Epicardial adipose tissue volume assessed by computed tomography and coronary artery disease: a systematic review and meta-analysis

Abstract

To conduct a systematic review and meta-analysis on the crude and adjusted associations between epicardial adipose tissue (EAT) volume determined by computed tomography (CT) and coronary artery disease (CAD). MEDLINE, Scopus, and Web of Science databases were screened for all observational studies assessing the association between EAT volume and CAD. We calculated pooled odds ratio (OR) or hazard ratio (HR) and 95% confidence intervals (CI) for the association per 10 cm3 variation of EAT by five different definitions of CAD: obstructive or significant coronary stenosis (luminal narrowing ≥50% and ≥70%, respectively), presence of coronary artery calcification (CAC), myocardial ischaemia, and major adverse cardiovascular events (MACE) using DerSimonian and Laird random-effects models. Seventy studies were identified comprising 41 534 subjects, mainly derived from community-based or hospital-based low-to-intermediate pretest probability of CAD populations. Participants with any outcome of CAD had a higher mean volume of EAT than those without. Accordingly, the analysis of crude associations showed that EAT volume was associated with obstructive stenosis, significant stenosis, any CAC, and MACE. Based on the analysis of adjusted associations, although attenuated, EAT volume remained associated with obstructive stenosis (OR 1.055, 95% CI 1.033-1.078; I2 = 63.5%), significant stenosis (OR 1.514, 95% CI 1.262-1.815; I2 = 51.8%), myocardial ischaemia (OR 1.062, 95% CI 1.006-1.122; I2 = 86.9%), and MACE (HR 1.040, 95% CI 1.024-1.056; I2 = 64.7%) but was only borderline significant with CAC (OR 1.007, 95% CI 1.000-1.011; I2 = 75.8%). In low-to-intermediate cardiovascular risk subjects, EAT volume was independently associated with coronary artery stenosis, myocardial ischaemia, and MACE.

Examination of the Epicardial Fat Area in Patients with Rheumatoid Arthritis by Computed Tomography of the Thorax

“…However, cardiac CT is an imaging method which provides more objective findings compared to ECHO for the evaluation of the EAT, and it gives results independently of any individual thanks to appropriate software [17][18][19][20] . In the present study, the EAT measurement was evaluated through the thorax CT with proper software.…”

“…CT is a more sensitive imaging method compared to echocardiogram (ECHO) in the evaluation of EAT and, with appropriate software, it ensures obtaining independent and objective results of a person [17][18][19][20] . In this study, it was aimed to evaluate the EAT, a significant risk indicator for CVDs, through CT in RA patients and healthy people.…”

Pericardial adipose tissue and cardiovascular diseases: New insights from basic research

“…Mounting evidence indicates that epicardial fat might not only mechanically protect coronary arteries, but also impact on cardiovascular (CV) morbidity and mortality in both obese and nonobese subjects . Although controversial, current paradigm distinguishes two anatomical regions with a different role in CV risk.…”

“…Mounting evidence indicates that epicardial fat might not only mechanically protect coronary arteries, but also impact on cardiovascular (CV) morbidity and mortality in both obese and nonobese subjects. 4,5 Although controversial, 6 current paradigm distinguishes two anatomical regions with a different role in CV risk. The epicardial fat is located between the myocardium and the inner (visceral) pericardial layer, whereas the pericardial adipose tissue accounts for the adipose tissue between the epicardial and paracardial layers.…”

Do the Roles of Fats from Different Depots Differ in the Coronary Artery?

“…10) Finally, a meta-analysis of epicardial fat near the coronary artery has proved that epicardial fat is an independent predictor of cardiac plaques in patients with less severe or slightly severe cardiovascular disease. 11) In contrast, paracardial fat is located between the visceral and the parietal pericardia. However, clinical reports pertaining to "paracardial fat" alone are rare 12) because a majority of studies collectively assess paracardial and epicardial fats as "pericardial fat."…”