NORMAL EPICARDIAL FAT VOLUME IS A EXCELLENT PREDICTOR FOR LESS CARDIOVASCULAR STRUCTURAL AND FUNCTIONAL ABNORMALITIES INCLUDING CORONARY CALCIUM SCORE

Therapeutic Area

ASCVD/CVD Risk Assessment

Background

Epicardial fat volume measurement has emerged as a significant marker in the early detection and prevention of cardiovascular diseases. Excess epicardial fat volume is strongly linked to endothelial dysfunction, which can ultimately lead to the development of coronary calcification. The purpose of this study was to assess whether normal epicardial fat volume is associated with lower structural and functional abnormalities including coronary calcification than have been reported with excess EFV.

Methods

389 asymptomatic subjects were screened for cardiovascular risk assessment. Out of 389 subjects, 286 had normal EFV. A total of 286 subjects were then screened for cardiovascular risk using the Early Cardiovascular Disease Risk Scoring System (ECVDRS). The ECVDRS incorporates 7 vascular tests and 3 cardiac tests, with an additional inclusion of C-reactive protein (CRP) and pro-BNP measurements. The coronary artery calcium (CAC) score and epicardial fat volume (EFV) were assessed using a Siemens SOMATOM Definition Dual Source 64 × 2 CT scanner values less then 125mL were considered normal.

Out of the 286 participants, 244(86%) subjects under the age of 80 were found to have low or normal EFV. These 244 individuals were further divided into age groups for analysis.

Group 1: < 40 years

Group 2: 40–49 years

Group 3: 50–64 years

Group 4: 65–79 years

See Table

Results

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  Majority of the patients have normal epicardial fat volume.
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  In the asymptomatic subjects with normal epicardial fat volume was associated with lower coronary calcium scores regardless of age category.
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  Normal EFV is assuring for decades to come with less cardiovascular structural and functional abnormalities as noted in the table.

Conclusions

In conclusion, normal epicardial fat volume (EFV) is associated with less structural and functional abnormalities including coronary calcium score than have been reported with excess EFV. Hence, we recommend future guidelines to mandate assessing and recording every EFV in all imaging of coronary calcium score in cardiovascular risk assessment.