الفهرس 
CORONARY ARTERY DISEASEOnly 14 pages are availabe for public view
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Abstract
SUMMARY
C
ardiovascular disease is the largest cause of death in the world, and coronary artery disease (CAD) makes up the greatest proportion of those deaths that may enable more sensitive measures for risk stratification, or offer novel therapeutic targets for the prevention and treatment of coronary vascular disease.
Excess adiposity has long been associated with increased cardiovascular disease. A growing amount of evidence suggests that regional fat distribution plays an important part in the development of an unfavorable metabolic and cardiovascular risk profile.
Epicardial fat is a metabolically active organ that generates various bioactive molecules, which might significantly affect cardiac function. This small, visceral fat depot is now recognized as a rich source of free fatty acids and a number of bioactive molecules, such as adiponectin, resistin and inflammatory cytokines, which could affect the coronary artery response.
The observed increases in concentrations of inflammatory factors in patients who have undergone coronary artery bypass grafting remain to be confirmed in healthy individuals. Furthermore, epicardial fat volume (EFV) might reflect significance and complexity of coronary artery disease.
Therefore, we propose that volumetric quantification of this tissue could serve as a reliable marker of early detection of severity of coronary artery disease by means of cardiac MDCT.
This cross-sectional study was conducted on 80 patients who were referred for performing MDCT coronary angiography to assess their complaint and during the non-contrast phase, EFV was quantified. Then, they were scheduled to undergo elective invasive coronary angiography at National Heart Institute and Air Force General Hospital in the period between January 2018 and August 2018.
Although previous studies linked epicardial fat to CAD our study highlights the relationship between EFV and complexity of CAD evaluated by SYNTAX score, which incorporates lesion characteristics and functional impact and Gensini score which evaluates coronary stenosis on the basis of the degree of luminal narrowing and its topographic importance and thus denotes CAD complexity.
The amount of epicardial fat was found to be clinically related to hypertension, diabetes, concentrations of LDL cholesterol and obesity.
Also, epicardial fat volum was significantly correlated to severity of CAD evaluated by means of SYNTAX and Gensini scores.
This study found that EFV is an independent predictor of the presence of both significant and complex coronary artery disease.
Quantification of epicardial fat by MDCT could be a simple and practical tool for cardiovascular risk stratification in clinical practice and research.
Thus, we recommend calculation of epicardial fat volume for patients undergoing CT coronary angiography as a marker of CAD significance and severity.