Comparison of epicardial adipose tissue volume of normal and coronary artery disease patients during diastolic and systolic phases of retrospective electrocardiogram-gated volume scan

Abstract

Introduction

The abundance of epicardial adipose tissue (EAT) correlates with the extent and severity of coronary artery disease (CAD). If the quantity of EAT varies between diastole and systole during an ECG-synchronized volume scan, it can potentially affect the diagnostic accuracy of CAD. The aim of this study was to compare the EAT volume between the diastolic and systolic phases during an ECG-gated volume scan of patients with or without CAD.

Methods

In this study, 47 patients (11 with and 36 without CAD) underwent coronary computed tomography (CT) angiography between September 2022 and August 2023. All patients underwent a second-generation 320-row computed tomography (CT) scan with a retrospective ECG-triggered volume scan. The data volumes obtained at 5 % steps of the R–R interval were automatically analyzed on a Ziostation2 Plus workstation using a CT coronary artery analysis application. Myocardial fat components ranging from −160 to −70 in CT value were extracted to determine fat content. EAT volumes between R–R intervals were compared for 40 % diastolic and 75 % systolic phases in the scans of patients with and without CAD.

Results

The median and interquartile range (IQR) of the EAT volumes were 130 (112–183) mL and 98 (67–129) mL for the groups with and without CAD, respectively, indicating a significant difference (p < 0.05). For the ECG-gated scan without CAD, the median and IQR of the EAT volumes were 98 (66–129) and 94 (68–134) mL in the diastolic and systolic phases (p = 0.82), respectively, and for CAD, 166 (129–191) and 158 (113–178) mL (p = 0.56), respectively. Thus, the differences in the EAT volume were not significant between diastolic and systolic phases (p > 0.05).

Conclusion

Differences in EAT volume between patients with and without CAD were significant. However, the EAT volume differences between the diastolic and systolic phases were not significant, irrespective of CAD, during the ECG-gated volume scans.

Implications for practice

The diastolic and systolic cardiac phases did not significantly influence EAT volume measurements.