CT Quantification of Epicardial Fat: Implications for Cardiovascular Risk Assessment

Abstract

Epicardial fat, a local visceral fat depot around the heart, surrounds the coronary arteries for most of their course and may contribute to the development of coronary atherosclerosis through local production of inflammatory cytokines. Several studies which measured epicardial fat volume noninvasively from CT have shown a relationship of increased epicardial fat volume with coronary artery disease, the presence and progression of coronary plaque, major adverse cardiovascular events, myocardial ischemia, and atrial fibrillation. Noninvasive quantitative measurement of epicardial fat volume from CT is feasible, and may play a clinical role in cardiovascular risk assessment. The scientific evidence, to date, warrants larger studies with longer follow-up to further investigate the role of epicardial fat as an imaging marker with prognostic importance.