Epicardial adipose tissue thickness assessed by cardiac magnetic resonance is an independent indicator for coronary artery stenosis in asymptomatic type 2 diabetic patients

Background

We investigated the association between epicardial adipose tissue (EAT) thickness and myocardial ischemia as well as coronary artery stenosis assessed by cardiovascular magnetic resonance (CMR) in asymptomatic type 2 diabetic patients.

Methods

A total of 100 type 2 diabetic subjects (51 men and 49 women; mean age: 56.4 ± 7.6 years) were enrolled. Silent myocardial ischemia by CMR was defined as an evidence of inducible ischemia or myocardial infarction and signal reduction or stenosis of ≥ 50% in the vessel diameter were used as the criteria for significant coronary artery stenosis on coronary MR angiography.

Results

EAT thickness was positively correlated with BMI, waist-to-hip ratio, systolic blood pressure, postprandial glucose, fasting/postprandial triglyceride, HbA1c level, and HOMA-IR. A total of 24 patients had significant coronary artery stenosis and 14 patients had silent myocardia ischemia in CMR (3 with silent myocardial infarction, 13 with inducible ischemia, 2 with both). EAT thickness was higher in patients who had significant stenosis; however, it was not different between the subjects with silent myocardial ischemia and the subjects with no evidence of silent myocardial ischemia in CMR (13.0 ± 2.6 mm vs. 11.5 ± 2.1 mm, p=0.01, 12.8 ± 2.1 vs. 11.7 ± 2.3 mm, p=0.11, respectively). In multivariate logistic regression analysis, EAT thickness was an independent indicator for significant coronary artery stenosis after adjusting for traditional risk factors (OR 1.353, p=0.031).

Conclusions

Increased EAT thickness assessed by CMR is an independent risk factor for significant coronary artery stenosis in asymptomatic type 2 diabetes; however, the thickness was not associated with silent myocardial ischemia.

Funding

None.