Pericardial fat volume and coronary risk factors as predictors of non-calcified coronary plaque presence among patients with coronary calcium score = 0.

INTRODUCTION: There is scarce data linking pericardial fat volume (PFV) and classical coronary risk factors with non-calcified plaque presence among patients with CAC = 0 in the literature. MATERIAL AND METHOD: A total of 811 patients with chest pain suggestive of angina underwent CT coronary angiography for the assessment of coronary artery disease were collected. Of these, 417 with CAC = 0 were included in the analysis. RESULT: Patients with non-calcified plaque were older (54 ± 9 versus 50 ± 10, P = 0.01) and had a higher prevalence of diabetes mellitus (31% versus 17%, P = 0.02), high BMI (29.9 versus 28.3, P = 0.04), and increased PFV (123 cm3 versus 99 cm3, P < 0.01) compared to patients without plaque. In multivariate regression analysis, high BMI[OR(CI) = 1.1(1-1.3), P = 0.02] was an independent predictor of non-calcified coronary plaque presence among patients with CAC = 0 after adjustment to variables with P < 0.05 in the univariate analysis. CONCLUSION: In patients with a CAC score of 0, advanced age, diabetes mellitus, increased PFV, and high BMI were all associated with the presence of non-calcified plaque. After multivariate adjustment, increased BMI remained a significant independent predictor for non-calcified plaque presence.

Aortic root diameter, main pulmonary artery diameter/aortic root diameter and pericardial fat volume as predictors of occlusive coronary artery disease.

The clinical relevance of aortic root diameter (ARD) and main pulmonary artery diameter (MPAd) or pericardial fat volume (PFV) in the assessment of coronary artery disease (CAD) is largely unknown. We aimed to assess the relationship of pericardial fat volume (PFV), ARD, MPAd, and MPAd/ARD ratio with occlusive CAD (stenosis>50%).This cross-sectional study included patients who had chest pain suggestive of CAD and underwent a 64-multislice multi-detector CT angiography exam to exclude occlusive CAD presence. A total of 145 patients were enrolled in this study. The mean age was 54±10 years, 51% were males. The mean PFV, ARD, MPAd, and MPAd/ARD ratio in all patients were 155 cm3, 29.9 mm, 23.4 mm and 0.8, respectively. On univariate analysis, PFV (OR (CI)=1.1 (1.01-1.3), P<0.01), ARD (OR (CI)=1.2 (1.1-1.4), P<0.01), and MPAd/ARD ratio (OR (CI)= 0.2 (0.1-0.5), p=0.02) showed significant association with occlusive CAD presence. After adjusting for cardiac risk factors, only PFV (OR (CI)=1.1 (1.02-1.3), p<0.01), but not ARD (OR (CI)=0.9(0.3-2), p=0.85) or MPAd/ARD ratio (OR (CI)=0.1(0.1-2), p=0.69), was independently associated with occlusive CAD. In conclusion, increased PFV, but not ARD or MPAd/ARD ratio, showed a significant and independent association with occlusive CAD presence in patients with chest pain suggestive of CAD.

Relationship of cardiovascular risk factors, pericardial fat, and carotid thickness with coronary plaque type in patients with diabetes mellitus.

Background: There is paucity of data on the potential predictors of coronary plaque types among patients with diabetes mellitus(DM). Aims: To assess the association of cardiovascular risk factors, pericardial fat volume (PFV) assessed by multi-detector CT(MDCT)angiography, and internal carotid intima media thickness with coronary atherosclerotic plaque types in patients with type 2 DM. Patients and methods: Patients with suspected coronary artery disease who underwent 64-slice MDCT angiography were enrolled in this retrospective study. Results: A total of 784 patients were enrolled in this study, 198 of whom had DM and 586 of whom did not. The prevalence of calcified and mixed plaques was significantly higher in the DM group than without DM group, while no significant difference was found in the distribution of non-calcified plaque between groups. There was significant association between smoking [OR(CI) = 4(2-10),P = 0.001] and increased age[OR(CI) = 1.1(1-1.3),P = 0.023] and calcified plaque presence. Regarding mixed and non-calcified plaque, increased PFV[OR(CI) = 1.1(1-1.3),P = 0.001] and positive family history[OR(CI) = 4(2-12),P = 0.049] showed a significant association with coronary mixed plaque presence while no significant association was observed between cardiovascular risk factors, PFV, and internal carotid intima media thickness and non-calcified plaque presence in patients with DM. Conclusion: Increased PFV showed significant and independent association with mixed coronary plaques development, which suggests that PFV may be used as an imaging marker for early detection of increased risk for future coronary events in patients with DM.

