Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 2/2019

01-02-2019 | Cardiac

Is the epicardial adipose tissue area on non-ECG gated low-dose chest CT useful for predicting coronary atherosclerosis in an asymptomatic population considered for lung cancer screening?

Authors: Kyu-Chong Lee, Hwan Seok Yong, Jaewook Lee, Eun-young Kang, Jin Oh Na

Published in: European Radiology | Issue 2/2019

Login to get access

Abstract

Objects

The purpose was to determine whether the epicardial adipose tissue (EAT) area on low-dose chest CT (LDCT) could be used to predict coronary atherosclerosis in an asymptomatic population considered for lung cancer screening.

Methods

Subjects aged 55-80 years with smoking history who underwent both LDCT and coronary CT angiography (CCTA) were retrospectively enrolled. Correlation between the EAT volume in CCTA and EAT area in LDCT was evaluated. Coronary risk factors including the body surface area (BSA) indexed EAT area were compared between coronary plaque negative and positive groups. Significant factors for predicting coronary atherosclerosis were analyzed with logistic regression analysis. Receiver-operating characteristic curve analysis was performed to determine the cutoff value.

Results

A total of 438 subjects were enrolled, including 299 subjects with coronary atherosclerosis. There was a good correlation between the EAT volume in CCTA and EAT area in LDCT (ρ = 0.712, p < 0.001). There were significant differences in age, systolic blood pressure, all BSA indexed EAT area, sex, and hypertension between plaque negative and positive groups. In multivariate logistic regression for the BSA indexed EAT area in LDCT at the RCA level, sex (OR: 11.168, 95% CI: 2.107-59.201, p = 0.005), systolic blood pressure (OR: 1.021, 95% CI: 1.005-1.036, p = 0.009), hypertension (OR: 1.723, 95% CI: 1.103-2.753, p = 0.017), and EAT area (OR: 1.273, 95% CI: 1.154-1.405, p < 0.001) were significant. The area under the curve of the BSA indexed EAT area in LDCT at the RCA level for coronary atherosclerosis was 0.657, and the cut-off value was 7.66 cm2/m2.

Conclusion

The EAT area in LDCT could be used to predict coronary atherosclerosis in an asymptomatic population considered for lung cancer screening.

