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Erschienen in: Current Cardiovascular Imaging Reports 10/2015

01.10.2015 | Cardiac Computed Tomography (TC Villines, Section Editor)

Cardiac CT for Quantification of Epicardial Fat: Where to Measure and Why?

verfasst von: Mohamed Marwan, Stephan Achenbach

Erschienen in: Current Cardiovascular Imaging Reports | Ausgabe 10/2015

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Abstract

Epicardial adipose tissue has been attracting increasing attention over the last decade with a large body of evidence pointing towards significant associations between the volume of epicardial fat and atherosclerotic and non-atherosclerotic heart diseases. On the other hand, recent data from relatively large studies question the hypothesis of epicardial fat as an independent risk factor for atherosclerosis. This article reviews the available literature concerning imaging and quantification of epicardial adipose tissue and its potential clinical significance.
Literatur
1.
Zurück zum Zitat Marwan M, Achenbach S. Quantification of epicardial fat by computed tomography: why, when and how? J Cardiovasc Comput Tomogr. 2013;7(1):3–10.CrossRefPubMed Marwan M, Achenbach S. Quantification of epicardial fat by computed tomography: why, when and how? J Cardiovasc Comput Tomogr. 2013;7(1):3–10.CrossRefPubMed
2.•
Zurück zum Zitat Cavalcante JL, Tamarappoo BK, Hachamovitch R, Kwon DH, Alraies MC, Halliburton S, et al. Association of epicardial fat, hypertension, subclinical coronary artery disease, and metabolic syndrome with left ventricular diastolic dysfunction. Am J Cardiol. 2012;110(12):1793–8. Role of epicardial adipose tissue on left ventricular diastolic dysfunction.PubMedCentralCrossRefPubMed Cavalcante JL, Tamarappoo BK, Hachamovitch R, Kwon DH, Alraies MC, Halliburton S, et al. Association of epicardial fat, hypertension, subclinical coronary artery disease, and metabolic syndrome with left ventricular diastolic dysfunction. Am J Cardiol. 2012;110(12):1793–8. Role of epicardial adipose tissue on left ventricular diastolic dysfunction.PubMedCentralCrossRefPubMed
3.
4.
Zurück zum Zitat Nakazato R, Shmilovich H, Tamarappoo BK, Cheng VY, Slomka PJ, Berman DS, et al. Interscan reproducibility of computer-aided epicardial and thoracic fat measurement from noncontrast cardiac CT. J Cardiovasc Comput Tomogr. 2011;5(3):172–9.PubMedCentralCrossRefPubMed Nakazato R, Shmilovich H, Tamarappoo BK, Cheng VY, Slomka PJ, Berman DS, et al. Interscan reproducibility of computer-aided epicardial and thoracic fat measurement from noncontrast cardiac CT. J Cardiovasc Comput Tomogr. 2011;5(3):172–9.PubMedCentralCrossRefPubMed
5.
Zurück zum Zitat Thanassoulis G, Massaro JM, Hoffmann U, Mahabadi AA, Vasan RS, O'Donnell CJ, et al. Prevalence, distribution, and risk factor correlates of high pericardial and intrathoracic fat depots in the Framingham heart study. Circ Cardiovasc Imaging. 2010;3(5):559–66.PubMedCentralCrossRefPubMed Thanassoulis G, Massaro JM, Hoffmann U, Mahabadi AA, Vasan RS, O'Donnell CJ, et al. Prevalence, distribution, and risk factor correlates of high pericardial and intrathoracic fat depots in the Framingham heart study. Circ Cardiovasc Imaging. 2010;3(5):559–66.PubMedCentralCrossRefPubMed
6.
