Quantification of epicardial and peri-coronary fat using cardiac computed tomography; reproducibility and relation with obesity and metabolic syndrome in patients suspected of coronary artery disease

Objective Adipose tissue surrounding coronary arteries may contribute to the development of coronary atherosclerosis given its localisation and potential for local production of inflammatory cytokines. We compared various measurements for quantifying epicardial adipose tissue (EAT) and peri-coronary fat using cardiac CT. Additionally, we estimated their relationship with obesity and metabolic syndrome in patients suspected of coronary artery disease (CAD). Methods EAT and peri-coronary fat measurements were performed on cardiac multi-slice CT scans in 60 patients (aged 50–70 years) referred for coronary angiography. EAT was measured as thickness on the right ventricular free wall, as area at the base of the ventricles, and as volume. Peri-coronary fat was assessed as thickness and cross-sectional area surrounding the three main coronary arteries. Linear regression analysis was used to assess the relation of EAT and peri-coronary fat with obesity and metabolic syndrome (ATPIII criteria). Results Volumetric EAT measurements showed good reproducibility with low coefficients of variation (CVs) varying between 3.0% and 5.0%. Measurements of EAT and peri-coronary fat thickness and area were moderately reproducible (CVs 11.0–23.4%). The amount of EAT and peri-coronary fat (per standard deviation) was related with obesity (BMI ≥30 kg/m2) (β 1.24; 95% CI 0.66; 1.81) and metabolic syndrome (β 0.81; 95% CI 0.28; 1.33). Conclusions Volumetric quantification of EAT using cardiac CT is highly reproducible compared to more simple measurements as EAT and peri-coronary fat thickness and area. The quantity of EAT and peri-coronary fat is related with the presence of obesity and metabolic syndrome in patients suspected of CAD.