Relationship of epicardial adipose tissue measured by transthoracic echocardiography with coronary artery disease

Background and purpose: Coronary artery disease (CAD) remains one of the leading causes of death worldwide. Its relationship with epicardial adipose tissue (EAT) is still not yet fully established. This study aimed to investigate the correlation between EAT thickness as measured by two-dimensional (2D) echocardiography and the presence of CAD. Methods: This comparative cross-sectional study included 100 patients presenting with chest pain who underwent echocardiography and coronary angiography. Patients with a history of ischemic heart disease, chronic liver disease, or familial hypercholesterolemia were excluded. Participants were divided into two groups; Group A (50 patients) with significant coronary artery stenosis (>70%) on angiography, and Group B (50 patients) with normal coronary findings on angiography. Results: Our study has shown that EAT thickness was significantly greater in Group A compared to Group B, with an average EAT thickness of 8.5 ± 2.2 mm and 5.4 ± 1.7 mm respectively (P < 0.001). A cut-off value of 6.6 mm thickness for EAT thickness was closely associated with significant CAD, demonstrating 94% sensitivity and 90% specificity. Multivariate analysis, adjusting for confounding factors, showed that EAT thickness (odds ratio [OR]: 29.16, P < 0.001) was independently correlated to the presence of significant CAD. Conclusions: EAT thickness measured by echocardiography correlates with the presence of obstructive CAD in patients presenting with acute coronary syndrome (ACS). A cut-off value of 6.6 mm is strongly linked with this condition.