Correlation between epicardial adipose tissue thickness and the degree of coronary artery atherosclerosis

Background/aim: The purpose of the current study was to evaluate the thickness of the epicardial adipose tissue and its association withthe degree of coronary artery disease in a group of autopsied cases.Materials and methods: A number of 79 cases were included in the study. Five preestablished incisions of the epicardial adipose tissue(EAT) were made on each of the hearts. These five points were next to/on the path of the major coronary vessels. The degree of coronaryatherosclerosis was evaluated during the autopsy.Results: The results revealed the greatest thickness of the EAT on the incision made on the anterior and posterior wall of the rightventricle. EAT was thicker in cases presenting atherosclerosis degree I or II in two of the coronary arteries, the left circumflex artery andleft main artery; on the left anterior descending artery, higher EAT thickness associated with fourth degree atherosclerosis.Conclusion: Epicardial adipose tissue thickness was greater at the incision points situated on the right side of the heart. Greater EATthickness was associated significantly with early atherosclerosis development in three of the coronary arteries (LCx, LMA, LADA).

PDF

___

Bertaso AG, Bertol D, Duncan BB, Foppa M. Epicardial fat: definition, measurements and systematic review of main outcomes. Arq Bras Cardiol 2013; 101: e18-e28.
Hirata Y, Tabata M, Kurobe H, Motoki T, Akaike M, Nishio C, Higashida M, Mikasa H, Nakaya Y, Takanashi S et al. Coronary atherosclerosis is associated with macrophage polarization in epicardial adipose tissue. J Am Coll Cardiol 2011; 58: 248-255.
Mazurek T, Zhang L, Zalewski A, Mannion JD, Diehl JT, Arafat H, Sarov-Blat L, O’Brien S, Keiper EA, Johnson AG et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circ J 2003; 108: 2460-2466.
Okada K, Ohshima S, Isobe S, Harada K, Hirashiki A, Funahashi H, Arai K, Hayashi D, Hayashi M, Ishii H et al. Epicardial fat volume correlates with severity of coronary artery disease in nonobese patients. J Cardiovasc Med (Hagerstown) 2014; 15: 384-390.
Iacobellis G, Lonn E, Lamy A, Singh N, Sharma AM. Epicardial fat thickness and coronary artery disease correlate independently of obesity. Int J Cardiol 2011; 146: 452-454.
Prabhu MH, Siraj A, Aftab B. Atherosclerosis of coronary arteries – an autopsy study. Glob J Med Research Surg Cardiovasc System 2013; 13: 18-24.
Libby P, Ridker PM, Hansson GK. Inflammation in atherosclerosis: from pathophysiology to practice. J Am Coll Cardiol 2009; 54: 2129-2138.
Verhagen SN, Visseren FL. Perivascular adipose tissue as a cause of atherosclerosis. Atherosclerosis 2011; 214: 3-10.
Alexopoulos N, McLean DS, Janik M, Arepalli CD, Stillman AE, Raggi P. Epicardial adipose tissue and coronary artery plaque characteristics. Atherosclerosis 2010; 210: 150-154.
Nakanishi K, Fukuda S, Tanaka A, Otsuka K, Jissho S, Taguchi H, Yoshikawa J, Shimada K. Persistent epicardial adipose tissue accumulation contributes coronary plaque vulnerability and future acute coronary syndrome in non-obese, coronary artery disease patients. Circ J 2014; 130: A13546.
Mahabadi AA, Lehmann N, Kälsch H, Robens T, Bauer M, Dykun I, Budde T, Moebus S, Jöckel KH, Erbel R et al. Association of epicardial adipose tissue with progression of coronary artery calcification is more pronounced in the early phase of atherosclerosis. JACC Cardiovasc Imaging 2014; 7: 909-916.
Sequeira DI, Ebert LC, Flach PM, Ruder TD, Thali MJ, Ampanozi G. The correlation of epicardial adipose tissue and postmortem CT with coronary artery stenosis as determined by autopsy. Forensic Sci Med Pathol 2015; 11: 186-192.
Rosito GA, Massaro JM, Hoffmann U, Ruberg FL, Mahabadi AA, Vasan RS, O’Donnell CJ, Fox CS. Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcification in a community-based sample: the Framingham Heart Study. Circ J 2008; 117: 605-613.
Taguchi R, Takasu J, Itani Y, Yamamoto R, Yokoyama K, Watanabe S, Masuda Y. Pericardial fat accumulation in men as a risk factor for coronary artery disease. Atherosclerosis 2001; 157: 203-209.
Thanassoulis G, Massaro JM, O’Donnel CJ, Hoffmann U, Levy D, Ellinor PT, Wang TJ, Schnabel RB, Vasan RS, Fox CS et al. Pericardial fat is associated with prevalent atrial fibrillation. The Framingham Heart Study. Circ J 2010; 3: 345-350.
Muñoz MJF, Acevedo LB, Pérez NC, Vázquez Martínez AL, Tepach Gutiérrez N, Vega García S, Rocha Cruz A, Díaz Martínez A, Saucedo García R, Zárate Treviño A et al. Epicardial adipose tissue is associated with visceral fat, metabolic syndrome, and insulin resistance in menopausal women. Rev Esp Cardiol 2014; 67: 436-441.
Tonbul HZ, Turkmen K, Kayikcioglu H, Ozbek O, Kayrak M, Biyik Z. Epicardial adipose tissue and coronary artery calcification in diabetic and nondiabetic end-stage renal disease patients. Ren Fail 2011; 33: 770-775.
Jover A, Corbella E, Muñoz A, Millán J, Pintó X, Mangas A, Zúñiga M, Pedro-Botet J, Hernández-Mijares A. Prevalencia del síndromemetabólico y de suscomponentes en pacientes con síndromecoronarioagudo. Rev Esp Cardiol 2011; 64: 579- 586 (in Spanish with an abstract in English).
Eroglu S, Sade LE, Yildirir A, Bal U, Ozbicer S, Ozgul AS, Bozbas H, Aydinalp A, Muderrisoglu H. Epicardial adipose tissue thickness by echocardiography is a marker for the presence and severity of coronary artery disease. Nutr Metab Cardiovas 2009; 19: 211-217.
López-Jiménez F, Cortés-Bergoderi M. Update: systemic diseases and the cardiovascular system (i): obesity and the heart. Rev Esp Cardiol 2011; 64: 140-149.