MỐI LIÊN QUAN GIỮA THỂ TÍCH MỠ THƯỢNG TÂM MẠC VÀ BỆNH ĐỘNG MẠCH VÀNH TRÊN CHỤP CẮT LỚP VI TÍNH MẠCH VÀNH

Abstract

Background: Epicardial adipose tissue exerts metabolic and pro-inflammatory effects that influence the coronary atherosclerotic process. Coronary computed tomography angiography (CCTA) is a first-line modality for quantifying epicardial fat volume (EFV). Prior studies suggest EFV is an independent prognostic factor for coronary artery disease (CAD) and an imaging biomarker reflecting atherosclerotic burden. Objectives: The aim of study was to examine the association between EFV and CAD, and the correlation between EFV and stenosis severity based on the CAD-RADS classification. To assess the diagnostic performance of EFV—area under the curve (AUC), sensitivity, and specificity—in predicting CAD. Methods: We included all consecutive patients aged ≥18 years with suspected CAD who underwent CCTA at Tam Anh General Hospital, Ho Chi Minh City, from October 2024 to September 2025. EFV was measured semi-automatically using Syngo.via software (Siemens Healthcare) with an attenuation threshold from −190 to −30 Hounsfield units; volumes were summed from the pulmonary artery bifurcation to the cardiac apex. CAD was defined as ≥50% diameter stenosis of at least one epicardial coronary artery on CCTA. Results: Among 213 patients (118 men, 55.4%; mean age 64.7 ± 11.3 years), EFV was higher in those with CAD than in those without (122.8 ± 40.8 vs. 85.6 ± 22.1 cm³; p < 0.001). EFV correlated positively and moderately with stenosis severity by CAD-RADS (Spearman’s r = 0.523, p < 0.001). EFV showed good discrimination for CAD with an AUC of 0.79 at a cut-off of 100 cm³, yielding 70.0% sensitivity and 81.2% specificity. Conclusions: EFV is associated with stenosis severity according to CAD-RADS and serves as a predictive imaging marker for coronary artery disease.