Cardiovascular risk factors and pericardial fat volume as predictors of coronary atherosclerosis burden in postmenopausal women: A retrospective, single center study.

Background and Aims: Little is known about the clinical relevance of pericardial fat volume (PFV), compared to other conventional cardiovascular risk factors, as predictors of coronary atherosclerosis severity among postmenopausal women. Our main aim was to assess the association of PFV and cardiovascular risk factors with coronary atherosclerosis burden, including occlusive coronary artery disease (CAD) (luminal stenosis >50%), coronary artery calcium score (CAC) >100, and plaque types in postmenopausal women. Methods: Patients who had chest pain of angina and referred for 64-slice multi-detector CT (MDCT) angiography examination to exclude occlusive CAD presence were enrolled in this retrospective study. Results: A total of 241 women with absence of menses for more than 2 consecutive years and not taking hormone replacement therapy were enrolled in the present study. Increased PFV (OR [CI] = 1.1 [1-1.3], p = 0.004), age (OR [CI] = 1.1 [1-1.4], p = 0.002), and diabetes mellitus (OR [CI] = 2 [1-4], p = 0.025) were significant predictors of occlusive CAD presence. Increased PFV (OR [CI] = 1.1 [1-1.4], p = 0.017) and increased age (OR [CI] = 1.2 [1.1-1.4], p < 0.001) were better predictors of CAC >100 than other cardiovascular risk factors. Regarding coronary plaque types, increased age (OR [CI] = 1.1 [1.1-1.3], p = 0.001) showed a significant association with coronary calcified plaque presence while increased body mass index(OR [CI] = 1.2 [1-1.4], p = 0.018) showed a significant association with coronary non-calcified plaque presence. Conclusion: Higher PFV values showed an independent association with occlusive CAD and significant coronary calcification. This may imply that increased PFV is likely associated with the development of advanced and severe phenotype of coronary atherosclerosis among postmenopausal women with suspected CAD.

Association of ABO blood group with in-hospital adverse outcome and long term persistent symptoms of COVID-19 infection: A single-center longitudinal observational study.

Background and Aims: There are gaps in knowledge regarding the association between the ABO blood group and coronavirus disease 2019 (COVID-19) immediate and long-term outcomes. We aimed to investigate the association of ABO blood group with COVID-19 in-hospital adverse outcomes and to determine whether ABO blood group is associated with post-COVID-19 persistent symptoms. Methods: This was a single-center longitudinal observational study that included patients who presented with symptoms suggestive of COVID-19 infection and a positive test for COVID-19 and were able to attend the out-patient clinic after 6 months following acute COVID-19. The main outcomes were intensive care unit admission, the requirement for respiratory support, in-hospital death, and persistent symptoms. χ 2 test and regression analysis were used to analyze the collected data. Results: A total of 169 patients were enrolled for the assessment of in-hospital adverse outcomes of whom 86 patients were included for the assessment of persistent symptoms after the exclusion of deceased patients or patients not attended the out-patient clinic. Patients with blood group B had higher prevalence of in-hospital death compared to blood group O (39% vs. 13%, p = 0.01) and this persisted after adjusting for sex (odds ratio, OR [confidence interval, CI] = 1.4 [1.1-2.1], p = 0.04), while patients with blood group AB had higher prevalence of requiring respiratory support than blood group O (54% vs. 10%, p = 0.02) and this persisted after adjusting for age (OR [CI] = 1.5 [1.1-2.3], p = 0.02). Concerning the association of ABO blood group and long-term symptoms, blood group AB showed a higher prevalence of palpitation (p < 0.001) and dizziness (p = 0.02) than other blood groups. Conclusions: Blood groups AB and B are significantly associated with respiratory support use and in-hospital death, respectively, compared to blood group O. Blood group AB is significantly associated with persistent palpitation and dizziness compared to other blood groups.

