Epicardial fat volume and its association with cardiac arrhythmias in CT coronary angiography

Area of Science:

• Cardiology
• Radiology
• Medical Imaging

Background:

• Epicardial adipose tissue (EAT) plays a role in cardiovascular health.
• Cardiac computed tomography (CT) allows for the assessment of EAT volume.
• The relationship between EAT and coronary artery disease (CAD) severity, as well as arrhythmias, is an area of ongoing research.

Purpose of the Study:

• To investigate epicardial fat volume using cardiac CT.
• To determine the association between epicardial fat volume and cardiac arrhythmias.
• To correlate epicardial fat volume with the Coronary Artery Disease Reporting and Data System (CAD-RADS) score.

Main Methods:

• Retrospective analysis of 96 patients who underwent CT coronary angiography (CTCA).
• Quantification of epicardial fat volume using a standardized algorithm.
• Application of the CAD-RADS scoring system to assess CAD extent.
• Statistical analyses including correlation and receiver operating characteristic (ROC) methods.

Main Results:

• A significant positive correlation was found between epicardial fat volume and CAD-RADS score (r² = 0.31, p < 0.001).
• Patients with higher epicardial fat volumes had a significantly increased likelihood of experiencing cardiac tachyarrhythmia (p < 0.001).
• ROC analysis identified a threshold of 123 cm³ for epicardial fat volume to predict tachyarrhythmia with 80% sensitivity (AUC = 0.69).

Conclusions:

• A minimum epicardial fat volume of 123 cm³ in native coronary calcium scans is associated with cardiac tachyarrhythmia.
• These findings suggest epicardial fat volume is a relevant biomarker for arrhythmia risk.
• Consideration of specific imaging protocols is advised for patients with significant epicardial fat volume.