Effect of Lipid-Lowering Therapy on Epicardial Adipose Tissue Radiodensity in Hyperlipidemic Post-Menopausal Women Open Access

Wang, Zeyuan (Spring 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/4x51hj94t?locale=en


Background: Epicardial Adipose Tissue (EAT) is the visceral fat around heart. EAT radiodensity is a measure from Computed Tomography (CT) to evaluate EAT attenuation. Previous studies have suggested EAT volume is associated with cardiovascular diseases and statin therapies were effective on reducing EAT volume. The relationship between EAT radiodensity and coronary artery diseases remains uncertain. We also want to evaluate whether statin therapies are effective on EAT radiodensity.

Methods: This is a sub-study of the Beyond Endorsed Lipid Lowering with Electron Beam Tomography Scanning (BELLES) Trial. This study involved a final sample of 420 subjects. Measurements involved in this study including EAT HU, Coronary Artery Calcium (CAC), EAT volume, Subcutaneous Adipose Tissue radiodensity (SCAT HU), lipid serum levels, and patients’ clinical features. Percent changes for EAT HU, EAT volume, SCAT HU, CAC score, and lipid serum levels were calculated and summarized by statin therapy groups; p-values were calculated with Wilcoxon rank sum test for the difference between therapies. Pearson correlations of EAT HU percent change with the above variables were calculated within whole group, atorvastatin group, and pravastatin group to evaluate association with EAT HU. A multivariable generalized linear regression model was used to find predictor variables for EAT HU. 

Results: Statin therapies were statistically effective on EAT radiodensity. The effect of two statin therapies on EAT HU showed no significant difference (p = 0.33). None of the variables indicated correlation with EAT HU percent change. The result of the multivariable generalized linear regression model showed only race could be considered as a predictor term for EAT HU. The impact of both statin therapies on SCAT HU showed no significant difference (p = 0.43).

Conclusion: Even though LDL and non-HDL cholesterol were found to be related with EAT volume, none of those lipid serum levels were demonstrated to be associated with EAT radiodensity. It is unexpected that EAT volume was not correlated with EAT radiodensity in our study. Statin therapies did not halt CAC progression. Statin therapies were not effective on SCAT HU, as expected. 

Table of Contents

Table of Contents

1. Introduction 1

2. Methods 2

2.1 Study Population and Screening Procedures 2

2.2 Computed Tomography Scans and Interpretation Guidelines 4

2.3 Outcome Measurements 5

2.4 Statistical Analyses 5

3. Results 7

4. Discussion 10

5. References 13

6. Appendix (Tables and Figures) 17

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