Paracrine effect of the epicardial adipose tissue may promote coronary atherosclerosis. Adipose tissue is the main determinant of interatrial septum thickness (IST) and is a true marker of cardiac adiposity. The relationship of IST with the presence and severity of coronary artery disease (CAD) is thoroughly investigated around the world. This study was conducted to evaluate the association of IST with severity of CAD in the Bangladeshi population.

A total of 100 patients with ischaemic heart disease who agreed to undergo coronary angiography were included in the study. Coronary angiogram was done during index hospital admission. Interatrial septal thickness was measured using bidimensional echocardiography. On the basis of IST, study subjects were divided into two groups: 50 patients with IST ≥14.2 mm were assigned as Thick and 50 patients with IST<14.2 mm were assigned as Thin. Clinical (age, sex, smoking habit, hypertension and diabetes mellitus, clinical presentation of CAD) and anthropometric (waist circumference and body mass index ) variables were collected. Severity of CAD expressed by vessels score and Gensini score. Patients with a Gensini score ≤36 points were considered as absent or mild and those with Gensini score >36 points as severe CAD.

Severe CAD patients were significantly more in thick group than thin group (78% vs 14%,p<0.001). The difference of mean IST between the mild and severe CAD groups was statistically significant (15.5 mm vs 12.1 mm, p<0.001). Interatrial septal thickness showed a positive correlation with Gensini score (r=0.58) and Vessel score(r=0.51). Univariate and multivariate regression analysis revealed IST was found to be independently significant predictor of severe CAD with odds ratio being 6.61 vs. 9.82.

The study demonstrated that there was a significant association of interatrial septal thickness with severe coronary artery disease. So presence of severe coronary artery disease can be predicted by echocardiographic measurement of interatrial septal thickness.