The Volume and Density of Epicardial Adipose Tissue Measured by Computed Tomography as Markers of the Effects of Cardiovascular Disease Risk Factors.

BACKGROUND/

OBJECTIVES

Epicardial adipose tissue (EAT), a visceral fat depot located between the myocardium and the visceral pericardium, has emerged as a potential imaging biomarker of cardiometabolic dysfunction and cardiovascular health. This study aimed to evaluate whether computed tomography (CT)-derived epicardial adipose tissue volume (EATV) and epicardial adipose tissue density (EATD) may serve as markers of the effects of major cardiovascular disease risk factors.

METHODS

This cross-sectional study included 105 participants (mean age: 62.12 ± 11.20 years; 58.1% women) examined with coronary computed tomography angiography. Clinical evaluation included anthropometric assessment, blood pressure measurement, laboratory testing, and questionnaire-based smoking status. EAT was assessed using semi-automatic segmentation on a dedicated post-processing workstation, with visual verification and manual correction, when necessary, within an attenuation range of -190 to -30 HU. Two parameters were analyzed: EATV and EATD.

RESULTS

EATV was significantly higher in men, participants with overweight/obesity, participants with dyslipidemia, and participants with type 2 diabetes. EATD was significantly lower in participants with overweight/obesity, dyslipidemia, and type 2 diabetes. Both EATV and EATD were associated with the total number of CVRFs. Correlation analysis showed that EATV was positively associated with age (r = 0.20, p = 0.04), BMI (r = 0.54, p = 0.01), fasting glycemia (r = 0.46, p = 0.01), and total CVRF number (r = 0.51, p = 0.01), whereas EATD was negatively associated with age (r = -0.26, p = 0.01), BMI (r = -0.40, p = 0.01), triglycerides (r = -0.44, p = 0.02), fasting glycemia (r = -0.49, p = 0.01), and total CVRF number (r = -0.40, p = 0.01). In regression analysis, older age, higher BMI, male gender, and dyslipidemia were independent risk factors for higher EATV, while dyslipidemia and type 2 diabetes were independent risk factors for lower EATD.

CONCLUSIONS

Greater exposure to major cardiovascular disease risk factors was associated with higher EAT volume and lower EAT density, supporting the role of EAT as a structural and metabolic marker of the effects of cardiovascular disease risk factors on cardiovascular health.