Epicardial adipose tissue thickness by echocardiography is a marker for the presence and severity of coronary artery disease

Background and aim: Epicardial. adipose tissue (EAT), which is thought to be a component of visceral. adiposity, is associated with the metabolic syndrome. We aimed to test the hypothesis that echocardiographic EAT thickness can be a marker for the presence and severity of coronary artery disease (CAD). Method and results: In all, 150 patients (100 patients with CAD and 50 patients with normal coronary arteries by diagnostic coronary angiography; 65 women, 85 men; mean age 55.7 +/- 7.4 years) were enrolled. EAT thickness was measured using 2-D echocardiographic parasternal. long- and short-axis views. EAT thickness measurements were compared with angiographic findings. EAT thickness was significantly higher in patients with CAD in comparison to those with normal. coronary arteries (6.9 +/- 1.5 mm vs. 4.4 +/- 0.8 mm; P < 0.001). Furthermore, EAT thickness increased with the severity of CAD (multivessel disease 7.4 +/- 1.2 mm vs. single vessel disease 5.7 +/- 1.7 mm; P < 0.001). Gensini's score significantly correlated with EAT thickness (r = 0.600, P < 0.001). EAT thickness of >= 5.2 mm had 85% sensitivity and 81% specificity (ROC area 0.914, P < 0.001, 95% Cl [0.86-0.96]) for predicting CAD. Conclusion: EAT thickness, which is easily and non-invasively evaluated by transthoracic echocardiography, can be an adjunctive marker to classical risk factors for the prediction of CAD. (C) 2008 Elsevier B.V. All rights reserved.