Epicardial adipose tissue is a promising imaging biomarker of subclinical atherosclerosis

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Published Jul 29, 2023
DOI: https://doi.org/10.18103/mra.v11i7.2.4016

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Maria Isabel Mendonça
1. Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
João Adriano Sousa
Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal; Serviço de Cardiologia, SESARAM, EPERAM
Marco Serrão
Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal; 2. Serviço de Cardiologia, SESARAM, EPERAM
Marina Santos
Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal; Serviço de Cardiologia, SESARAM, EPERAM
Margarida Temtem
Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal; Serviço de Cardiologia, SESARAM, EPERAM
Débora Sá
Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal; Serviço de Cardiologia, SESARAM, EPERAM
Francisco Sousa
Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal; Serviço de Cardiologia, SESARAM, EPERAM
Eva Henriques
Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal;
Sofia Borges
Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
Sónia Freitas
1. Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
Mariana Rodrigues
1. Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
Graça Guerra
1. Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
António Drumond
Serviço de Cardiologia, SESARAM, EPERAM
Ana Célia Sousa
Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal; Faculdade de Medicina da Universidade da Madeira (UMa), Funchal, Portugal
Roberto Palma Reis
Hospital Pulido Valente EPE, Centro Hospitalar Universitário Lisboa Norte (CHULN); Faculdade de Ciências Médicas, Universidade Nova de Lisboa (Nova Medical School), Lisboa, Portugal

Abstract

Introduction: Identifying markers to discriminate high and low-risk individuals better is essential. Coronary Calcium Score (CAC) is an established marker of subclinical atherosclerosis. Epicardial Adipose Tissue (EAT), a new imaging biomarker, has shown considerable interest in the scientific community.


Purpose: Study the impact of EAT volume in discrimination and reclassification of cardiovascular events when added to CAC score. Investigate whether EAT volume is a good prognosis marker in an asymptomatic population.


Methods: A cohort of 1024 individuals without coronary disease were selected and followed prospectively during an extended period. CAC score was evaluated by cardiac tomography. Quantification of EAT was performed through a semi-automated technique (TeraRecon Aquarius Workstation). Pearson’s or Spearman’s correlations identified EAT-associated parameters. Harrel C-statistics assessed the discriminative ability for events. Categorical free Net Reclassification Improvement (cfNRI) and Integrated Discrimination Index (IDI) reclassified the individuals. Kaplan-Meier evaluated cardiovascular disease prognosis, and Cox regression identified variables independently associated with cardiovascular events.


Results: EAT volume was significantly correlated with age, body mass index, non-high-density lipoprotein (HDL) cholesterol, triglycerides, systolic and diastolic blood pressure, and inversely with HDL cholesterol. CAC score and EAT had a C-Statistic of 0.737 (0.651 - 0.823) and 0.662 (0.564-0.760), respectively. When EAT was added to CAC, it increased to 0.777 (0.681 - 0.873) and 60% of the participants were better reclassified (NRI=60%). Higher EAT volume displayed the worst prognosis (p=0.006) and was associated, independently, with cardiovascular events, even after adjusting for risk factors and CAC score (p=0.021).


Conclusions: EAT may be an essential imaging marker of subclinical atherosclerosis and a potential therapeutic target for primary prevention. Reducing EAT volume with adequate measures (physical exercise, proper diet, pharmacological interventions) could decrease atherosclerosis and improve outcomes.

Keywords: Epicardial adipose tissue, imaging biomarker, subclinical atherosclerosis

Article Details

How to Cite
MENDONÇA, Maria Isabel et al. Epicardial adipose tissue is a promising imaging biomarker of subclinical atherosclerosis. Medical Research Archives, [S.l.], v. 11, n. 7.2, july 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4016>. Date accessed: 15 may 2024. doi: https://doi.org/10.18103/mra.v11i7.2.4016.
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Issue
Vol 11 No 7.2 (2023): July Issue, Vol.11, Issue 7.2
Section
Research Articles

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