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Home  >  Medical Research Archives  >  Issue 149  > Epicardial adipose tissue is a promising imaging biomarker of subclinical atherosclerosis
Published in the Medical Research Archives
Jul 2023 Issue

Epicardial adipose tissue is a promising imaging biomarker of subclinical atherosclerosis

Published on Jul 29, 2023




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.

Author info

Sofia Borges, Maria Mendonça, João Sousa, Marco Serrão, Marina Santos, Margarida Temtem, Débora Sá, Francisco Sousa, Eva Henriques, Sónia Freitas, Mariana Rodrigues, Graça Guerra, António Drumond, Ana Sousa, Roberto Reis

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