Long-term persistent symptoms of COVID-19 infection in patients with diabetes mellitus.

Objective: The study aimed to assess the long-term persistent symptoms of patients with diabetes mellitus (DM) and COVID-19 infection at 9 months after acute infection. Methods: This single-center cross-sectional study was conducted from May 20 to June 1, 2021. Results: A total of 112 patients were included in the present study. The most frequently reported persistent symptoms among DM group were fatigue (p = 0.01), shortness of breath (p = 0.01), and chest pain (p = 0.02) compared to non-DM group. Sulfonylurea use was associated with persistent cough (p = 0.04). Conclusion: Long-term persistent symptoms of COVID-19 infection are common among patients with DM.

ECG markers of malignant arrhythmias and in-hospital outcome of COVID-19 pneumonia.

Background: ECG abnormalities associated with COVID-19 pneumonia and adverse outcome are undefined and poorly described in prior studies. Objectives: To assess the predictive role of baseline ECG markers of increased risk of malignant arrhythmias and cardiac death for adverse in-hospital outcomes. Patients and methods: A retrospective study included 93 patients of newly diagnosed COVID-19 with features consistent with pneumonia who were admitted to the hospital from August 20 to September 20, 2020. The main outcomes were defined as receiving mechanical ventilation, in-hospital cardiac arrest, length of ICU stay, and degree of lung damage according to computed tomography (CT) score. Results: Increased QTc (QT corrected) interval, Tp-e (T from peak to end) interval, and transmural dispersion of repolarization (TDR) were independent predictors of prolonged ICU stay (P < .0001) after adjustment for baseline clinical characteristics. Increasing age (P < .0001) followed by increased QTc interval (P = .02) and history of chronic lung disease (P = .04) were independent predictors of extensive lung damage. The independent predictors for in-hospital cardiac arrest were increased QTc (P = .02) followed by increasing age (P = .04) and increased Tp-e interval (P = .04). Conclusion: Repolarization abnormalities on baseline ECG may be useful prognostic markers in patients with COVID-19 pneumonia.

Blood indices, in-hospital outcome and short-term prognosis in patients with COVID-19 pneumonia.

The predictive role of blood indices in coronavirus disease 2019 (COVID-19) related in-hospital adverse outcomes and post-recovery status is not fully defined. The main aim was to assess the association of complete blood indices measured at baseline with COVID-19 related in-hospital clinical outcomes, including length of hospital and intensive care unit (ICU) stay, receiving mechanical ventilation, degree of lung injury and in-hospital death, and post-recovery status. This retrospective study included patients with newly diagnosed COVID-19 infection from August 20, to September 25, 2020. The initial study cohort included 127 patients with newly diagnosed COVID-19. Of whom 26 patients were excluded, leaving 101 patients for final analysis. low lymphocytes % [Odds ratio and confidence intervals = OR (CI)] [0.2(0.0-0.2, p=0.03] increased the odds of ICU stay length while high platelet mean volume (PMV) [0.9 (1.1-5, p<0.00], high platelet distribution width (PDW) [0.3(0.4-1.9), p<0.00], and low lymphocytes % [0.2 (0.0-0.2), p=0.02] increased the odds of length of hospital stay. Decreased lymphocytes % showed significant independent association with increased risk for mechanical ventilation use [0.9 (0.9-1), p=0.04], extensive degree of lung injury [0.2 (0.1-0.7), p<0.00], and in-hospital death [0.5 (0.3-0.8), p=0.01]. High lymphocytes %[0.9 (0.9-1), p<0.00] and high PMV [0.3 (0.3-0.8), p=0.02] were significantly associated with complete recovery while increased neutrophil % [1 (1-1.1), p=0.04] was associated with increased risk for post recovery fatigue. In conclusion, low lymphocytes % and high neutrophil % are useful markers for predicting adverse in-hospital outcome and post-recovery persistent fatigue, respectively. High PMV and lymphocyte % showed significant association with favorable short-term prognosis.

