The relation between total epicardial fat volume assessed by cardiac CT and the presence of atrial fibrillation

Tabl, Mohamed Abdelshafy; Torky, Ahmed; Ahmad, Fayyaz

doi:10.1016/j.ehj.2015.12.001

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…Our results also indicate that the BMI correlates only moderately with the total ECF and PCF volume. This observation is in line with previous studies (9,22,23) and underlines that estimation of ECF and PCF volumes by mere measurement of the BMI is not reliable. Of note, due to its local expression of inflammatory mediators, ECF plays a special role in cardiac diseases and is not to be equated with visceral fat in general (24).…”

Section: Discussionsupporting

confidence: 92%

“…In addition, ECF appears to play a role in remodeling after surgical aortic valve replacement, with greater amounts of ECF associated with more pronounced and severe left ventricular remodeling in patients with severe aortic stenosis (8). Furthermore, the amount of ECF was shown to correlate with the recurrence of atrial fibrillation after ablation therapy (9).…”

Section: Introductionmentioning

confidence: 99%

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Association between single-slice and whole heart measurements of epicardial and pericardial fat in cardiac MRI

et al. 2021

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Background Epicardial (ECF) and pericardial fat (PCF) are important prognostic markers for various cardiac diseases. However, volumetry of the fat compartments is time-consuming. Purpose To investigate whether total volume of ECF and PCF can be estimated by axial single-slice measurements and in a four-chamber view. Material and Methods A total of 113 individuals (79 patients and 34 healthy) were included in this retrospective magnetic resonance imaging (MRI) study. The total volume of ECF and PCF was determined using a 3D-Dixon sequence. Additionally, the area of ECF and PCF was obtained in single axial layers at five anatomical landmarks (left coronary artery, right coronary artery, right pulmonary artery, mitral valve, coronary sinus) of the Dixon sequence and in a four-chamber view of a standard cine sequence. Pearson's correlation coefficient was calculated between the total volume and each single-slice measurement. Results Axial single-slice measurements of ECF and PCF correlated strongly with the total fat volumes at all landmarks (ECF: r = 0.85–0.94, P < 0.001; PCF: r = 0.89–0.94, P < 0.001). The best correlation was found at the level of the left coronary artery for ECF and PCF ( r = 0.94, P < 0.001). Correlation between single-slice measurement in the four-chamber view and the total ECF and PCF volume was lower ( r = 0.75 and r = 0.8, respectively, P < 0.001). Conclusion Single-slice measurements allow an estimation of ECF and PCF volume. This time-efficient analysis allows studies of larger patient cohorts and the opportunistic determination of ECF/PCF from routine examinations.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Association between single-slice and whole heart measurements of epicardial and pericardial fat in cardiac MRI

et al. 2021

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“…1 Other cross-sectional studies underscored the importance of volumetric measures of pericardial fat on prevalence, 9-12 severity, 9, 13 and recurrence 9, 14 of AF. To our knowledge, only 1 study has examined the longitudinal association between pericardial fat with incident AF.…”

Section: Discussionmentioning

confidence: 99%

Relation of Pericardial Fat, Intrathoracic Fat, and Abdominal Visceral Fat With Incident Atrial Fibrillation (from the Framingham Heart Study)

