Cardiac Metabolic Implications of Fat Depot Imaging

Abstract

Visceral adipose tissues differentiate from subcutaneous fat by its local and systemic effects. As visceral adipose tissue within the thorax, the epicardial adipose tissue (EAT) surrounds the heart and the coronary arteries. Several studies described the association of EAT and cardiovascular risk factors as well as prevalence and incidence of coronary artery disease. General measures of obesity like body mass index can easily be assessed. In contrast, visceral adipose tissue requires imaging modalities like computed tomography or ultrasonography for assessment. While computed tomography is considered the gold standard for measurement of 3D volume of adipose tissues, it acquires high demands in resources and radiation exposure is indispensable. Echocardiography might be an easy accessible alternative without any radiation exposure. Epicardial adipose tissue is not routinely measured in clinical routine and further studies are needed to establish measurement of epicardial adipose tissue to alter risk stratification and therefore improve patient’s management. This review article provides an overview over the existing literature describing EAT as an independent cardiovascular risk factor. Furthermore, we describe different imaging modalities which are frequently used in recent studies for EAT assessment.