TY - JOUR
T1 - Relationship between epicardial adipose tissue and coronary artery stenoses on computed tomography in patients scheduled for carotid artery revascularization
AU - Sato, Yoshihiro
AU - Kawai, Hideki
AU - Hoshino, Meiko
AU - Matsumoto, Shoji
AU - Hayakawa, Motoharu
AU - Sadato, Akiyo
AU - Sarai, Masayoshi
AU - Motoyama, Sadako
AU - Takahashi, Hiroshi
AU - Naruse, Hiroyuki
AU - Ishii, Junnichi
AU - Toyama, Hiroshi
AU - Ozaki, Yukio
AU - Nakahara, Ichiro
AU - Hirose, Yuichi
AU - Izawa, Hideo
N1 - Publisher Copyright:
© 2021
PY - 2022/5
Y1 - 2022/5
N2 - Background: We aimed to clarify the relationship between epicardial adipose tissue (EAT) volume and the presence of severe stenoses (SS) on coronary computed tomography angiography (CTA) for risk stratification of the patients with carotid artery stenoses. Methods: We prospectively performed CTA for 125 consecutive patients (72.4 ± 8.1 years, 85% men) without a history of coronary artery disease (CAD), who were scheduled for carotid artery revascularization from 2014 to 2020. SS was defined as ≥70% luminal stenosis on CTA. EAT was quantified automatically as the total volume of tissue with -190 to -30 HU. Results: Of 125 patients, 76 had SS. Between the patients with and without SS, there were significant differences in coronary artery calcium score (CACS), left ventricular ejection fraction (LVEF), dyslipidemia, and EAT, despite no differences in carotid echocardiography findings. After adjustment for age, gender, and dyslipidemia, EAT was an independent factor associated with SS (p=0.011), as well as CACS and LVEF. The addition of EAT to a baseline model including age, gender, dyslipidemia, LVEF, and CACS achieved both net reclassification improvement (0.505, p=0.003) and integrated discrimination improvement (0.059, p=0.003). Conclusions: In patients with carotid stenoses, EAT is associated with CAD and is useful for additional risk stratification. Epicardial fat may have a specific role in the development of CAD in patients with suspected systemic atherosclerosis.
AB - Background: We aimed to clarify the relationship between epicardial adipose tissue (EAT) volume and the presence of severe stenoses (SS) on coronary computed tomography angiography (CTA) for risk stratification of the patients with carotid artery stenoses. Methods: We prospectively performed CTA for 125 consecutive patients (72.4 ± 8.1 years, 85% men) without a history of coronary artery disease (CAD), who were scheduled for carotid artery revascularization from 2014 to 2020. SS was defined as ≥70% luminal stenosis on CTA. EAT was quantified automatically as the total volume of tissue with -190 to -30 HU. Results: Of 125 patients, 76 had SS. Between the patients with and without SS, there were significant differences in coronary artery calcium score (CACS), left ventricular ejection fraction (LVEF), dyslipidemia, and EAT, despite no differences in carotid echocardiography findings. After adjustment for age, gender, and dyslipidemia, EAT was an independent factor associated with SS (p=0.011), as well as CACS and LVEF. The addition of EAT to a baseline model including age, gender, dyslipidemia, LVEF, and CACS achieved both net reclassification improvement (0.505, p=0.003) and integrated discrimination improvement (0.059, p=0.003). Conclusions: In patients with carotid stenoses, EAT is associated with CAD and is useful for additional risk stratification. Epicardial fat may have a specific role in the development of CAD in patients with suspected systemic atherosclerosis.
KW - Carotid artery disease
KW - Coronary computed tomography
KW - Epicardial adipose tissue
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U2 - 10.1016/j.jjcc.2021.12.008
DO - 10.1016/j.jjcc.2021.12.008
M3 - Article
C2 - 34974941
AN - SCOPUS:85122037945
SN - 0914-5087
VL - 79
SP - 588
EP - 595
JO - Journal of cardiology
JF - Journal of cardiology
IS - 5
ER -