Association between epicardial and pericadial fat thickness and coronary artery calcification severity in chronic kidney disease patients: A pilot study.

Background: This study aims to investigate the association between Coronary Artery Calcium (CAC) score and epicardial fat thickness (EFT) and pericardial fat thickness as indicators of inflammation in patients with chronic kidney disease (CKD).

Methods: This cross-sectional study measured patients' CAC scores using dual-source cardiac CT, quantified with Agatston's score and dedicated Ca-Scoring software. Epicardial and pericardial fat thicknesses were assessed via echocardiography.

Results: Thirty-one CKD patients participated in the study, with an average age of 54.45 ± 15.12 years. Of these, 22 were male (70.97%) and 9 were female (29.03%). Fifteen CKD patients (48.39%) had moderate to severe CAC scores. Patients with CKD exhibiting severe coronary calcification were found to be older (P = 0.003). A significant positive correlation was observed between epicardial fat thickness (r = 0.58, P < 0.001) and pericardial fat thickness (r = 0.56, P = 0.001) with CAC score. Multivariable analysis revealed that for each one-unit increase in EFT, the odds of having a moderate to severe CAC score were 2.88 times greater than those of a normal score (OR = 2.88, 95% CI = 1.04-7.96, P = 0.041). Similarly, a one-unit increase in pericardial fat thickness was associated with 1.51 times higher odds of a moderate to severe CAC score compared to a normal score (OR = 1.51, 95% CI = 0.93-2.46, P = 0.093).

Conclusion: The insights gained from this study advocate for a holistic approach to assessing cardiac function in patients with coronary calcification. By integrating echocardiographic analysis with traditional risk factor assessment, healthcare providers can gain a more comprehensive understanding of cardiovascular health, ultimately leading to better-targeted therapies to improve CKD patient outcomes.