Lee

Yin

Hoffmann

et al. 2016

The American Journal of Cardiology

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Obesity is associated with increased risk of developing atrial fibrillation (AF). Different fat depots may have differential associations with cardiac pathology. We examined the longitudinal associations between pericardial, intrathoracic, and visceral fat with incident AF. We studied Framingham Heart Study Offspring and Third Generation Cohorts who participated in the multi-detector computed tomography sub-study examination 1. We constructed multivariable-adjusted Cox proportional hazard models for risk of incident AF. Body mass index (BMI) was included in the multivariable-adjusted model as a secondary adjustment. We included 2,135 participants (53.3% women; mean age 58.8 years). During a median follow-up of 9.7 years, we identified 162 cases of incident AF. Across the increasing tertiles of pericardial fat volume, age- and sex-adjusted incident AF rate per 1000 person-years of follow-up were 8.4, 7.5, and 10.2. Based on an age- and sex-adjusted model, greater pericardial fat [hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.03-1.34] and intrathoracic fat (HR 1.24, 95% CI 1.06-1.45) were associated with increased risk of incident AF. The HRs (95% CI) for incident AF were 1.13 (0.99-1.30) for pericardial fat, 1.19 (1.01-1.40) for intrathoracic fat, and 1.09 (0.93-1.28) for abdominal visceral fat after multivariable adjustment. After additional adjustment of BMI, none of the associations remained significant (all p>0.05). Our findings suggest that cardiac ectopic fat depots may share common risk factors with AF, which may have led to a lack of independence in the association between pericardial fat with incident AF.

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“…The workload for segmenting the pericardium slice by slice was heavy. Having taken into account that adjacent slices are similar, Tabl, Bastarrika, Spearman, Milanese and Nichols et al 17–21 . manually traced the pericardium every few slices and then automatically interpolated the border in the intervening slices.…”

Section: Introductionmentioning

confidence: 99%

Automatic quantification of epicardial adipose tissue volume

Sun

et al. 2021

Medical Physics

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Purpose Epicardial fat is the adipose tissue between the serosal pericardial wall layer and the visceral layer. It is distributed mainly around the atrioventricular groove, atrial septum, ventricular septum and coronary arteries. Studies have shown that the density, thickness, volume and other characteristics of epicardial adipose tissue (EAT) are independently correlated with a variety of cardiovascular diseases. Given this association, the accurate determination of EAT volume is an essential aim of future research. Therefore, the purpose of this study was to establish a framework for fully automatic EAT segmentation and quantification in coronary computed tomography angiography (CCTA) scans. Methods A set of 103 scans are randomly selected from our medical center. An automatic pipeline has been developed to segment and quantify the volume of EAT. First, a multi‐slice deep neural network is used to simultaneously segment the pericardium in multiple adjacent slices. Then a deformable model is employed to reduce false positive and negative regions in the segmented binary pericardial images. Finally, the pericardium mask is used to define the region of interest (ROI) and the threshold method is utilized to extract the pixels ranging from −175 Hounsfield units (HU) to −15 HU for the segmentation of EAT. Results The Dice indices of the pericardial segmentation using the proposed method with respect to the manual delineation results of two radiology experts were 97.1% ± 0.7% and 96.9% ± 0.6%, respectively. The inter‐observer variability was also assessed, resulting in a Dice index of 97.0% ± 0.7%. For the EAT segmentation results, the Dice indices between the proposed method and the two radiology experts were 93.4% ± 1.5% and 93.3% ± 1.3%, respectively, and the same measurement between the experts themselves was 93.6% ± 1.9%. The Pearson’s correlation coefficients between the EAT volumes computed from the results of the proposed method and the manual delineation by the two experts were 1.00 and 0.99 and the same coefficients between the experts was 0.99. Conclusions This work describes the development of a fully automatic EAT segmentation and quantification method from CCTA scans and the results compare favorably with the assessments of two independent experts. The proposed method is also packaged with a graphical user interface which can be found at https://github.com/MountainAndMorning/EATSeg.

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The relation between total epicardial fat volume assessed by cardiac CT and the presence of atrial fibrillation

Cited by 4 publications

References 13 publications

Association between single-slice and whole heart measurements of epicardial and pericardial fat in cardiac MRI

Association between single-slice and whole heart measurements of epicardial and pericardial fat in cardiac MRI

Relation of Pericardial Fat, Intrathoracic Fat, and Abdominal Visceral Fat With Incident Atrial Fibrillation (from the Framingham Heart Study)

Automatic quantification of epicardial adipose tissue volume

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