Epicardial adipose tissue measured by multidetector computed tomography: Practical tips and clinical implications
Journal
Acta Cardiologica Sinica
Journal Volume
26
Journal Issue
2
Pages
55-68
Date Issued
2010-06
Author(s)
Abstract
Epicardial adipose tissue (EAT) is the fat depot surrounding the heart and confined within the pericardial sac. It accounts for approximately 20% of total heart weight and covers 80% of the cardiac surfaces, mostly in the grooved segments along the paths of coronary arteries. To clearly delineate the asymmetric distribution of EAT and explore its pathophysiologic significance, EAT should be measured by multidetector computed tomography (MDCT) in three dimensions: regional thickness, cross-sectional areas, and total volume. Details regarding MDCT measurements of EAT are introduced herein. Regardless of differences in ethnicity and body habitus, EAT thickness in the grooved segments is greater than that in the non-grooved segments. Among the grooved segments, the right atrio-ventricular groove has the thickest fat where the right coronary artery is located, followed by the left atrio-ventricular groove where both the left circumflex artery and great cardiac vein are present. The average volume of EAT is generally between 110-125 cm3. Although EAT constitutes only 1% of total fat mass, studies have shown that the amount of EAT is dose-dependently associated with obesity, intra-abdominal adiposity, cardio-metabolic risk factors (including hypertension, atherogenic dyslipidemia, insulin resistance, and diabetes mellitus), cardiac structural changes, coronary atherosclerosis, and the prevalence and incidence of coronary heart disease events. It is still a matter of debate as to whether these associations to EAT are direct or indirect. Our observation that EAT thickness in the left atrio-ventricular groove bests total EAT volume as an indicator of its metabolic and atherogenic risks merits further verification.
Subjects
Atherosclerosis; Coronary disease; Fat; Risk factor; Tomography
SDGs
Other Subjects
insulin; adipose tissue; anatomy; association; body fat distribution; cardiovascular risk; coronary artery atherosclerosis; diabetes mellitus; dyslipidemia; epicardium; human; hypertension; image analysis; insulin resistance; ischemic heart disease; measurement; multidetector computed tomography; obesity; pathophysiology; review; thickness
Type
review