EPICARDIAL ADIPOSE TISSUE AND CORONARY MICROVASCULAR FUNCTION IN PATIENTS WITH SUSPECTED ANGINA AND NON-OBSTRUCTIVE CORONARY ARTERY

초록

Background Little is known for relationship between coronary microvascular function and epicardial adipose tissue (EAT). We evaluated the correlation between EAT and coronary microvascular function in patients with suspected angina but non-obstructive coronary artery (NOCA). Methods From the 2 tertiary hospitals, consecutive 187 patients with chest pain who had no significant coronary artery stenosis in coronary angiography and underwent adenosine stress-echocardiography were included. Coronary blood flow (CBF) velocities of distal left anterior descending artery were obtained and coronary flow reserve (CFR) was defined as peak to baseline mean diastolic velocity of CBF. EAT was measured from the right ventricular free wall perpendicular to the aortic annulus at end systole. Coronary microvascular dysfunction (CMD) was defined as CFR less than 2.3. Results Of total 187 patients, mean age was 61 years old, and 129 (69%) patients were women. CMD was present in 42.8% of patients with suspected angina but NOCA. In women, CMD was more prevalent compared to men in these patients (men vs women, 32.1% vs 47.6%, p - 0.053). EAT was significantly thicker in women compared to men (men vs women, 5.3 (4.2-6.3) vs 6.0 (4.8-6.9), p = 0.012). EAT was linearly correlated with aging (r = 0.192, p = 0.009), especially in women (r = 0.202, p = 0.022), not in men (r = 0.140, p = 0.300). CFR was not correlated with aging (r = -0.082, p = 0.27). There was no correlation between EAT thickness and CFR, regardless of sex, however, EAT thickness was weakly correlated with septal e’ (r = -0.150, p = 0.041). Conclusion In patients with suspected angina and NOCA, CMD was common and more prevalent in women. EAT was correlated with left ventricular diastolic function while it showed no correlation with CFR in these patients. EAT might be related to the function of myocardial substrate, not coronary microvascular function itself.