Electrocardiographic markers of increased risk of sudden cardiac death in patients with COVID-19 pneumonia.

BACKGROUND: Little is known about the role of ECG markers of increased risk of sudden cardiac death during the acute period of coronavirus disease 2019 ( COVID-19) pneumonia. OBJECTIVES: To evaluate ECG markers of sudden cardiac death on admission, including the index of cardiac electrophysiological balance (iCEB) (QTc/QRS) and transmural dispersion of repolarization (TDR) (T from peak to end (Tp-e) interval and Tp-e/QTc), in patients with COVID-19 pneumonia. PATIENTS AND METHODS: This cross-sectional study included 63 patients with newly diagnosed COVID-19 pneumonia who presented to the outpatient clinic or admitted to the respiratory care unit between August 20 and September 15, 2020. Forty-six persons matched for sex and age were selected from data collected before COVID-19 pandemic. RESULTS: QRS and QTc showed a significant prolongation in patients with COVID-19 pneumonia compared to the controls (87 vs. 78, p < .00, and 429 versus. 400, p < .00, respectively). After categorization of patients with COVID-19 pneumonia into 3 groups according to the severity of pneumonia as mild-moderate, severe, and critical groups, a decreased values of QRS were observed in the critical COVID-19 pneumonia group compared to severe and mild-moderate COVID-19 pneumonia groups (p = .04) while increased values of QTc and iCEB(QTc/QRS) were noted in critical COVID-19 pneumonia group compared to other 2 groups(p < .00). CONCLUSIONS: Patients with COVID-19 pneumonia showed significant changes in repolarization and conduction parameters compared to controls. Patients with mild to severe COVID-19 pneumonia may be at low risk for torsades de pointes development.

Pericardial adiposity versus body adiposity measured by BMI in the assessment of coronary atherosclerosis burden in patients with hypertension.

OBJECTIVES: The link between obesity and hypertension with coronary atherosclerosis is complex. We aimed to assess the association of cardiac fat deposition measured by pericardial fat volume(PFV) using by multi-detector CT(MDCT) and general obesity measured by BMI with subclinical coronary atherosclerotic markers (coronary artery calcium score (CAC), coronary plaque and stenosis) in patients with hypertension and suspected coronary artery disease. METHODS: Among 496 patients presenting with chest pain who underwent 64-slice MDCT angiography to exclude occlusive coronary disease, 261 patients with hypertension (age: 57 ± 8 years, 45% males) enrolled in the present study. RESULTS: PFV showed a significant association with CAC(r = 0.2,P = .001),coronary stenosis severity(PFV median(IQR) 88(63-161) in patients with coronary stenosis<50% compared to PFV median(IQR) 125(85-140) in patients with coronary stenosis ≥ 50%, P = .001) and coronary plaque presence (PFV median (IQR) 89(65-128) in patients without plaque compared to PFV median (IQR) 115(74-150) in patients with plaque presence = 0.03).the significant association of PFV with CAC[odds ratio(95% confidence interval = 0.5(0.19-0.97),P = .001] and coronary stenosis severity [odds ratio(95% confidence interval = 1.1(1.00-1.01),P = .01]persisted after adjustment for conventional cardiac risk. BMI showed a significant association with significant coronary stenosis presence (P = .02).The association of BMI with significant coronary stenosis presence after adjustment for conventional cardiac risk factors (P = .03).BMI showed no significant association with CAC and coronary plaque presence (P > .05). CONCLUSION: PFV showed a significant independent association with coronary calcification and significant coronary stenosis in patients with hypertension rather than BMI.

