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ASSOCIATION BETWEEN EPICARDIAL ADIPOSE TISSUE, INFLAMMATORY MARKERS, AND CORONARY MICROVASCULAR DYSFUNCTION IN PATIENTS WITH NON-OBSTRUCTIVE CORONARY ARTERY DISEASE
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DOI：10.18087/cardio.2026.3.n3080.png)
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Abstract
En 中文
Objective To explore the association among epicardial adipose tissue (EAT), inflammatory markers, and coronary microvascular dysfunction (CMD) in patients with non-obstructive coronary artery disease (NOCAD) and to determine independent risk factors for CMD in patients with non-obstructive coronary artery disease. Material and methods We retrospectively analyzed clinical data from 286 NOCAD patients who underwent coronary angiography between January 2022 and June 2024. The patients were stratified into a CMD group (n=152) and a non-CMD group (n=134), according to coronary flow reserve (CFR) greater than 2.0 and / or an index of microcirculatory resistance (IMR) greater or equal to 25 (units). Quantitative measure- ments of EAT volume and area were obtained by coronary computed tomography angiography, and serum concentrations of inflammatory markers were assessed. Correlation analysis and multivariate logistic regression analysis identified independent predictors of CMD, and receiver operating charac- teristic curves evaluated predictive performance. A combined predictive model was constructed based on the multivariate logistic regression equation, and predicted probabilities were calculated for each patient. Receiver operating characteristic (ROC) curve analysis was then performed using the predict- ed probabilities of the model. Results the CMD group had significantly higher EAT volume and mean EAT area compared to the non-CMD group (both p<0.001). Patients in the CMD group exhibited elevated hs-CRP, IL-6, TNF-alpha, and monocyte chemoattractant protein-1 (MCP-1) along with reduced adiponectin (all p<0.001). IL-1 beta concentrations showed no significant intergroup difference (p=0.055). EAT volume correlated negatively with CFR (r=-0.542) and positively with IMR (r=0.518), while demonstrating positive associations with major pro-inflammatory markers and negative correlation with adiponectin (all p<0.001). MCP-1 (OR=1.012), and EAT volume (OR=1.028) as independent risk factors for CMD, whereas adiponectin (OR=0.682) was identified as a protective factor (all p<0.05). The combined predictive model demonstrated an area under the curve of 0.912, with 86.2 % sensitivity and 83.6 % specificity. Conclusion Increased EAT in NOCAD patients is closely associated with CMD, potentially mediated through inflammatory pathways. EAT and specific inflammatory markers, may function as biomarkers for early CMD identification, and EAT may represent a potential therapeutic target.
Keywords:
Non-obstructive coronary artery disease
coronary microvascular dysfunction
epicardial adipose tissue
inflammatory markers
interleukin-6
monocyte chemoattractantprotein-1
adiponectin
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