ARYA Atherosclerosis Journal

Association between epicardial and pericadial fat thickness and coronary artery calcification severity in chronic kidney disease patients: A pilot study

Document Type : Original Article

Authors

Roxana Sadeghi 1
Pedram Sadeghi 2
Niloufar Taherpour 1
Taraneh Faghihi Langroudi 3
Shima Samavat 4
Mohammad Haji Aghajani 1
Mohammad Parsa Mahjoob 2
Mehrdad Jafari Fesharaki 5

1 Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Cardiology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Radiology Department, Shahid Modarres Hospital, Shahis Beheshti University of Medical Sciences, Tehran, Iran

4 Chronic Kidney Disease Research Center (CKDRC), Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran

5 Department of Cardiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

https://doi.org/10.48305/arya.2025.43184.3005
Abstract
BACKGROUND: This study aims to investigate the association between Coronary Artery Calcium (CAC) score and epicardial fat thickness (EFT) and pericardial fat thickness as indicators of inflammation in patients with chronic kidney disease (CKD).
METHODS: This cross-sectional study measured patients’ CAC scores using dual-source cardiac CT, quantified with Agatston’s score and dedicated Ca-Scoring software. Epicardial and pericardial fat thicknesses were assessed via echocardiography. 
RESULTS: Thirty-one CKD patients participated in the study, with an average age of 54.45 ± 15.12 years. Of these, 22 were male (70.97%) and 9 were female (29.03%). Fifteen CKD patients (48.39%) had moderate to severe CAC scores. Patients with CKD exhibiting severe coronary calcification were found to be older (P = 0.003). A significant positive correlation was observed between epicardial fat thickness (r = 0.58, P < 0.001) and pericardial fat thickness (r = 0.56, P = 0.001) with CAC score. Multivariable analysis revealed that for each one-unit increase in EFT, the odds of having a moderate to severe CAC score were 2.88 times greater than those of a normal score (OR = 2.88, 95% CI = 1.04–7.96, P = 0.041). Similarly, a one-unit increase in pericardial fat thickness was associated with 1.51 times higher odds of a moderate to severe CAC score compared to a normal score (OR = 1.51, 95% CI = 0.93–2.46, P = 0.093).
CONCLUSION: The insights gained from this study advocate for a holistic approach to assessing cardiac function in patients with coronary calcification. By integrating echocardiographic analysis with traditional risk factor assessment, healthcare providers can gain a more comprehensive understanding of cardiovascular health, ultimately leading to better-targeted therapies to improve CKD patient outcomes.

Keywords

Chronic Kidney Disease
Coronary Artery Calcification
Epicardial Fat Thickness
Pericardial Fat Thickness
Echocardiography
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ARYA Atherosclerosis Journal
Volume 21, Issue 3
May and June 2025
Pages 38-48

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