The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Association of epicardial adipose tissue with metabolic risk factors on cardiovascular outcomes: serial coronary computed tomography angiography study

  • Sungjoon Park (Department of Internal Medicine, Seoul National University Hospital) ;
  • Dong Eun Kim (Seoul National University College of Medicine) ;
  • Su Min Kim (Seoul National University College of Medicine) ;
  • JungMin Choi (Department of Internal Medicine, Seoul National University Hospital) ;
  • Sang Joon Park (Research and Science Division, Research and Development Center, MEDICALIP Co. Ltd.) ;
  • Hae-Young Lee (Department of Internal Medicine, Seoul National University Hospital) ;
  • Eun Ju Chun (Division of Radiology, Seoul National University Bundang Hospital)
  • Received : 2023.09.18
  • Accepted : 2023.11.29
  • Published : 2024.03.01
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Abstract

Background/Aims: Epicardial adipose tissue (EAT) shares pathophysiological properties with other visceral fats and potentially triggers local inflammation. However, the association of EAT with cardiovascular disease (CVD) is still debatable. The study aimed to observe the changes and associations in EAT and risk factors over time, as well as to investigate whether EAT was associated with CVD. Methods: A total of 762 participants from Seoul National University Hospital (SNUH) and SNUH Gangnam Center were included in this study. EAT was measured using coronary computed tomography angiography. Results: Baseline EAT level was positively associated with body mass index (BMI), calcium score, atherosclerotic cardiovascular disease (ASCVD) 10-year risk score, glucose, triglycerides (TG)/high-density lipoprotein (HDL), but not with total cholesterol, low-density lipoprotein (LDL). At follow-up, EAT levels increased in all groups, with low EAT groups demonstrating a significant increase in EAT per year. Change in EAT was associated with a change in BMI, TG/HDL, and glucose, while changes in LDL, calcium score, and ASCVD 10-year risk score were not associated. Although calcium score and ASCVD 10-year risk score were associated with CVD events, baseline information of EAT, baseline EAT/body surface area, or EAT change was not available. Conclusions: Metabolic risks, e.g., BMI, TG/HDL, and glucose, were associated with EAT change per year, whereas classical CVD risks, e.g., LDL, calcium score, and ASCVD 10-year risk score, were not. The actual CVD event was not associated with EAT volume, warranting future studies combining qualitative assessments with quantitative ones.

Keywords

Acknowledgement

We thank Soo Yeon Shin and Kyung Min Jung for their technical assistance in the radiological assessment of EAT.

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