Predictors of adverse in-hospital outcome and recovery in patients with diabetes mellitus and COVID-19 pneumonia in Iraq.

BACKGROUND AND AIMS: There is limited data about the prognosis and impact of COVID-19 pneumonia on patients with diabetes mellitus (DM). We aimed to assess blood indices, ECG markers of sudden death and malignant arrhythmias on admission, and diabetes lowering drugs as possible predictors of adverse in-hospital outcome and COVID-19 pneumonia recovery status. METHODS: A retrospective study included patients with newly diagnosed COVID-19 pneumonia from August 20, to October 5, 2020. RESULTS: A total of 192 patients with COVID-19 pneumonia were included in the present study, of whom 67 patients had DM. Low lymphocytes % [0.4(0.1-0.9), P = .011] and QTc interval prolongation [0.4(0.1-0.8), P = .022] were associated with increased length of ICU stay. On the other hand, metformin use [0.3(0.2-4), P = .032] and DPP-4 inhibitors use [0.3(0.2-3), P = .040] were associated with decreased length of ICU stay. QTc interval prolongation [0.4(0.1-0.9), P = .017] was associated with increased length of hospital stay, while using metformin [0.4(0.2-3), P = .022] was associated with decreased length of hospital stay. Low lymphocytes % [0.5(0.4-1.6), P = .001], insulin use [0.4(0.3-5), P = .003], and old age [0.5(0.1-2.3), P = .025] were associated with extensive lung injury. The risk for in-hospital death was associated with high neutrophil% [1(1-1.4), P = .045], while metformin use was associated with decreased risk for in-hospital death [0.1(0.1-0.6), P = .025]. Insulin use [0.3(0.2-4), P = .013] was associated with partial recovery following acute COVID pneumonia. CONCLUSIONS: Metformin and DPP-4 inhibitors use were associated with favorable in-hospital outcomes, while insulin use was associated with extensive lung injury and post-acute COVID-19 pneumonia partial recovery.

Sex-Related Differences in the Association of BMI and Pericardial Fat Volume With Coronary Atherosclerotic Markers in Young.

We assessed sex-related differences in the association of pericardial fat volume (PFV) and obesity measured by body mass index (BMI) with coronary atherosclerotic markers (coronary artery calcium score [CAC], coronary luminal stenosis severity, and coronary plaque) in young patients. Patients (n = 174; age <50 years) with suspected coronary artery disease who underwent 64-slice multidetector computed tomography angiography were enrolled. Females tended to have a younger age and increased BMI, normal coronary arteries (free from luminal stenosis), and increased percentage of absent coronary plaque compared with males. There was a significant independent association between PFV with coronary luminal stenosis and between PFV and BMI with coronary noncalcified plaque presence after adjustment for conventional cardiac risk factors. On the other hand, males showed a more increment in PFV, CAC, percentage of calcified plaque, and percentage of significant coronary luminal stenosis compared with females. There was a significant independent association of PFV with CAC, significant coronary stenosis, and calcified plaque presence, while no association was observed between BMI with coronary markers in young males. In conclusion, PFV, but not BMI, showed a significant independent association with advanced coronary atherosclerosis in young male patients.

Pericardial fat volume and coronary atherosclerotic markers among body mass index groups.

