The Relationship Between Epicardial Adipose Tissue Volume And Its Correlation Measured By MSCT And The Degree Of Coronary Artery Stenosis And Their Difference In Different Age Groups Of Adults

PurposeTo investigate the correlation between epicardial adipose tissue volume(EATV),left atrioventricular sulcus thickness(LAVG),right atrioventricular sulcus thickness(RAVG)and the degree of coronary artery stenosis measured by coronary CT imaging(CCTA).Materials and methods303 patients(119 males and 184 females)who underwent cardiac and coronary CTA in Linyi Central Hospital from April 2019 to September 2019 were collected retrospectively.According to the degree of coronary artery stenosis shown by CCTA results,they were divided into three groups:no stenosis group:CCTA results were negative,no coronary artery stenosis and main branch artery stenosis;Mild stenosis group:CCTA results showed that the stenosis rate of any one or more of the three main branch arteries was less than 50%;Moderate and severe stenosis group:the stenosis rate of any one or more of the three main branch arteries in CCTA results is≥50%.Among them,there were 61 in the non stenosis group,154 in the mild stenosis group and 88 in the moderate and severe stenosis group.The age was divided into four groups according to WHO standards:9 people under 45(middle-aged),122 people aged 45-59(young elderly),134 people aged 60-74(elderly),and 38 people aged 75 and over(very old elderly).The German Siemens company definition flash is used for CCTA inspection.The scanning range is from the carina of trachea to the diaphragmatic surface of heart,including the whole heart.Iodixanol was injected through elbow vein with high-pressure syringe.Siemens syngo Via vb20 for image reconstruction and post-processing analysis.CCTA images at 45%and 75%were reconstructed,and the degree of stenosis of three main coronary arteries was analyzed in diastole.Two radiologists with more than 5 years’ experience were evaluated independently by double-blind method.When they disagree,the results were discussed and unified.At the post-processing workstation,select the anatomical structure display measurement tool to measure eatv and its related values.The volume of epicardial adipose tissue and the thickness of fat at the left and right atrioventricular sulcus were standardized by body surface area(BSA).The above data were measured by the same radiologist in the post-processing workstation after training.Using SPSS 23 0 statistical software for data analysis.The risk factors affecting the degree of coronary artery stenosis were analyzed by ordered multi classification logistic regression.P<0.05 means the difference is statistically significant.ResultsThere were significant differences in gender and age among no stenosis group,mild stenosis group and moderate and severe stenosis group(x 2=8.214,p=0.016;F=12.078,p<0.001)。There was significant difference in epicardial adipose tissue volume between non stenosis group and moderate and severe stenosis group,between mild stenosis group and moderate and severe stenosis group(P<0.001,P=0.001),and there was no significant difference between non stenosis group and mild stenosis group(P=0.152).There was no significant difference in fat thickness between the three groups(right atrioventricular sulcus fat thickness:z=0.578,P=0.749;left atrioventricular sulcus fat thickness:z=3.565,P=0.168).There was a rank correlation between gender,age,epicardial adipose tissue volume and the degree of coronary artery stenosis(r=0.157,P=0.006;r=0.281,P<0.001;r=0.223,P<0.001).The risk of increasing the degree of coronary artery stenosis by one grade for each unit of epicardial adipose tissue volume was 3.3%(P=0.001,or=1.033).The coefficients of variation of epicardial adipose tissue volume and fat thickness at right and left atrioventricular sulcus after standardization were lower than those before standardization.There was significant correlation between the fat thickness at the right and left atrioventricular sulcus before and after standardization and the volume of epicardial adipose tissue(before standardization:r=0.600,P<0.001;r=0.536,P<0.001;after standardization:r=0.515,P<0.001;r=0.470,P<0.001).The overall mean difference of adipose tissue thickness at left atrioventricular sulcus in different age groups of adults was statistically significant(F=2.847,P=0.038).There was significant difference between 45-59 year old age group and 60-74 year old age group(P=0.029),and there was significant difference between 60-74 year old age group and 75 year old and above age group(P=0.012).ConclusionAge,sex and epicardial adipose tissue volume are the risk factors for the increase of coronary artery stenosis.The volume of epicardial adipose tissue increased and the degree of coronary artery stenosis increased.There is a linear correlation between the thickness of fat in the left and right atrioventricular sulcus and the volume of epicardial adipose tissue,which may be a potential index to replace the volume of epicardial adipose tissue in the evaluation of coronary artery stenosis.The thickness of adipose tissue in the left atrioventricular sulcus is statistically significant between the 45-59 and 60-74 age groups,and between the 60-74 age group and the 75 age group and above.It may have potential predictive value in physical examination and screening at different ages.