Correlation between epicardial fat volume as detected by echocrdiography and multidetector computed tomography with the extent and severity of coronary atherosclerosis

Background
Epicardial fat is a visceral deposition of fat. It causes local inflammation and affects coronary artery disease (CAD), so it has been considered a risk factor for cardiovascular disease.


Aim
To study the relationship between epicedial fat, as measured by multidetector computed tomography and transthoracic echocardiography, and the severity of CAD using invasive coronary angiography (ICA).


Patients and methods
This is an observational study that included 100 patients with suspected CAD presented to the Department of Cardiology in Kopry Elkoppa Hospital from September 2015 to December 2017. Epicardial fat thickness (EFT) was measured by transthoracic echocardiography, and epicardial fat volume (EFV) was measured by multidetector computed tomography, and ICA was done.


Results
The studied population was divided into two groups: group A (86 patients) with significant CAD and group B (14 patients) without significant CAD. We divided group A according to the number of vessel affected by ICA into group I (single-vessel or two-vessel disease) and group II (multivessel disease). EFT and EFV were significantly increased in group II compared with group I. EFT and EFV were positively correlated with age, weight, family history of ischemic heart disease, and high Ca score more than or equal to 400. Cutoff value of EFV in predicting multivessel disease was more than or equal to 55 ml, and EFT was more than or equal to 6.5 mm. By multivariate analysis, the EFV is considered an independent risk factor for CAD.


Conclusion
EFT and EFV are sig. higher in patients with multivessel disease. Epicardial fat is an indicator and also a predictor of CAD severity and multivessel disease occurrence.