Key Points

• To quantify EAT, the EAT area in LDCT can be used instead of the EAT volume in CCTA.
• The EAT area measured in LDCT can be used as a predictor of coronary artery disease.
• The extensive CAD group tended to have a greater EAT area than the non-extensive CAD group.
Literature
1.
Sacks HS, Fain JN (2007) Human epicardial adipose tissue: a review. Am Heart J 153:907–917CrossRef
2.
Şengül C, Özveren O (2013) Epicardial adipose tissue: a review of physiology, pathophysiology, and clinical applications. Anadolu Kardiyol Derg 13:261–265
3.
Hatem SN, Sanders P (2014) Epicardial adipose tissue and atrial fibrillation. Cardiovasc Res 102:205–213CrossRef
4.
Rosito GA, Massaro JM, Hoffmann U et al (2008) Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcification in a community-based sample. Circulation 117:605–613CrossRef
5.
Wang T-D, Lee W-J, Shih F-Y et al (2010) Association of epicardial adipose tissue with coronary atherosclerosis is region-specific and independent of conventional risk factors and intra-abdominal adiposity. Atherosclerosis 213:279–287CrossRef
6.
Kim S-H, Chung J-H, Kwon B-J, Song S-W, Choi W-S (2013) The associations of epicardial adipose tissue with coronary artery disease and coronary atherosclerosis. Int Heart J 55:197–203CrossRef
7.
Marwan M, Achenbach S (2013) Quantification of epicardial fat by computed tomography: why, when and how? J Cardiovasc Comput Tomogr 7:3–10CrossRef
8.
Hajsadeghi F, Nabavi V, Bhandari A et al (2014) Increased epicardial adipose tissue is associated with coronary artery disease and major adverse cardiovascular events. Atherosclerosis 237:486–489CrossRef
9.
Saad Z, El-Rawy M, Donkol RH, Boghattas S (2015) Quantification of epicardial fat: Which method can predict significant coronary artery disease? World J Cardiol 7:287CrossRef
10.
Eroglu S, Sade LE, Yildirir A et al (2009) Epicardial adipose tissue thickness by echocardiography is a marker for the presence and severity of coronary artery disease. Nutr Metab Cardiovasc Dis 19:211–217CrossRef
11.
Picard FA, Gueret P, Laissy J-P et al (2014) Epicardial adipose tissue thickness correlates with the presence and severity of angiographic coronary artery disease in stable patients with chest pain. PLoS One 9:e110005CrossRef
12.
Wang T, Liu Q, Liu C et al (2014) Correlation of echocardiographic epicardial fat thickness with severity of coronary artery disease in patients with acute myocardial infarction. Echocardiography 31:1177–1181CrossRef
13.
Sicari R, Sironi AM, Petz R et al (2011) Pericardial rather than epicardial fat is a cardiometabolic risk marker: an MRI vs echo study. J Am Soc Echocardiogr 24:1156–1162CrossRef
14.
Team NLSTR (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 2011:395–409
15.
Moyer VA (2014) Screening for lung cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med 160:330–338
16.
Greenland P, Alpert JS, Beller GA et al (2010) 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance. J Am Coll Cardiol 56:e50–e103CrossRef
17.
Hecht HS, Cronin P, Blaha MJ et al (2017) 2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans: A report of the Society of Cardiovascular Computed Tomography and Society of Thoracic Radiology. J Cardiovasc Comput Tomogr 11:74–84CrossRef
18.
Leber AW, Becker A, Knez A et al (2006) Accuracy of 64-slice computed tomography to classify and quantify plaque volumes in the proximal coronary system: a comparative study using intravascular ultrasound. J Am Coll Cardiol 47:672–677CrossRef
19.
Yong HS, Kim EJ, Seo HS et al (2010) Pericardial fat is more abundant in patients with coronary atherosclerosis and even in the non-obese patients: evaluation with cardiac CT angiography. Int J Card Imaging 26:53–62CrossRef
20.
Habets J, van den Brink RB, Uijlings R et al (2012) Coronary artery assessment by multidetector computed tomography in patients with prosthetic heart valves. Eur Radiol 22:1278–1286CrossRef
21.
Austen WG, Edwards JE, Frye RL et al (1975) A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 51:5–40CrossRef
22.
Hulten E, Bittencourt MS, Singh A et al (2014) Coronary artery disease detected by coronary computed tomographic angiography is associated with intensification of preventive medical therapy and lower low-density lipoprotein cholesterol. Circ Cardiovasc Imaging 7:629–638CrossRef
23.
Lu MT, Park J, Ghemigian K et al (2016) Epicardial and paracardial adipose tissue volume and attenuation–Association with high-risk coronary plaque on computed tomographic angiography in the ROMICAT II trial. Atherosclerosis 251:47–54CrossRef
24.
Mancio J, Pinheiro M, Ferreira W et al (2017) Gender differences in the association of epicardial adipose tissue and coronary artery calcification: EPICHEART study: EAT and coronary calcification by gender. Int J Cardiol 249:419–425CrossRef
25.
Djaberi R, Schuijf JD, van Werkhoven JM, Nucifora G, Jukema JW, Bax JJ (2008) Relation of epicardial adipose tissue to coronary atherosclerosis. Am J Cardiol 102:1602–1607CrossRef
26.
Jang H-C, Lee H-K, Lee H, Cha J-G, Kim Y-S, Cho J-H (2015) Analyzing correlation between epicardial fat area and metabolic syndrome risk factor by using low-dose Lung CT. Pak J Med Sci 31:1207CrossRef
27.
Anderson KM, Wolson P, Odell PM, Kannel WB (1991) An updated coronary risk profile: a statement for health professionals. Circulation 83:356–362CrossRef
28.
Oyama N, Goto D, Ito YM et al (2011) Single-slice epicardial fat area measurement: do we need to measure the total epicardial fat volume? Jpn J Radiol 29:104–109CrossRef
29.
Simon-Yarza I, Viteri-Ramírez G, Saiz-Mendiguren R, Slon-Roblero PJ, Paramo M, Bastarrika G (2012) Feasibility of epicardial adipose tissue quantification in non-ECG-gated low-radiation-dose CT: comparison with prospectively ECG-gated cardiac CT. Acta Radiol 53:536–540CrossRef
30.
Tanami Y, Jinzaki M, Kishi S et al (2015) Lack of association between epicardial fat volume and extent of coronary artery calcification, severity of coronary artery disease, or presence of myocardial perfusion abnormalities in a diverse, symptomatic patient population. Clin Perspect Circ Cardiovasc Imaging 8:e002676
31.
Forouzandeh F, Chang SM, Muhyieddeen K et al (2012) Does quantifying epicardial and intrathoracic fat with noncontrast computed tomography improve risk stratification beyond calcium scoring alone? Circ Cardiovasc Imaging: CIRCIMAGING 976316:112
32.
Khawaja T, Greer C, Thadani SR et al (2015) Increased regional epicardial fat volume associated with reversible myocardial ischemia in patients with suspected coronary artery disease. J Nucl Cardiol 22:325–333CrossRef
Metadata
Title
Is the epicardial adipose tissue area on non-ECG gated low-dose chest CT useful for predicting coronary atherosclerosis in an asymptomatic population considered for lung cancer screening?
Authors
Kyu-Chong Lee
Hwan Seok Yong
Jaewook Lee
Eun-young Kang
Jin Oh Na
Publication date
01-02-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5562-4

Other articles of this Issue 2/2019

European Radiology 2/2019 Go to the issue

Magnetic Resonance

Prospective comparison of diffusion-weighted MRI and dynamic Gd-EOB-DTPA-enhanced MRI for detection and staging of hepatic fibrosis in primary sclerosing cholangitis

Musculoskeletal

Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference

Interventional

Intracardiac cement embolism during percutaneous vertebroplasty: incidence, risk factors and clinical management

Ultrasound

Shear wave elastography for liver fibrosis in chronic hepatitis B: Adapting the cut-offs to alanine aminotransferase levels improves accuracy

Interventional

Patient dose reference levels in surgery: a multicenter study

Interventional

Dose reference levels and clinical determinants in stroke neuroradiology interventions