Epicardial adipose tissue differentiates in patients with and without coronary microvascular dysfunction

Area of Science:

• Cardiology
• Vascular Biology
• Inflammation Research

Background:

• Coronary microvascular dysfunction (CMD) presents symptoms similar to obstructive coronary artery disease and has significant prognostic implications.
• Local inflammation is a suspected contributor to CMD development.
• Epicardial adipose tissue (EAT), a visceral fat depot around the heart, influences the cardiac inflammatory environment.

Purpose of the Study:

• To compare epicardial adipose tissue (EAT) characteristics in patients with and without coronary microvascular dysfunction (CMD).
• To investigate the association between EAT index and the presence of CMD.

Main Methods:

• Retrospective analysis of 399 patients undergoing coronary angiography and echocardiography.
• Measurement of EAT thickness and calculation of EAT index (EAT thickness/body surface area).
• Logistic regression analysis to determine the association between EAT index and CMD.

Main Results:

• Patients with CMD exhibited significantly higher EAT thickness compared to those without CMD.
• A higher EAT index was associated with a 30% increased frequency of CMD in univariate analysis.
• This association remained significant after adjusting for BMI and was particularly pronounced in patients over 65 years old.

Conclusions:

• Epicardial adipose tissue (EAT) thickness is independently associated with CMD.
• EAT can help differentiate between patients with and without CMD, especially in older populations.
• These findings support the role of epicardial fat in modulating local inflammation and contributing to CMD development.