Quantification of epicardial adipose tissue in coronary calcium score and CT coronary angiography image data sets: comparison of attenuation values, thickness and volumes

Grutta, Ludovico La; Toia, Patrizia; Farruggia, Alfonso; Albano, Domenico; Grassedonio, Emanuele; Palmeri, Angelo; Maffei, Erica; Galia, Massimo; Vitabile, Salvatore; Cademartiri, Filippo; Midiri, Massimo

doi:10.1259/bjr.20150773

Cited by 34 publications

(23 citation statements)

References 37 publications

(81 reference statements)

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“…To further back these notions, epicardial adipose tissue density appears to increase on contrast-enhanced scans compared to unenhanced scans, favoring the hypothesis that it may present with a more developed vascularization to support its metabolic activity. This result is in line with findings from one study by La Grutta et al [ 12 ], who observed that epicardial adipose tissue density was significantly higher on contrast-enhanced CT scans. However, these authors reported density values lower than ours on unenhanced scans and higher values on contrast-enhanced scans, such differences being possibly due to different methods of epicardial adipose tissue segmentation.…”

Section: Discussionsupporting

confidence: 92%

“…Therefore, even though the association between an increased epicardial adipose tissue density and myocardial ischemia is still a matter for debate, analyzing the potential relation between its density and CAD may unravel the potential of the former as a cardiovascular risk biomarker [ 11 ]. In this regard, different studies have been conducted both with and without the intravenous administration of iodinated contrast agents [ 12 ]. As a consequence, the relationship between epicardial adipose tissue density and contrast enhancement may benefit from additional insights.…”

Section: Introductionmentioning

confidence: 99%

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Subcutaneous, Paracardiac, and Epicardial Fat CT Density Before/After Contrast Injection: Any Correlation with CAD?

Monti

Capra

Malavazos

et al. 2021

JCM

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Adipose tissue, in particular epicardial adipose tissue, has been identified as a potential biomarker of cardiovascular pathologies such as coronary artery disease (CAD) in the light of its metabolic activity and close anatomic and pathophysiologic relationship to the heart. Our purpose was to evaluate epicardial adipose tissue density at both unenhanced and contrast-enhanced computed tomography (CT), along with CT densities of paracardiac and subcutaneous adipose tissue, as well as the relations of such densities with CAD. We retrospectively reviewed patients who underwent cardiac CT at our institution for CAD assessment. We segmented regions of interest on epicardial, paracardiac, and subcutaneous adipose tissue on unenhanced and contrast-enhanced scans. A total of 480 patients were included, 164 of them presenting with CAD. Median epicardial adipose tissue density measured on contrast-enhanced scans (−81.5 HU; interquartile range −84.9 to −78.0) was higher than that measured on unenhanced scans (−73.4 HU; −76.9 to −69.4) (p < 0.001), whereas paracardiac and subcutaneous adipose tissue densities were not (p ≥ 0.055). Patients with or without CAD, did not show significant differences in density of epicardial, paracardiac, and subcutaneous adipose tissue either on unenhanced or contrast-enhanced scans (p ≥ 0.092). CAD patients may experience different phenomena (inflammation, fibrosis, increase in adipose depots) leading to rises or drops in epicardial adipose tissue density, resulting in variations that are difficult to detect.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Subcutaneous, Paracardiac, and Epicardial Fat CT Density Before/After Contrast Injection: Any Correlation with CAD?

Monti

Capra

Malavazos

et al. 2021

JCM

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“…Larger, less dense, and poorly vascularized adipocytes may experience more oxidative stress leading to metabolic dysfunction and production of pro-inflammatory adipocytokines 19 . Importantly, however, there may be significant regional variation of adipose tissue characteristics, particularly within the pericardium 20 , and this may be reflected in regional variation of radiodensity 21 . Future studies in the HIV+ and general populations should consider more granular characterization of PCF volumes and radiodensity by location within the pericardium.…”

Section: Discussionmentioning

confidence: 99%

Effect of Pericardial Fat Volume and Density on Markers of Insulin Resistance and Inflammation in Patients With Human Immunodeficiency Virus Infection

Longenecker

Margevicius

Liu

et al. 2017

The American Journal of Cardiology

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Treated HIV infection is characterized by ectopic fat deposition, a persistent inflammatory state, and increased cardiometabolic risk. In this secondary analysis of a placebo controlled trial of rosuvastatin among 147 HIV+ subjects (median age 46; 78% male) on stable antiretroviral therapy, we aimed to evaluate longitudinal associations between CT measures of pericardial fat (PCF) volume and density, insulin resistance and inflammation. We measured PCF volume and density (mean attenuation in Hounsfield Units) by non-contrast gated computed tomography at baseline and week 96. Homeostatic model of insulin resistance was calculated from fasting insulin and glucose at entry, 24, 48, and 96 weeks. At baseline, insulin resistance correlated positively with PCF volume and negatively with density. Similarly divergent correlations of volume and density were observed with waist:hip ratio, nadir CD4+ count, and duration of antiretroviral therapy. In a linear mixed model, PCF density was associated with insulin resistance independent of PCF volume, body mass index, metabolic syndrome, and biomarkers of immune activation and systemic inflammation; however, baseline PCF measures were not associated with longitudinal changes in insulin resistance. Soluble CD163, a marker of monocyte activation, positively correlated with PCF volume and was associated with insulin resistance in linear models. Statin treatment assignment did not affect PCF volume or density change (both p> 0.8). In conclusion, the quantity and quality (i.e. radiodensity) of PCF are differentially related to insulin resistance and inflammation in patients with treated HIV infection.

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“…Epicardial adipose tissue can be measured with different imaging techniques: ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) (12,13). Cardiac CT angiography (CCTA) with volumetric acquisition shows the highest spatial resolution and reproducibility for quantitative analysis of EFV, including the assessment of the CT attenuation coefficient (14)(15)(16). A number of studies described EFV features mainly in asymptomatic subjects, with a minor proportion of symptomatic subjects.…”

mentioning

confidence: 99%

Quantification of epicardial fat with cardiac CT angiography and association with cardiovascular risk factors in symptomatic patients: from the ALTER-BIO (Alternative Cardiovascular Bio-Imaging markers) registry

Milanese

Silva

Bruno

et al. 2019

Diagn Interv Radiol

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Quantification of epicardial adipose tissue in coronary calcium score and CT coronary angiography image data sets: comparison of attenuation values, thickness and volumes

Abstract: EAT may be measured by processing either the CS or CTCA image data sets.

Cited by 34 publications

References 37 publications

Subcutaneous, Paracardiac, and Epicardial Fat CT Density Before/After Contrast Injection: Any Correlation with CAD?

Subcutaneous, Paracardiac, and Epicardial Fat CT Density Before/After Contrast Injection: Any Correlation with CAD?

Effect of Pericardial Fat Volume and Density on Markers of Insulin Resistance and Inflammation in Patients With Human Immunodeficiency Virus Infection

Quantification of epicardial fat with cardiac CT angiography and association with cardiovascular risk factors in symptomatic patients: from the ALTER-BIO (Alternative Cardiovascular Bio-Imaging markers) registry

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