Impact of epicardial adipose tissue volume quantified by non-contrast electrocardiogram-gated computed tomography on ergonovine-induced epicardial coronary artery spasm

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• 作者：Tsuyoshi Ito ; ^{tuyosiito@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Hiroshi Fujita ; Taku Ichihashi ; Nobuyuki Ohte
• 关键词：Epicardial adipose tissue ; Ergonovine ; Coronary spasm
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：15 October 2016
• 年：2016
• 卷：221
• 期：Complete
• 页码：877-880
• 全文大小：390 K

文摘

Endothelial dysfunction of the coronary artery is thought to lead to the development of coronary spasms. Epicardial adipose tissue may be a marker of coronary atherosclerosis. This study investigated the diagnostic impact of epicardial fat volume (EFV), quantified with non-contrast electrocardiogram (ECG)-gated computed tomography (CT), on ergonovine-induced coronary spasms.

Methods

We included 97 patients with suspected coronary spastic angina who underwent ECG-gated CT and an ergonovine provocation test. The EFV was measured with CT data sets using dedicated software. Coronary spasm was defined as total or subtotal occlusion (compared with the relaxed state after nitroglycerin) that was associated with ischemic ECG changes and concurrent chest pain.

Results

Coronary spasms were observed in 27 patients (28%). The EFV was significantly higher in patients with spasms compared with those without spasms (175.0 ± 57.8 cm³ vs. 129.7 ± 57.8 cm³, p < 0.01). Univariate logistic regression analyses indicated significant relationships between coronary spasms and EFV (per 10 cm³, odds ratio (OR): 1.13; p < 0.01), male gender (OR: 3.34; p < 0.01), and smoking (OR: 3.42; p < 0.01). In the multivariate model, EFV (per 10 cm³, OR: 1.10; p = 0.03) and male gender (OR: 5.94; p = 0.02) remained significant predictors of coronary spasm. The optimal EFV threshold for predicting coronary spasm was 149.4 cm³, identified with a receiver operating characteristic curve.

Conclusions

Increased EFV was associated with ergonovine-induced epicardial coronary artery spasms.