that echocardiographic EAT thickness could be a marker for the presence and severity of CAD.
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Methods
Patients who underwent coronary angiography due to chest pain and/or an abnormal stress test were enrolled. One hundred patients with CAD and 50 patients with normal coronary arteries were consecutively studied. The study complies with the declaration of Helsinki. All participants gave informed consent, and the Institutional Review Board of the University of Baskent approved the research protocol. Patients were excluded if they had abnormal images on transthoracic echocardiography, a history of
Results
There were 65 women and 85 men in the study population. The mean age was 55.7 ± 7.4 years. The demographic and laboratory characteristics of the study groups are presented in Table 1.
Discussion
This study shows an association between EAT thickness and the presence and severity of CAD. EAT thickness emerged as an independent predictor of CAD among other well-known risk factors. Two potential mechanisms for this association have been proposed: First, EAT is a component of visceral adiposity and is related to MS and cardiovascular risk factors [1], [2], [3], [4]; secondly, EAT has paracrine and endocrine functions. It can secrete numerous bioactive molecules (adipokines) such as
Acknowledgements
The authors wish to thank Mrs. Vahide Simsek in the echocardiography laboratory for her devoted co-operation and the nutritionists for their measurements of total fat ratios.
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