Epicardial adipose tissue volume and coronary artery calcium to predict myocardial ischemia on positron emission tomography-computed tomography studies
Abstract
Background There appears to be an association of epicardial adipose tissue (EAT) with coronary artery disease (CAD) and its risk factors. EAT is assumed to influence CAD development by altering vasomotor tone and via toxic paracrine effects. The relationship of EAT to myocardial perfusion has not been studied.Methods Quantification of EAT and CAC was performed on positron emission tomography/computed tomography (PET/CT) studies in 45 subjects (77% intermediate pre-test probability of CAD) with mild-moderate myocardial ischemia (5-14% perfusion defect, n = 23), severe ischemia (≥15% defect, n = 22) and a control group with no ischemia matched for CAD risk factors (n = 52).Results EAT volume showed a better correlation with myocardial ischemia than total CAC (r = .47 vs r = .28, P < .01). EAT volume increased significantly from the control group to subjects with mild-moderate and severe ischemia (96.9, 124.5, and 143.9 cm(3), P < .01 for both ischemia groups vs controls). Total mean CAC was significantly higher in the severe ischemia group (676.3) than in control group (229.4) (P < .01). Multivariable logistic regression analyses showed that EAT volume was, but CAC was not, a significant predictor of ischemia after adjustment for age, sex, body mass index, and each other. EAT volume was a better predictor of ischemia than total CAC [area under the curve (AUC): .764 vs .6291, P = .04]. The combination of EAT + CAC (AUC = .7694) did not improve over EAT volume alone (P = .57).Conclusions In this study, EAT volume assessed by CT was an independent predictor of ischemia on PET, and outperformed CAC score in a CAD naïve population at intermediate pre-test probability of disease.
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EAT may be evaluated on positron emission tomography/CCT to associate anatomical data and functional information.
“To associate anatomical data and functional information, EAT may be evaluated on positron emission tomography/CCT [113].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [113]
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- Authors
- Janik, M., Hartlage, G., Alexopoulos, N., Mirzoyev, Z., McLean, D. S., Arepalli, C. D., Chen, Z., Stillman, A. E., & Raggi, P.
- Affiliations
- Emory University (US)
- Corresponding author
- Raggi, Paolo
- Venue
- Journal of Nuclear Cardiology
- Publisher
- Elsevier BV
- Published
- 2010-10
- Volume
- 17
- Issue
- 5
- Pages
- 841-847
- ISSN
- 1071-3581 (ISSN-L)
- OpenAlex
- W2093766001
- Cited by
- 77
- References
- 25
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 7 · 2020: 3 · 2019: 5 · 2017: 5 · 2016: 5 · 2015: 9 · 2014: 10 · 2013: 9 · 2012: 7
- FWCI
- 4.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Nuclear Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- epicardial adipose tissue, coronary artery calcium, myocardial ischemia, coronary artery disease, myocardial perfusion, PET/CT, EAT volume, ischemia prediction, coronary artery calcification
- MeSH terms
- Adipose Tissue, Adult, Aged, Calcium, Coronary Vessels, Female, Humans, Male, Middle Aged, Pericardium, Risk Factors, Tomography, X-Ray Computed, Myocardial Ischemia, Positron-Emission Tomography
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