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Subcutaneous, Paracardiac, and Epicardial Fat CT Density Before/After Contrast Injection: Any Correlation with CAD?

Caterina Beatrice Monti1, Davide Capra1, Alexis Malavazos2

  • 1Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy.

Journal of Clinical Medicine
|March 6, 2021
PubMed

Insights

Epicardial adipose tissue density measured by computed tomography (CT) does not reliably indicate coronary artery disease (CAD). While contrast-enhanced CT showed higher epicardial fat density, neither unenhanced nor enhanced scans differentiated CAD patients from controls.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Biomarkers

Background:

  • Epicardial adipose tissue (EAT) is metabolically active and linked to cardiovascular pathologies like coronary artery disease (CAD).
  • EAT's density on computed tomography (CT) is explored as a potential imaging biomarker for CAD.
  • Understanding EAT density variations is crucial for its role in cardiovascular risk assessment.

Purpose of the Study:

  • To evaluate epicardial adipose tissue (EAT) density using unenhanced and contrast-enhanced CT.
  • To compare EAT density with paracardiac and subcutaneous adipose tissue densities.
  • To determine the association between adipose tissue densities and the presence of coronary artery disease (CAD).

Main Methods:

  • Retrospective review of 480 patients undergoing cardiac CT for CAD assessment.
  • Segmentation of regions of interest in epicardial, paracardiac, and subcutaneous adipose tissue on unenhanced and contrast-enhanced scans.
  • Analysis of adipose tissue densities and their correlation with diagnosed CAD.

Main Results:

  • Median EAT density was higher on contrast-enhanced CT (-81.5 HU) versus unenhanced CT (-73.4 HU) (p < 0.001).
  • Paracardiac and subcutaneous adipose tissue densities showed no significant changes with contrast enhancement (p ≥ 0.055).
  • No significant differences in EAT, paracardiac, or subcutaneous adipose tissue densities were found between patients with and without CAD on either scan type (p ≥ 0.092).

Conclusions:

  • Contrast-enhanced CT increases epicardial adipose tissue density measurements.
  • Adipose tissue densities, including epicardial fat, do not reliably differentiate patients with or without coronary artery disease.
  • Variations in EAT density due to inflammation or fibrosis in CAD patients may obscure diagnostic differences.

Keywords:
X-ray computedadipose tissuebeigecoronary artery diseasesubcutaneous fattomography

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