Epicardial Adipose Tissue: A Multimodal Imaging Diagnostic Perspective

Area of Science:

• Cardiology
• Biomedical Imaging
• Adipose Tissue Biology

Background:

• Epicardial adipose tissue (EAT) is an active endocrine organ secreting adipokines.
• Pericoronary adipose tissue (PCAT), a subset of EAT, has a bidirectional relationship with coronary arteries.
• PCAT dysfunction and inflammation are linked to coronary artery disease (CAD) pathogenesis and cardiovascular events.

Purpose of the Study:

• To review imaging methodologies for evaluating EAT.
• To highlight cardiac computed tomography (CCT) for assessing EAT and PCAT.
• To explore CCT-derived PCAT attenuation as a biomarker for coronary inflammation in CAD.

Main Methods:

• Review of existing literature on EAT and PCAT imaging.
• Emphasis on cardiac computed tomography (CCT) capabilities.
• Discussion of PCAT attenuation as a quantitative imaging biomarker.

Main Results:

• CCT excels at visualizing and quantifying EAT and PCAT, unlike other modalities.
• CCT enables concurrent assessment of coronary arteries and PCAT.
• CCT-derived PCAT attenuation shows potential as a noninvasive biomarker for coronary inflammation.

Conclusions:

• PCAT inflammation is a significant factor in CAD development.
• CCT is the preferred modality for evaluating EAT and PCAT.
• CCT-derived PCAT attenuation may aid in monitoring anti-inflammatory therapies for CAD.