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Epicardial Fat Distribution Assessed with Cardiac CT in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

Mounes Aliyari Ghasabeh1, Anneline S J M Te Riele1, Cynthia A James1

  • 1From the Russell H. Morgan Department of Radiology and Radiological Sciences (M.A.G., J.E., I.R.K., S.L.Z.) and Division of Cardiology (A.S.J.M.T.R., C.A.J., C.T., B.M., B.G.K., H.T., H.C.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Halsted B180, Baltimore, MD 21287; Division of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands (A.S.J.M.T.R.); Netherlands Heart Institute, Utrecht, the Netherlands (A.S.J.M.T.R.); and Department of Medicine/Cardiology, Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Ind (H.S.V.C.).

Radiology
|August 22, 2018
PubMed

Insights

Patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) have significantly higher epicardial fat volumes, particularly around the left and right ventricles. This finding aids in differentiating ARVD/C from healthy individuals and correlates with disease severity.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is a genetic heart muscle disease.
  • Epicardial adipose tissue (EAT) distribution may play a role in cardiac pathology.
  • Understanding EAT in ARVD/C can aid in diagnosis and understanding disease mechanisms.

Purpose of the Study:

  • To compare epicardial fat volumes in patients diagnosed with ARVD/C versus healthy controls.
  • To investigate regional differences in EAT and their association with ARVD/C.
  • To determine the diagnostic utility of EAT measurements in ARVD/C.

Main Methods:

  • Retrospective analysis of cardiac CT scans from 44 ARVD/C patients and 45 controls.
  • Quantification of total, mediastinal (MAT), and regional EAT (RV, LV, atrial) volumes.
  • Normalization of EAT volumes to MAT; logistic regression and ROC analysis for diagnostic assessment.

Main Results:

  • Total EAT volume was significantly higher in ARVD/C patients (98 mL vs 76 mL, P=.04).
  • Indexed LV EAT (0.49 vs 0.15) and RV EAT (0.91 vs 0.52) were markedly elevated in ARVD/C (P<.0005).
  • An LV EAT index cutoff of 0.24 showed 91% sensitivity and 71% specificity for ARVD/C diagnosis.

Conclusions:

  • Increased epicardial fat, especially around the ventricles, is characteristic of ARVD/C.
  • Indexed LV and RV EAT are valuable biomarkers for differentiating ARVD/C from healthy subjects.
  • Elevated EAT correlates with disease severity, as indicated by RV diameter correlations.

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