BACKGROUND: Increased pericardial fat volume (PFV) is associated with coronary atherosclerosis burden independent of body mass index (BMI) in many clinical studies. However, the association of PFV with markers of coronary atherosclerosis has not yet been assessed by dividing the patients according to BMI categories. HYPOTHESIS: To assess the association of PFV measured by multi-detector CT (MDCT) angiography with coronary atherosclerotic markers (coronary artery calcium score [CAC], plaque type, and luminal stenosis) among BMI categories. METHODS: A total of 496 patients with suspected coronary artery disease who underwent 64-slice MDCT angiography examination were enrolled. Patients divided into obese, overweight, and normal weight groups according to BMI degree. RESULTS: PFV showed a significant association with CAC, non-calcified coronary plaque, and significant coronary stenosis in obese group. After adjusting for cardiac risk factors, the association of PFV with the non-calcified coronary plaque and significant coronary stenosis persisted. There was a significant association between PFV with CAC and significant coronary stenosis in normal weight group. The association between PFV with CAC and significant coronary stenosis in normal weight was persisted afar adjusting for cardiac risk factors. No significant association was noted between PFV with coronary plaque type in normal weight group. There was no significant independent association between PFV with coronary atherosclerotic markers in overweight group. CONCLUSIONS: Increased PFV was associated with advanced stage atherosclerosis in normal weight group, while increased PFV was associated with non-calcified plaque in obese. These results highlight the differential relationship of PFV with coronary atherosclerotic markers among BMI categories.

Pericardial fat versus BMI in the assessment of coronary atherosclerotic burden in patients with diabetes mellitus.

AIMS: To investigate the association of obesity measured by body mass index (BMI) versus pericardial fat volume (PFV) measured by multi-detector computed tomography (MDCT) with coronary atherosclerotic markers (coronary artery calcium score (CAC), coronary stenosis severity and coronary plaque presence) in patients with type 2 diabetes mellitus (DM). METHODS: Among 496 patients with suspected coronary artery disease who underwent 64-slice MDCT angiography to exclude occlusive coronary artery disease, 102 patients with DM were enrolled in the present study. RESULTS: PFV showed a significant association with CAC (r = 0.2, P = 0.01) and significant coronary artery stenosis [PFV median (IQR) = 75 (51-136) in patients with coronary stenosis < 50% versus PFV median (IQR) = 113 (68-140) in patients with coronary stenosis ≥ 50%, P = 0.01] while there was no significant association of PFV with coronary plaque presence (PFV median (IQR) = 84 (56-140) in patients without plaque versus PFV median (IQR) = 109 (70-136) in patients with plaque presence, P = 0.4). The association between PFV with CAC persisted after adjustment for conventional cardiac risk factors. BMI showed no significant association with CAC, coronary stenosis severity and coronary plaque presence (P > 0.05). CONCLUSIONS: PFV was independently associated with CAC in diabetic patients. PFV, rather than obesity measured by BMI, could be used as an imaging biomarker for assessing coronary atherosclerotic burden in patients with DM.

ECG changes and markers of increased risk of arrhythmia in patients with myocardial bridge.

BACKGROUND: The clinical significance and prognosis of myocardial bridge (MB) is still a matter of debate. OBJECTIVES: To assess the novel ECG markers of T peak-to-end (Tp-e) interval, transmural dispersion of repolarization (TDR), is assessed by Tp-e/QT ratio, and index of electrophysiogical index(iCEB),is defined by QT/QRS ratio and changes (ST-T changes) in MB patients. PATIENTS AND METHODS: Forty one patients who were diagnosed as having MB (MB group) and other 41 patients without MB (non-MB group) at multi-detector CT (MDCT) exam matched by age, sex were enrolled in the study. RESULTS: iCEB was significantly increased in MB group in comparison to non-MB group particularly in patients with no coronary atherosclerosis (5.3 Vs 4.5, p = 0.04). Tp-e and TDR values were decreased in MB in comparison to non-MB patients particularly in patients with coronary atherosclerosis (69 Vs 80, p = 0.003 and 0.18 Vs 0.2, p = 0.01 respectively). Isolated T inversion in V1 was observed more in MB compared to non-MB patients (58% Vs 5%, p ≤ 0.0001) particularly in patients without coronary atherosclerosis. CONCLUSION: MB patients have shown decreased Tp-e and TDR markers particularly in MB patients with coronary atherosclerosis.

ECG markers of arrythmogenic risk relationships with pericardial fat volume and BMI in patients with coronary atherosclerosis.

