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Updated: May 20, 2025

Ultrasonic Assessment of Myocardial Microstructure
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Evaluating Epicardial Fat Density Using ROI-Based Analysis: A Feasibility Study.

Giovanni Lorusso1, Nicola Maggialetti1, Luca De Marco1

  • 1Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy.

Journal of Cardiovascular Development and Disease
|March 26, 2025
PubMed
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This summary is machine-generated.

Epicardial fat density (EFD) varies significantly by heart region. Region-specific measurements using coronary CT may not accurately represent overall EFD, impacting cardiovascular disease assessment.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Biomedical Engineering

Background:

  • Epicardial fat density (EFD) is a marker for cardiovascular disease risk.
  • Accurate EFD measurement is crucial for risk stratification.
  • Understanding regional EFD variability is essential for precise assessment.

Purpose of the Study:

  • To investigate regional differences in epicardial fat density (EFD) using coronary computed tomography (CCT).
  • To assess the utility of region-of-interest (ROI)-based EFD measurements compared to global segmentation.
  • To determine if ROI measurements can reliably represent overall EFD.

Main Methods:

  • Retrospective analysis of 171 patients undergoing CCT.
  • Global EFD measured via semi-automated segmentation (3D Slicer).
Keywords:
cardiac computed tomography (CCT)epicardial adipose tissue (EAT)epicardial fat density (EFD)epicardial fat tissue (EFT)epicardial fat volume (EFV)region of interest (ROI)

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  • Regional EFD measured manually in the aortic bulb, right posterolateral wall, and cardiac apex.
  • Main Results:

    • Global EFD averaged -83.92 ± 5.19 HU.
    • Significant regional EFD variability observed: aortic bulb (-97.54 HU), apex (-93.42 HU), right posterolateral wall (-94.99 HU).
    • Statistically significant differences (p < 0.000) between global and regional EFD values.

    Conclusions:

    • Epicardial fat density exhibits significant regional heterogeneity.
    • ROI-based EFD measurements may not accurately reflect global EFD.
    • Current ROI methods might be insufficient for comprehensive cardiovascular risk assessment based on EFD.