Correlation Between Severity Of Coronary Artery Stenosis And Epicardial Adipose Tissue Thickness From320-slice Dynamic Volume MDCT

Objective:1、 A retrospective analysis of coronary atherosclerosis severity of129patients was detected by320-row-640-slice dynamic volume MDCT scans，compared the difference of that detectedby coronary angiography. The sensitivity and specificity of320-row-640-slice dynamicvolume MDCT used to assess coronary atherosclerosis severity was calculated, and itsclinical value was evaluated。2、 A retrospective analysis of epicardial adipose tissue thickness of129cases was detected by320-row-640-slice dynamic volume CT scans. its relationship with coronary artery stenosiswas analyzed, And if it was an independent factor of coronary atherosclerotic heart diseasewas determined.Methods:1Clinical data：129hospitalized patients underwent320-row-640-slice dynamic volume CTscan and coronary angiography with complete clinic information from January2013toDecember2013in our hospital.2The detection of coronary atherosclerosis: Using Toshiba Aqilion One320-row-640-slicedynamic volume MDCT scanning and Vitrea workstation for image post-processing,according to severity of coronary artery stenosis:0score for normal;1score for mildcoronary stenosis (<50%);2scores for moderate coronary stenosis (50-75%);3score forsevere stenosis (>75%). We calculated the sensitivity and specificity of320-row-640-slicedynamic volume CT in the diagnosis of coronary artery stenosis，and analyzed thecorrelation of the two methods diagnosed the degree of coronary atherosclerosis3Determination of epicardial adipose tissue thickness：Three measurements of the rightventricular anterior free wall were made: at the25%,50%, and75%levels of the RV wall,from the visceral epicardium to the outside of the myocardium, and perpendicular to thesurface of the heart. The mean of the3measurements was used for analysis. Continuousdata were expressed the average of RV free-wall EAT thickness and Right AVG EATthickness. 4Patients were divided into three groups according to Gensini score:＜20for the low-riskgroup,20-40for the medium risk group,＞40for the high-risk group. Analyzed thedifference of epicardial fat thickness between groups, and further analyzed the correlationbetween epicardial fat thickness and Gensini score.5Patients were divided into three groups according to Body Mass Index. underweight: BMI<18.5kg.m-2;Normal:18.5<BMI <23.9kg.m-2; Obesity: BMI≥24kg.m-2, Analyzed thedifference of epicardial fat thickness between groups, and further analyzed correlationbetween epicardial fat thickness and BMI.6Whether epicardial fat thickness was an independent factor of Gensini score of coronarystenosis was determined by multivariate linear regression analysis.Results:1、 The result of coronary images of320-row-640-slice dynamic volume MDCT fordiagnostic accuracy of coronary artery stenosis was as followings:①In normal coronary angiography group, CT coronary imaging for dianosis of coronaryartery stenosis was with a sensitivity of80.7%and a specificity of90.6%. In mildstenosis group by coronary angiography, CT coronary imaging for detection of coronaryartery stenosis was with a sensitivity of57.1%and a specificity of90.3%; while coronaryangiography was moderate stenosis, CT imaging for detectction of coronary arterydisease was with a sensitivity of57.8%and a specificity of90.3%; when in severestenosis group, CT imaging for detectection coronary artery lesions was with a sensitivityof78.2%and a specificity of95.8%.②320-row-640-slice dynamic volume MDCT predict coronary heart disease with highsensitivity (82.5%) and specificity (90.0%).③320-row-640-slice dynamic volume MDCT and coronary angiography has a goodconsistency (kappa=0.621).2、 According to the Gensini score:in the high-risk group, epicardial fat thickness in rightventricular free wall and right atrioventricular groove was5.97±1.39mm and20.6±4.10mm, respectively; in the medium-risk group, it was5.01±1.25mm,15.2±3.28mmrespectively; In low-risk group, it was4.64±0.95mm,14.6±2.72mm respectively. EAT andAVG EAT in high-risk patients was significantly higher than in low-risk (P＜0.001) and medium–risk group(P＜0.001) There was no significant difference between low-risk andintermediate-risk group （P1=0.326P2=0.81）.3、 Epicardial fat thickness in right ventricular free wall was positively correlated withcoronary stenosis Gensini score(r=0.493，P＜0.001). RV free-wall EAT thickness waspositively correlated with coronary stenosis Gensini score (r=0.701, P <0.001).4、 According to BMI criteria: in the obesity groups,right ventricular free wall and rightatrioventricular groove epicardial fat thickness were5.66±1.39mm、19.1±3.94mm;Normalgroup were4.85±1.17mm、15.0±3.65mm; the slim group were4.52±0.81mm、13.3±2.36mm.EAT and AVG EAT in obesity group are significant higher than normal group（P1=0.015P2＜0.001）, obesity group significant higher than the slim group(P＜0.001),normal group and the slim group had no significant difference（P1=0.707P2=0.233）.5、 Right ventricular free wall epicardial fat thickness was positively correlated with BMI (r=0.470, P <0.001), right atrioventricular groove fat thickness is positively correlated with BMI(r=0.599, P <0.00).6、 Multiple linear regression analysis showed that the right atrioventricular groove epicardialfat thickness (B=4.471P <0.001), serum LDL-C levels (B=4.761P=0.005) were bothindependent predictors of Gensini score.Conclusion:1、320-row-640-slice dynamic volume MDCT predicted the severity of coronary stenosis with ahigh sensitivity and specificity.2、The thicker the patients’ epicardial fat thickness, the more severe their coronaryatherosclerosis stenois.3、The higher the patients’ BMI，the thicker their epicardial fat thickness.4、Epicardial adipose tissue thickness was a risk factor of coronary atherosclerosis.