Zurück zum Zitat Cheng VY, Dey D, Tamarappoo B, Nakazato R, Gransar H, Miranda-Peats R, et al. Pericardial fat burden on ECG-gated noncontrast CT in asymptomatic patients who subsequently experience adverse cardiovascular events. JACC Cardiovasc Imaging. 2010;3(4):352–60.PubMedCentralCrossRefPubMed Cheng VY, Dey D, Tamarappoo B, Nakazato R, Gransar H, Miranda-Peats R, et al. Pericardial fat burden on ECG-gated noncontrast CT in asymptomatic patients who subsequently experience adverse cardiovascular events. JACC Cardiovasc Imaging. 2010;3(4):352–60.PubMedCentralCrossRefPubMed
7.
Zurück zum Zitat Tamarappoo B, Dey D, Shmilovich H, Nakazato R, Gransar H, Cheng VY, et al. Increased pericardial fat volume measured from noncontrast CT predicts myocardial ischemia by SPECT. JACC Cardiovasc Imaging. 2010;3(11):1104–12.PubMedCentralCrossRefPubMed Tamarappoo B, Dey D, Shmilovich H, Nakazato R, Gransar H, Cheng VY, et al. Increased pericardial fat volume measured from noncontrast CT predicts myocardial ischemia by SPECT. JACC Cardiovasc Imaging. 2010;3(11):1104–12.PubMedCentralCrossRefPubMed
8.
Zurück zum Zitat Shmilovich H, Dey D, Cheng VY, Rajani R, Nakazato R, Otaki Y, et al. Threshold for the upper normal limit of indexed epicardial fat volume: derivation in a healthy population and validation in an outcome-based study. Am J Cardiol. 2011;108(11):1680–5.PubMedCentralCrossRefPubMed Shmilovich H, Dey D, Cheng VY, Rajani R, Nakazato R, Otaki Y, et al. Threshold for the upper normal limit of indexed epicardial fat volume: derivation in a healthy population and validation in an outcome-based study. Am J Cardiol. 2011;108(11):1680–5.PubMedCentralCrossRefPubMed
9.
Zurück zum Zitat Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med. 2005;2(10):536–43.CrossRefPubMed Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med. 2005;2(10):536–43.CrossRefPubMed
10.
Zurück zum Zitat Sacks HS, Fain JN. Human epicardial adipose tissue: a review. Am Heart J. 2007;153(6):907–17.CrossRefPubMed Sacks HS, Fain JN. Human epicardial adipose tissue: a review. Am Heart J. 2007;153(6):907–17.CrossRefPubMed
11.
Zurück zum Zitat Konishi M, Sugiyama S, Sugamura K, Nozaki T, Ohba K, Matsubara J, et al. Association of pericardial fat accumulation rather than abdominal obesity with coronary atherosclerotic plaque formation in patients with suspected coronary artery disease. Atherosclerosis. 2010;209(2):573–8.CrossRefPubMed Konishi M, Sugiyama S, Sugamura K, Nozaki T, Ohba K, Matsubara J, et al. Association of pericardial fat accumulation rather than abdominal obesity with coronary atherosclerotic plaque formation in patients with suspected coronary artery disease. Atherosclerosis. 2010;209(2):573–8.CrossRefPubMed
12.
Zurück zum Zitat Alexopoulos N, McLean DS, Janik M, Arepalli CD, Stillman AE, Raggi P. Epicardial adipose tissue and coronary artery plaque characteristics. Atherosclerosis. 2010;210(1):150–4.CrossRefPubMed Alexopoulos N, McLean DS, Janik M, Arepalli CD, Stillman AE, Raggi P. Epicardial adipose tissue and coronary artery plaque characteristics. Atherosclerosis. 2010;210(1):150–4.CrossRefPubMed
13.•
