Evaluation of the Relationship between Presternal Fatty Tissue Thickness, Epicardial Fatty Tissue Volume, and Coronary Artery Disease.

Abstract

Introduction: This cross-sectional study aimed to evaluate the relationship between presternal adipose tissue thickness and the pericardial adipose tissue volume in relation to coronary artery disease.

Methods: A total of 108 patients who underwent coronary computed tomography angiography (CCTA) for suspected coronary disease between 2019 and 2022 were evaluated. Patients whose epicardial adipose tissue could not be optimally measured due to imaging artifacts, those with a pre-existing coronary artery anomaly or known heart disease, individuals under 18 years of age, and those who had undergone sternotomy and bypass surgery were excluded from the study. Accordingly, 95 patients (61 males and 34 females) who met the inclusion criteria and did not meet any of the exclusion criteria were included in the study. CCTA images were analyzed retrospectively. Pericardial adipose tissue volume was measured automatically using Syngo Via software. Presternal fat thickness (PFTT) was measured at the level of the pulmonary artery bifurcation, from the anterior to the posterior surface.

Results: The study sample comprised 64.2% males and 35.7% females. The median thickness of the presternal fat tissue was found to be 11.5 mm, with a range of 3 to 44 mm. The median PFTT was measured at 9 mm (3-23 mm) in the male patient group, while in the female patient group, it was 20 mm (10-44 mm). The median epicardial fat volume (EFV) for the full sample was 83.1 ml (22.3-171 ml), measuring 81.1 ml (37-171 ml) and 79.5 ml (22.3-167 ml) in males and females, respectively. A significant correlation was observed between PFTT and EFV in the full sample (Rho = 0.236, p = 0.02), as well as among male patients (Rho = 0.409, p = 0.001), but not in the female patient group (Rho = 0.264, p = 0.131). In the male cohort, there was no significant difference between EFV and PFTT, and the presence of coronary plaque.

Discussion: This study examines the relationship between presternal adipose tissue thickness (PFTT) and coronary heart disease (CHD), building on previous evidence that links epicardial adipose tissue (EAT) to cardiovascular risk. We found a significant correlation between PFTT and epicardial fat volume (EFV) in male patients, but not in females, which is likely due to hormonal influences and variability in breast tissue. Importantly, measurement of PFTT provides a practical, non-invasive method for assessing CAD risk in clinical settings. Although our small sample size limits the generalisability of our findings, these results suggest that PFTT may serve as an indirect marker of CAD risk and highlight the need for further research with larger cohorts to validate its clinical relevance. Incorporating PFTT assessment into routine practice may improve the early identification of high-risk patients and enhance strategies for preventing ischemic heart disease.

Conclusion: The study reveals that increased presternal fat thickness correlates with elevated epicardial fat volume, indicating that presternal fat measurements could serve as a simple and effective tool for assessing the risk of coronary artery disease, particularly in male patients.