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. (C) 2018 Elsevier Inc. All rights reserved.