Zurück zum Zitat Rajani R, Shmilovich H, Nakazato R, Nakanishi R, Otaki Y, Cheng VY, et al. Relationship of epicardial fat volume to coronary plaque, severe coronary stenosis, and high-risk coronary plaque features assessed by coronary CT angiography. J Cardiovasc Comput Tomogr. 2013;7(2):125–32. Relationship between epicardial adipose tissue and potentially vulnerable plaques.PubMedCentralCrossRefPubMed Rajani R, Shmilovich H, Nakazato R, Nakanishi R, Otaki Y, Cheng VY, et al. Relationship of epicardial fat volume to coronary plaque, severe coronary stenosis, and high-risk coronary plaque features assessed by coronary CT angiography. J Cardiovasc Comput Tomogr. 2013;7(2):125–32. Relationship between epicardial adipose tissue and potentially vulnerable plaques.PubMedCentralCrossRefPubMed
14.
Zurück zum Zitat Yerramasu A, Dey D, Venuraju S, Anand DV, Atwal S, Corder R, et al. Increased volume of epicardial fat is an independent risk factor for accelerated progression of sub-clinical coronary atherosclerosis. Atherosclerosis. 2012;220(1):223–30.CrossRefPubMed Yerramasu A, Dey D, Venuraju S, Anand DV, Atwal S, Corder R, et al. Increased volume of epicardial fat is an independent risk factor for accelerated progression of sub-clinical coronary atherosclerosis. Atherosclerosis. 2012;220(1):223–30.CrossRefPubMed
15.••
Zurück zum Zitat Hartiala O, Magnussen CG, Bucci M, Kajander S, Knuuti J, Ukkonen H, Saraste A, Rinta-Kiikka I, Kainulainen S, Kahonen M, Hutri-Kahonen N, Laitinen T, Lehtimaki T, Viikari JS, Hartiala J, Juonala M, Raitakari OT. Coronary heart disease risk factors, coronary artery calcification and epicardial fat volume in the Young Finns Study. Eur Heart J Cardiovasc Imaging 2015. Recent prospective study with a long follow-up Hartiala O, Magnussen CG, Bucci M, Kajander S, Knuuti J, Ukkonen H, Saraste A, Rinta-Kiikka I, Kainulainen S, Kahonen M, Hutri-Kahonen N, Laitinen T, Lehtimaki T, Viikari JS, Hartiala J, Juonala M, Raitakari OT. Coronary heart disease risk factors, coronary artery calcification and epicardial fat volume in the Young Finns Study. Eur Heart J Cardiovasc Imaging 2015. Recent prospective study with a long follow-up
16.••
Zurück zum Zitat Tanami Y, Jinzaki M, Kishi S, Matheson M, Vavere AL, Rochitte CE, et al. Lack of association between epicardial fat volume and extent of coronary artery calcification, severity of coronary artery disease, or presence of myocardial perfusion abnormalities in a diverse, symptomatic patient population: results from the CORE320 multicenter study. Circ Cardiovasc Imaging. 2015;8(3):e002676. Relatively large patient sample performed in a multi-center setting with information regarding epicardial fat and several CAD parameters.CrossRefPubMed Tanami Y, Jinzaki M, Kishi S, Matheson M, Vavere AL, Rochitte CE, et al. Lack of association between epicardial fat volume and extent of coronary artery calcification, severity of coronary artery disease, or presence of myocardial perfusion abnormalities in a diverse, symptomatic patient population: results from the CORE320 multicenter study. Circ Cardiovasc Imaging. 2015;8(3):e002676. Relatively large patient sample performed in a multi-center setting with information regarding epicardial fat and several CAD parameters.CrossRefPubMed
17.
Zurück zum Zitat Oka T, Yamamoto H, Ohashi N, Kitagawa T, Kunita E, Utsunomiya H, et al. Association between epicardial adipose tissue volume and characteristics of non-calcified plaques assessed by coronary computed tomographic angiography. Int J Cardiol. 2012;161(1):45–9.CrossRefPubMed Oka T, Yamamoto H, Ohashi N, Kitagawa T, Kunita E, Utsunomiya H, et al. Association between epicardial adipose tissue volume and characteristics of non-calcified plaques assessed by coronary computed tomographic angiography. Int J Cardiol. 2012;161(1):45–9.CrossRefPubMed
