Can epicardial fat tissue thickness help determine the need for coronary angiography before heart valve surgery?

Patients with CAD had significantly higher epicardial adipose tissue thickness than those without CAD.

• Mean EAT thickness was 4.87 mm in CAD patients vs 3.50 mm in non-CAD patients (p < 0.001).
• Median values were 4.80 (IQR 0.80) and 3.50 (IQR 0.85), respectively.
• 72 patients scheduled for heart valve surgery were included in this prospective study.
• EAT was measured by transthoracic echocardiography (TTE) preoperatively.

EAT thickness demonstrated strong diagnostic value for predicting coronary lesions by ROC analysis.

• Area under the curve (AUC) was 0.929 in ROC analysis (p < 0.001).
• At a cut-off point of 4.3 mm, EAT predicted the presence of any coronary lesion with sensitivity of 78% and specificity of 92%.
• EAT thickness > 4.3 mm was identified as a strong predictor of suspected CAD.

Patients with concomitant hypertension had significantly higher EAT thickness than those without hypertension.

• Mean EAT thickness was 4.11 mm in hypertensive patients vs 3.57 mm in non-hypertensive patients (p = 0.02).
• Median values were 4.10 (IQR 1.50) and 3.60 (IQR 0.80), respectively.

Smoking habit, ascending aortic diameter, and body mass index showed positive correlations with EAT thickness.

• Smoking habit had a positive correlation with EAT thickness (Rho = 0.414, p = 0.013).
• Ascending aortic diameter had a positive correlation with EAT thickness (Rho = 0.24, p = 0.043).
• Body mass index had a positive correlation with EAT thickness (Rho = 0.360, p = 0.002).
• Spearman Correlation was used to analyze non-normally distributed variables.