Predictive value of epicardial adipose tissue volume for early detection of left ventricular dysfunction in patients suspected of coronary artery disease

AIM

To investigate the relationship between epicardial adipose tissue (EAT) and myocardial strain and the severity of coronary artery disease (CAD), and to evaluate the predictive value of EAT parameters in early left ventricular (LV) diastolic dysfunction.

MATERIALS AND METHODS

One hundred seventy patients with suspected CAD who underwent both coronary computed tomography angiography and echocardiography were enrolled in 2020. LV global strains were calculated using commercial software. Epicardial adipose tissue was defined as adipose tissue between -190 HU and -30 HU in the visceral pericardium from the level of pulmonary artery bifurcation to the apical level. EAT volume and average attenuation values were measured. LV diastolic dysfunction was determined by echocardiography.

RESULTS

The mean age of the participants was 56.65 ± 12.64 years, and 57.65% were male. EAT volume and mean attenuation values were significantly correlated with CAD severity. EAT volume was significantly positively correlated with global longitudinal strain (GLS) (r=0.313, P<0.01), and EAT attenuation values were positively correlated with global circumferential strain and GLS (r=0.236, 0.164, respectively, both P<0.05). Age (β = 0.125, OR = 1.134, P<0.01) and EAT volume (β = 0.019, OR = 1.019, P=0.018) were independent predictors of LV diastolic dysfunction. Age combined with EAT volume improved the diagnostic efficacy of left ventricular diastolic dysfunction.

CONCLUSION

EAT parameters can reflect the severity of CAD. EAT volume is capable of predicting early LV diastolic dysfunction. Compared with GLS, EAT volume may be able to predict LV diastolic dysfunction earlier.