18.
Zurück zum Zitat Harada K, Amano T, Uetani T, Tokuda Y, Kitagawa K, Shimbo Y, et al. Cardiac 64-multislice computed tomography reveals increased epicardial fat volume in patients with acute coronary syndrome. Am J Cardiol. 2011;108(8):1119–23.CrossRefPubMed Harada K, Amano T, Uetani T, Tokuda Y, Kitagawa K, Shimbo Y, et al. Cardiac 64-multislice computed tomography reveals increased epicardial fat volume in patients with acute coronary syndrome. Am J Cardiol. 2011;108(8):1119–23.CrossRefPubMed
19.
Zurück zum Zitat Ding J, Hsu FC, Harris TB, Liu Y, Kritchevsky SB, Szklo M, et al. The association of pericardial fat with incident coronary heart disease: the multi-ethnic study of atherosclerosis (MESA). Am J Clin Nutr. 2009;90(3):499–504.PubMedCentralCrossRefPubMed Ding J, Hsu FC, Harris TB, Liu Y, Kritchevsky SB, Szklo M, et al. The association of pericardial fat with incident coronary heart disease: the multi-ethnic study of atherosclerosis (MESA). Am J Clin Nutr. 2009;90(3):499–504.PubMedCentralCrossRefPubMed
20.••
Zurück zum Zitat Mahabadi AA, Berg MH, Lehmann N, Kalsch H, Bauer M, Kara K, et al. Association of epicardial fat with cardiovascular risk factors and incident myocardial infarction in the general population: the Heinz Nixdorf recall study. J Am Coll Cardiol. 2013;61(13):1388–95. Data from a well-designed prospective study on the prognostic relevance of epicardial fat.CrossRefPubMed Mahabadi AA, Berg MH, Lehmann N, Kalsch H, Bauer M, Kara K, et al. Association of epicardial fat with cardiovascular risk factors and incident myocardial infarction in the general population: the Heinz Nixdorf recall study. J Am Coll Cardiol. 2013;61(13):1388–95. Data from a well-designed prospective study on the prognostic relevance of epicardial fat.CrossRefPubMed
21.
Zurück zum Zitat Forouzandeh F, Chang SM, Muhyieddeen K, Zaid RR, Trevino AR, Xu J, et al. Does quantifying epicardial and intrathoracic fat with noncontrast computed tomography improve risk stratification beyond calcium scoring alone? Circ Cardiovasc Imaging. 2013;6(1):58–66.CrossRefPubMed Forouzandeh F, Chang SM, Muhyieddeen K, Zaid RR, Trevino AR, Xu J, et al. Does quantifying epicardial and intrathoracic fat with noncontrast computed tomography improve risk stratification beyond calcium scoring alone? Circ Cardiovasc Imaging. 2013;6(1):58–66.CrossRefPubMed
22.
Zurück zum Zitat Stojanovska J, Kazerooni EA, Sinno M, Gross BH, Watcharotone K, Patel S, et al. Increased epicardial fat is independently associated with the presence and chronicity of atrial fibrillation and radiofrequency ablation outcome. Eur Radiol. 2015. doi:10.1007/s00330-015-3643-1.PubMed Stojanovska J, Kazerooni EA, Sinno M, Gross BH, Watcharotone K, Patel S, et al. Increased epicardial fat is independently associated with the presence and chronicity of atrial fibrillation and radiofrequency ablation outcome. Eur Radiol. 2015. doi:10.​1007/​s00330-015-3643-1.PubMed
Metadaten
Titel
Cardiac CT for Quantification of Epicardial Fat: Where to Measure and Why?
verfasst von
Mohamed Marwan
Stephan Achenbach
Publikationsdatum
01.10.2015
Verlag
Springer US
Erschienen in
Current Cardiovascular Imaging Reports / Ausgabe 10/2015
Print ISSN: 1941-9066
Elektronische ISSN: 1941-9074
DOI
https://doi.org/10.1007/s12410-015-9354-9

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