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Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Coronary Artery Disease II: Pathophysiology01:26

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Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
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Coronary Artery Disease I: Introduction01:30

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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Related Experiment Video

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Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
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Relationship Between Epicardial Fat Volume and Coronary Microvascular Dysfunction.

Tsuyoshi Ito1, Atsushi Niwa1, Masashi Yokoi1

  • 1Department of Cardiology, Nagoya City University Graduate School of Medical Sciences Nagoya Japan.

Circulation Reports
|August 11, 2025
PubMed
Summary

Epicardial fat volume (EFV) is linked to coronary microvascular dysfunction (CMD) in individuals without obstructive coronary artery disease (CAD). This finding suggests EFV may be a useful indicator for assessing CMD risk in this patient group.

Keywords:
Coronary flow reserveCoronary microvascular dysfunctionEpicardial fat volumeIndex of microcirculatory resistanceIschemia without obstructive coronary artery disease

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Vascular Biology

Background:

  • Coronary microvascular dysfunction (CMD) is a key factor in myocardial ischemia, particularly in patients without obstructive coronary artery disease (CAD).
  • Epicardial fat volume (EFV) has been implicated in epicardial CAD and diastolic dysfunction.
  • The specific relationship between EFV and CMD requires further elucidation.

Purpose of the Study:

  • To investigate the association between epicardial fat volume (EFV) and coronary microvascular dysfunction (CMD).
  • To determine if EFV is an independent predictor of CMD in patients without obstructive CAD.

Main Methods:

  • 103 patients without obstructive CAD were assessed for CMD using coronary flow reserve (CFR) and index of microcirculatory resistance (IMR).
  • Epicardial fat volume (EFV) was quantified via computed tomography, and the EFV index was calculated.
  • Statistical analyses, including logistic regression, were employed to evaluate the relationship between EFV index and CMD.

Main Results:

  • Coronary microvascular dysfunction (CMD) was identified in 33% of the study cohort.
  • Patients with CMD exhibited a significantly larger EFV index compared to those without CMD.
  • The EFV index demonstrated a significant positive correlation with IMR and a negative correlation with CFR, and was independently associated with CMD.

Conclusions:

  • Epicardial fat volume (EFV) is significantly associated with coronary microvascular dysfunction (CMD) in patients lacking obstructive coronary artery disease.
  • EFV may serve as a valuable imaging biomarker for identifying CMD in this population.