BACKGROUND: Several novel ECG markers are proposed to predict the risk of sudden cardiac death in several clinical conditions in the recent years. However, little is known about the association of pericardial fat or obesity with these markers. OBJECTIVES: To assess the possible relationship between pericardial fat volume (PFV) and body mass index (BMI) with novel ECG markers (Tp-e, Tp-e/QT, Tp-e/QTc*QRS and QTc/QRS) in patients with coronary atherosclerosis. PATIENTS AND METHODS: We enrolled 100 patients with suspected coronary artery disease who underwent 64-slice multi-detector CT angiography. RESULTS: Higher values of Tp-e/QTc*QRS and QTc/QRS were observed among high PFV group in comparison to low PFV group particularly in patient with coronary atherosclerosis and these relationships persisted after adjustment for cardiac risk factors and coronary calcium score (CAC) while no significant differences in QTc, Tp-e, Tp-e/QTc and Tp-e/QRS values were observed between the PFV groups in patients without coronary atherosclerosis. There was no significant difference in QTc, Tp-e/QTc, Tp-e/QRS, Tp-e/QTc*QRS and QTc/QRS observed between the BMI groups either in patients with and without coronary atherosclerosis. CONCLUSION: PFV and not obesity measured by BMI is significantly associated with novel ECG markers of arrhythmia risk in patients with coronary atherosclerosis. These results could suggest the potential role of PFV in cardiac arrhythmogenesis through depolarization-repolarization conduction abnormalities.

Index of cardiac electrophysiological balance and transmural dispersion of the repolarization index relationships with pericardial fat volume and coronary calcification.

AIM: To assess the possible relationship between coronary atherosclerosis markers, pericardial fat volume (PFV) and coronary artery calcification, with ECG markers of index of the cardiac electrophysiological balance (iCEB) and transmural dispersion of the repolarization in patients with suspected coronary artery disease. METHODOLOGY: One hundred patients who underwent 64-slice multidetector computed tomography angiography were found to be eligible and were enrolled in the study. RESULTS: Patients with high iCEB levels tended to have a higher PFV values compared with patients with low iCEB levels (median [interquartile range]) (152 [29-206] vs 96 [14-177]; p = 0.03). No significant differences in coronary artery calcification values were observed between iCEB and transmural dispersion of the repolarization groups. CONCLUSION: A higher PFV value was observed in patients with high iCEB. Larger prospective studies are required to confirm the results.

The relationship of socioeconomic status with coronary artery calcification and pericardial fat.

BACKGROUND: Little data currently exist supporting the correlation of socioeconomic status (SES) to markers of subclinical coronary atherosclerosis. AIM: The main aim was to investigate the relationship of SES measured by economic status and educational level with coronary artery calcification (CAC) and pericardial fat volume (PFV) assessed by multi-detector computed tomography (MDCT). METHODS: A total of 220 consecutive patients with suspected coronary artery disease, who underwent 64-slice MDCT angiography for assessment of coronary atherosclerosis, were recruited between January 2014 and March 2015. Of these, 186 patients were enrolled in this cross sectional study. RESULTS: Low economic status patients showed higher PFV values; median (inter-quartile range [IQR] was 94 [50-140] cm3, p = 0.00001 and r = 0.37, compared to patients with high economic status, and this association persisted even after multiple logistic regression to conventional cardiac risk factors (p = 0.004, CI 7.3-30.4), while patients with low economic status reported a higher calcium score (but statistically non significant) (p = 0.12) compared to high economic status patients. Pa-tients with no formal education showed higher PFV (median [IQR] was 93 [48-140] cm3, p = 0.01) compared to patients with bachelor's degree (median [IQR] was 56 [28-92] cm3), but this association was attenuated after further adjustment for conventional cardiac risk factors (p = 0.1, CI -9.52-10.88), while CAC showed no significant correlation with educational level (p = 0.2, r = 0.117). CONCLUSIONS: Socioeconomic status, particularly economic status measure, reported a significant inverse relationship with PFV independent of conventional cardiac risk factors.