Epicardial fat density obtained with computed tomography imaging - more important than volume?

Area of Science:

• Cardiology
• Radiology
• Biomedical Imaging

Background:

• Epicardial adipose tissue (EAT) is a distinct fat depot surrounding the heart, interacting closely with cardiac structures.
• EAT includes pericoronary (PCAT), periatrial (PAAT), and periventricular (PVentAT) depots, each with unique properties.
• EAT volume and density are measurable via computed tomography (CT).

Purpose of the Study:

• To review the utility of CT-derived fat attenuation index (FAI) for assessing EAT.
• To explore FAI's potential as a diagnostic and prognostic marker in cardiovascular disorders.
• To highlight FAI's emerging role in understanding EAT and its clinical implications.

Main Methods:

• Utilizing computed tomography (CT) imaging to quantify EAT volume and density.
• Analyzing the fat attenuation index (FAI) as a measure of EAT characteristics, including inflammation and fibrosis.
• Reviewing current literature on FAI's association with cardiovascular conditions.

Main Results:

• FAI reflects inflammation and fibrosis in PCAT and PAAT, with less known relevance for PVentAT.
• Emerging data suggests FAI is a valuable tool for diagnosing and predicting coronary artery disease and atrial fibrillation.
• FAI may serve as a future marker for therapeutic efficacy and ventricular pathologies.

Conclusions:

• CT-derived FAI is a significant tool for studying epicardial adipose tissue.
• FAI shows potential as a predictive marker for various cardiovascular disorders.
• Further research is needed to fully establish FAI's clinical utility, especially for PVentAT and therapeutic monitoring.