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European Heart Journal Advance Access published online on December 20, 2007

European Heart Journal, doi:10.1093/eurheartj/ehm564
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Peri-coronary epicardial adipose tissue is related to cardiovascular risk factors and coronary artery calcification in post-menopausal women

Alexander M. de Vos1,2, Mathias Prokop2, Cornelis J Roos3, Matthijs F.L. Meijs1, Yvonne T. van der Schouw3, Annemarieke Rutten2, Petra M. Gorter4, Maarten-Jan Cramer1, Pieter A. Doevendans1, Benno J. Rensing5, Marie-Louise Bartelink3, Birgitta K. Velthuis2, Arend Mosterd1,3,6 and Michiel L. Bots3,*

1 Department of Cardiology, University Medical Centre Utrecht, Heidelberglaan 100, 3584CX Utrecht, The Netherlands
2 Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
3 Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Huispost: str. 6.131, Heidelberglaan 10, 3584 CX, Utrecht, The Netherlands
4 Department of Vascular Medicine, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
5 Department of Cardiology, Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands
6 Department of Cardiology, Meander Medical Centre, Amersfoort, The Netherlands

Received 8 May 2007; revised 29 October 2007; accepted 13 November 2007.

* Corresponding authors. Tel: +31-(0)88 75 59352, Fax: +31-(0)88 755 55485, Email: m.l.bots{at}umcutrecht.nl

Aims: To determine whether peri-coronary epicardial adipose tissue (EAT) is associated with vascular risk factors and coronary atherosclerosis.

Methods and results: In this study, 573 healthy post-menopausal women underwent a cardiac CT scan to assess coronary calcification. Peri-coronary EAT thickness was measured in the areas of right coronary artery (RCA), left anterior descending (LAD) artery, and left circumflex (LCX) coronary artery. Average EAT thickness was 16.5 ± 4.3 mm (range 5.9–34.6) in the RCA area, 6.4 ± 2.2 mm (range 2.0–14.0) in the LAD area, and 10.8 ± 3.0 mm (range 2.8–29.1) in the LCX area. Overall average thickness was 11.2 ± 2.2 mm (range 5.4–19.1). EAT was positively related to age (P = 0.002). In age-adjusted linear regression models, EAT was positively related to weight (P< 0.001), waist circumference (P< 0.001), waist-to-hip ratio (P< 0.001), body mass index (P< 0.001), glucose (P< 0.001), triglycerides (P = 0.001), use of anti-hypertensive drugs (P = 0.007), and systolic blood pressure (P = 0.034), and inversely to HDL cholesterol (P = 0.005). In multivariable models, age, weight, waist circumference, smoking, and glucose were the main determinants of EAT. EAT showed a graded relation with coronary calcification (P = 0.026).

Conclusion: EAT is strongly related to vascular risk factors and coronary calcification. Our findings support the hypothesis that EAT affects coronary atherosclerosis and possibly coronary risk.

Key Words: Epidemiology • CT and MRI • Risk factors • Imaging • Lipid • Lipoprotein metabolism


The abstract was presented at the American Heart Association, Scientific Sessions 2006.


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