Background: The role of epicardial fat in the genesis and progression of coronary atherosclerosis and the clinical utility of epicardial fat volume (EFV) in risk stratifying cardiovascular disease patients continue to gain the attention of health experts and researchers worldwide. Our study aims to investigate on the correlation between EFV and severity of coronary artery disease through measurable parameters such as coronary artery calcium scores (CACS), coronary artery stenosis, and myocardial perfusion abnormalities.
Methods: 152 patients (> 40 years old) who underwent calcium scoring with or without coronary CT angiogram were included. EFVs were semi-automatically generated by Pixel method. CACS were calculated by calcium analysis software. Results of the coronary angiogram and myocardial perfusion scan were obtained. Spearman's correlation was used to determine significant relationship between epicardial fat volume (EFV) and severity of coronary plaque burden, coronary artery stenosis, and myocardial perfusion abnormalities. Multivariate regression analysis was also made.
Results: The mean EFV obtained was 107.80 cc while mean coronary artery calcium score was 507.46. EFV showed significant direct strong correlation with CACS (rho 0.89, p < 0.001) and moderate positive correlation with myocardial perfusion abnormalities (rho 0.53, p 0.01). Weak and insignificant correlation was drawn between EFV and coronary artery stenosis(rho 0.27, p 0.08).
Conclusion: EFV correlates significantly with coronary artery plaque burden and presence of myocardial perfusion abnormalities. Possibility of its utility as a coronary artery disease screening and risk stratification tool can be considered.