Introduction: Even though early detection of coronary artery disease (CAD) can reduce mortality, CAD with diabetes is often not accompanied by typical symptom and it is still difficult to detect CAD. Recently, quantification of epicardial adipose tissue (EAT), which is thought to be an ectopic adipose tissue, has been developed for detecting of CAD.
Hypothesis: EAT thickness measured by echocardiography may be associated with the presence of CAD in patients with type 2 diabetes.
Methods: We enrolled 182 patients with type 2 diabetes (mean age 67±11 yrs, 128 men) who underwent coronary angiography between June 2011 and June 2016 at our hospital. We measured the EAT thickness in anterior interventricular groove (EAT-AIG) by echocardiography using high-frequency linear probe (Figure A). Subjects were divided into two groups with and without significant coronary stenosis (CAD group: 108 patients and non-CAD group: 74 patients) from coronary angiography.
Results: Forty-seven (44%) patients in the CAD group were asymptomatic. The EAT-AIG thickness was significantly greater in the CAD group than in the non-CAD group(8.3±2.8 vs. 5.7±2.1 mm, p <0.001). By receiver operating characteristic analysis, EAT-AIG thickness had the high c-statics (AUC: 0.82, p <0.001) after adjustment of conventional risk factors (age, male gender, body mass index, hypertension, dyslipidemia, and smoking). EAT-AIG thickness had incremental diagnostic value over other conventional risk factors (AUC: 0.82 vs 0.65, comparison p < 0.001) regardless of the presence of symptom (Figure B).
Conclusions: Echocardiographic EAT-AIG thickness was greater in the CAD group than that in the non-CAD group. This non-invasive index may an useful diagnostic maker for detecting coronary atherosclerosis in patients with type 2 diabetes.