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Lack of association between epicardial fat volume and extent of coronary artery calcification, severity of coronary artery disease, or presence of myocardial perfusion abnormalities in a diverse, symptomatic patient population: results from the CORE320 multicenter study.
Circ Cardiovasc Imaging. 2015 Mar; 8(3):e002676.CC

Abstract

BACKGROUND

Epicardial fat may play a role in the pathogenesis of coronary artery disease (CAD). We explored the relationship of epicardial fat volume (EFV) with the presence and severity of CAD or myocardial perfusion abnormalities in a diverse, symptomatic patient population.

METHODS AND RESULTS

Patients (n=380) with known or suspected CAD who underwent 320-detector row computed tomographic angiography, nuclear stress perfusion imaging, and clinically driven invasive coronary angiography for the CORE320 international study were included. EFV was defined as adipose tissue within the pericardial borders as assessed by computed tomography using semiautomatic software. We used linear and logistic regression models to assess the relationship of EFV with coronary calcium score, stenosis severity by quantitative coronary angiography, and myocardial perfusion abnormalities by single photon emission computed tomography (SPECT). Median EFV among patients (median age, 62.6 years) was 102 cm(3) (interquartile range: 53). A coronary calcium score of ≥1 was present in 83% of patients. Fifty-nine percent of patients had ≥1 coronary artery stenosis of ≥50% by quantitative coronary angiography, and 49% had abnormal myocardial perfusion results by SPECT. There were no significant associations between EFV and coronary artery calcium scanning, presence severity of ≥50% stenosis by quantitative coronary angiography, or abnormal myocardial perfusion by SPECT.

CONCLUSIONS

In a diverse population of symptomatic patients referred for invasive coronary angiography, we did not find associations of EFV with the presence and severity of CAD or with myocardial perfusion abnormalities. The clinical significance of quantifying EFV remains uncertain but may relate to the pathophysiology of acute coronary events rather than the presence of atherosclerotic disease.

Authors+Show Affiliations

From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.).From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.).From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.).From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.).From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.).From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.).From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.).From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.).From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.).From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.).From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.).From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.).From the Department of Radiology, Keio University, Tokyo, Japan (Y.T., M.J., S.Kuribayashi); Department of Medicine/Cardiology (S.Kishi, A.L.V., J.A.C.L., A.A.-Z.) and Department of Epidemiology, Bloomberg School of Public Health (M.M., C.C.), Johns Hopkins University, Baltimore, MD; Department of Medicine/Cardiology, InCor Heart Institute, Sao Paulo, Brazil (C.E.R.); Department of Radiology, Charité University Hospital, Berlin, Germany (M.D.); Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (M.E.C.). azadeh1@jhmi.edu.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25752899

Citation

Tanami, Yutaka, et al. "Lack of Association Between Epicardial Fat Volume and Extent of Coronary Artery Calcification, Severity of Coronary Artery Disease, or Presence of Myocardial Perfusion Abnormalities in a Diverse, Symptomatic Patient Population: Results From the CORE320 Multicenter Study." Circulation. Cardiovascular Imaging, vol. 8, no. 3, 2015, pp. e002676.
Tanami Y, Jinzaki M, Kishi S, et al. Lack of association between epicardial fat volume and extent of coronary artery calcification, severity of coronary artery disease, or presence of myocardial perfusion abnormalities in a diverse, symptomatic patient population: results from the CORE320 multicenter study. Circ Cardiovasc Imaging. 2015;8(3):e002676.
Tanami, Y., Jinzaki, M., Kishi, S., Matheson, M., Vavere, A. L., Rochitte, C. E., Dewey, M., Chen, M. Y., Clouse, M. E., Cox, C., Kuribayashi, S., Lima, J. A., & Arbab-Zadeh, A. (2015). Lack of association between epicardial fat volume and extent of coronary artery calcification, severity of coronary artery disease, or presence of myocardial perfusion abnormalities in a diverse, symptomatic patient population: results from the CORE320 multicenter study. Circulation. Cardiovascular Imaging, 8(3), e002676. https://doi.org/10.1161/CIRCIMAGING.114.002676
Tanami Y, et al. Lack of Association Between Epicardial Fat Volume and Extent of Coronary Artery Calcification, Severity of Coronary Artery Disease, or Presence of Myocardial Perfusion Abnormalities in a Diverse, Symptomatic Patient Population: Results From the CORE320 Multicenter Study. Circ Cardiovasc Imaging. 2015;8(3):e002676. PubMed PMID: 25752899.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lack of association between epicardial fat volume and extent of coronary artery calcification, severity of coronary artery disease, or presence of myocardial perfusion abnormalities in a diverse, symptomatic patient population: results from the CORE320 multicenter study. AU - Tanami,Yutaka, AU - Jinzaki,Masahiro, AU - Kishi,Satoru, AU - Matheson,Matthew, AU - Vavere,Andrea L, AU - Rochitte,Carlos E, AU - Dewey,Marc, AU - Chen,Marcus Y, AU - Clouse,Melvin E, AU - Cox,Christopher, AU - Kuribayashi,Sachio, AU - Lima,Joao A C, AU - Arbab-Zadeh,Armin, PY - 2015/3/11/entrez PY - 2015/3/11/pubmed PY - 2015/4/10/medline KW - coronary artery disease KW - coronary stenosis KW - myocardial ischemia SP - e002676 EP - e002676 JF - Circulation. Cardiovascular imaging JO - Circ Cardiovasc Imaging VL - 8 IS - 3 N2 - BACKGROUND: Epicardial fat may play a role in the pathogenesis of coronary artery disease (CAD). We explored the relationship of epicardial fat volume (EFV) with the presence and severity of CAD or myocardial perfusion abnormalities in a diverse, symptomatic patient population. METHODS AND RESULTS: Patients (n=380) with known or suspected CAD who underwent 320-detector row computed tomographic angiography, nuclear stress perfusion imaging, and clinically driven invasive coronary angiography for the CORE320 international study were included. EFV was defined as adipose tissue within the pericardial borders as assessed by computed tomography using semiautomatic software. We used linear and logistic regression models to assess the relationship of EFV with coronary calcium score, stenosis severity by quantitative coronary angiography, and myocardial perfusion abnormalities by single photon emission computed tomography (SPECT). Median EFV among patients (median age, 62.6 years) was 102 cm(3) (interquartile range: 53). A coronary calcium score of ≥1 was present in 83% of patients. Fifty-nine percent of patients had ≥1 coronary artery stenosis of ≥50% by quantitative coronary angiography, and 49% had abnormal myocardial perfusion results by SPECT. There were no significant associations between EFV and coronary artery calcium scanning, presence severity of ≥50% stenosis by quantitative coronary angiography, or abnormal myocardial perfusion by SPECT. CONCLUSIONS: In a diverse population of symptomatic patients referred for invasive coronary angiography, we did not find associations of EFV with the presence and severity of CAD or with myocardial perfusion abnormalities. The clinical significance of quantifying EFV remains uncertain but may relate to the pathophysiology of acute coronary events rather than the presence of atherosclerotic disease. SN - 1942-0080 UR - https://www.unboundmedicine.com/medline/citation/25752899/Lack_of_association_between_epicardial_fat_volume_and_extent_of_coronary_artery_calcification_severity_of_coronary_artery_disease_or_presence_of_myocardial_perfusion_abnormalities_in_a_diverse_symptomatic_patient_population:_results_from_the_CORE320_multicenter_study_ DB - PRIME DP - Unbound Medicine ER -