Subepicardial adipose tissue and the presence and severity of coronary artery disease

Background Mechanistic studies suggest that paracrine effects of subepicardial adipose tissue may promote coronary atherosclerosis, but this has not been confirmed in clinical studies. Methods and results Of 180 consecutive patients who underwent echocardiography and coronary angiography within 1 week (mean 2.5 ± 2.0 days), 139 (80 men, 68 ± 13 years) were studied. Subepicardial adipose tissue on the free wall of right ventricle was measured at end-diastole from parasternal long- and short-axis views of three cardiac cycles. Angiograms were analyzed for the presence, extent and severity of coronary artery disease (CAD), using a 27-segment classification. The number of segments with at least 20% (CAGE ≥ 20) and 50% (CAGE ≥ 50) stenosis was recorded. Age showed a significant correlation with subepicardial adipose tissue thickness measured from parasternal long- (r = 0.25, p = 0.003) and short-axis view (r = 0.23, p = 0.01). No significant correlation was found between subepicardial adipose tissue thickness and any angiographic or other clinical variables (p > 0.05). Neither the proportion of patients with significant or any CAD nor the severity score, CAGE ≥ 20, and CAGE ≥ 50 among each of four quartiles was significantly associated with subepicardial adipose tissue thickness. Conclusions In this selected population, the amount of subepicardial adipose tissue thickness was not associated with the severity of CAD. Whether subepicardial adipose tissue has any atherosclerotic effect remains to be proven.