Association between region-specific epicardial adipose tissue and CT-derived fractional flow reserve-defined myocardial ischemia: a retrospective coronary CTA study stratified by hypertension and type 2 diabetes mellitus - Summary - MDSpire
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Association between region-specific epicardial adipose tissue and CT-derived fractional flow reserve-defined myocardial ischemia: a retrospective coronary CTA study stratified by hypertension and type 2 diabetes mellitus
To investigate the association between region-specific EAT thickness and CT-FFR-defined myocardial ischemia, emphasizing its significance in patients with hypertension and type 2 diabetes mellitus.
Approach:
Key Findings:
Ischemic subgroups had greater EAT thickness compared to controls, particularly in the left atrioventricular groove (LAVG-EAT) (p < 0.001).
LAVG-EAT was independently associated with myocardial ischemia (OR 1.41, 95% CI 1.26–1.58; p < 0.001).
Adding LAVG-EAT to clinical and coronary calcium burden models improved discrimination (AUC 0.886–0.912; DeLong p = 0.024).
Interpretation:
LAVG-EAT may serve as a practical adjunctive imaging marker for ischemia identification and risk stratification in patients with hypertension and/or T2DM, potentially guiding clinical decision-making.
Limitations:
Retrospective design may introduce selection bias.
Single-center study limits generalizability.
Potential confounding factors may not have been controlled for.
Conclusion:
Region-specific EAT, particularly LAVG-EAT, is associated with myocardial ischemia and provides incremental value beyond conventional clinical variables.
