الفهرس 
Chapter IOnly 14 pages are availabe for public view
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Abstract
fat, which is shown to be strongly related to the development of coronary artery disease (CAD). The accumulation of EF is known to be a rich source of free fatty acids and a number of inflammatory cytokines.
There is growing evidence that epicardial fat thickness and pericoronarty fat is associated with increased cardiovascular risk.
Multislice CT provides an accurate and reproducible quantification of EAT due to its high temporal and spatial resolution.
The current study included 70 Patients with suspected coronary artery disease (Low-intermediate probability). The patients were divided into 3 groups:
group 1: no atherosclerosis. (20 patients).
group 2: nonobstructive atherosclerosis (luminal narrowing less than50% in diameter). (25 patients).
group 3: obstructive atherosclerosis (luminal narrowing ≥ 50%). (25 patients).
All patients were subjected to:
Detailed history taking, full Clinical examination and 12 leads ECG.
Routine laboratory investigations including: Fating Blood glucose level, serum creatinine, complete lipid profile.
CT Coronary Angiography: assessment of the severity of stenosis and calcium score.
Measurement of epicardial fat thickness.
Coronary angiography: The angiography was performed to patients in group 3 (≥ 50%stenosis by MDCT). The severity of coronary stenosis was estimated by the Syntax and Gensini coronary scores.
Results:
Ca score was significantly higher in group 3 (320 ± 454.5) than in group 2 (69.4 ± 132.8) and group 1(0).
The average epicardial adipose tissues thickness (EAT) was significantly larger in group 3 (8.5 ± 3.1 mm) than in group 2 (7.2 ± 1.4mm) and group 1(6.2 ± 1.2).
The average pericoronary fat thickness (PCFT) was significantly larger in group 3 (14 ± 2.4 mm) than in group 2 (12.6 ± 2.0 mm) and group 1(10.8 ± 1.7 mm).
EAT and PCFT showed statistical significance positive correlation with each other (p<0.001)
EAT and Ca score showed statistical significance positive correlation with each other (p0.004).
PCFT and Ca score showed statistical significance positive correlation with each other.
ROC curve was used to define the best cut off value of EAT and PCFT in predicting the obstructive CAD group (3) and it was ≥7.2 and 12.6mm for EAT and PCFT respectively with sensitivity of 67%and 72% respectively, specificity of 67.4% and 62.2% respectively, positive predictive value (PPV) of 50%and 51.4% respectively, negative predictive value (NPV) of 76.3% and 80% respectively with diagnostic accuracy of 64.3% and 65.7% respectively.
There was higher Ca score (non-significant) in patients with three vessels disease compared to patients with single and two vessels disease, however there was no significant difference in PCFT and EAT among the 3 groups of patients with single, double and three vessels disease.
There was negative correlation between both Syntax and Gencini scores at one side and both EFT and PCFT in group 3.