Evaluation of Regression in Epicardial Adipose Tissue Thickness on Cardiac MRI in Post-Acute Coronary Syndrome Patients
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-6.14208Keywords:
Acute Coronary Syndrome, Cardiac Magnetic Resonance Imaging, Coronary Artery Disease, Epicardial Adipose TissueAbstract
Objective: To evaluate changes in epicardial adipose tissue (EAT) on cardiac magnetic resonance imaging (CMRI) in patients treated for acute coronary syndrome (ACS) and to assess its association with the severity of coronary artery disease (CAD).
Study Design: Prospective longitudinal study.
Place and Duration of Study: Cardiology Department of Armed Forces Institute of Cardiology, National Institute of Heart Diseases, Rawalpindi, Pakistan; from Aug 2025 to Nov 2025.
Methods: Overall, 102 ACS patients aged 18–65 years, underwent both PCI and cardiac magnetic resonance imaging (CMR) were enrolled through consecutive sampling. Prior CABG patients, patients with LVEF <40%, MRI contraindications, eGFR <30 mL/min/1.73m², or statin intolerance were excluded from study. EAT thickness was measured on baseline and 3-month follow-up CMR scans, with regression defined as ≥10% reduction in EAT thickness. Cardiovascular outcomes, included stroke, revascularization, heart failure, and mortality, and assessed at follow-up.
Results: A total of 102 patients with a median age of 60(52.75-63.00) years were included, of whom 64(62.7%) were male. The median EAT thickness decreased from 0.48 mm (IQR: 0.42–0.58) at baseline to 0.45 mm (IQR: 0.40–0.53) at 3 months. The EAT regression was 0.03 mm (IQR: 0.05-0.02). This reduction was statistically significant (p<0.001). Which did not meet the predefined ≥10% regression criterion. The correlation between CAD severity and EAT regression was weaker but statistically significant (r=0.302, p=0.002).
Conclusion: EAT thickness showed a strong positive correlation with CAD severity but did not demonstrate significant regression over three months.
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References
Li C, Liu X, Adhikari BK, Chen L, Liu W, Wang Y, et al. The role of epicardial adipose tissue dysfunction in cardiovascular diseases: an overview of pathophysiology, evaluation, and management. Front Endocrinol 2023; 14: 1167952.
https://doi.org/10.3389/fendo.2023.1167952
2. Conte M, Petraglia L, Poggio P, Valerio V, Cabaro S, Campana P, et al. Inflammation and cardiovascular diseases in the elderly: the role of epicardial adipose tissue. Front Med 2022; 9: 844266.
https://doi.org/10.3389/fmed.2022.844266
3. Konwerski M, Gąsecka A, Opolski G, Grabowski M, Mazurek T. Role of epicardial adipose tissue in cardiovascular diseases: a review. Biology 2022; 11(3): 355.
https://doi.org/10.3390/biology11030355
4. Krauz K, Kempiński M, Jańczak P, Momot K, Zarębiński M, Poprawa I, et al. The role of epicardial adipose tissue in acute coronary syndromes, post-infarct remodeling and cardiac regeneration. Int J Mol Sci 2024; 25(7): 3583.
https://doi.org/10.3390/ijms25073583
5. Antoniades C, Tousoulis D, Vavlukis M, Fleming I, Duncker DJ, Eringa E, et al. Perivascular adipose tissue as a source of therapeutic targets and clinical biomarkers: a clinical consensus statement from the European Society of Cardiology Working Group on Coronary Pathophysiology and Micro-circulation. Eur Heart J 2023; 44(38): 3827–3844.
https://doi.org/10.1093/eurheartj/ehad484
6. Zamani SK. Pathophysiologic Consequences of Pericardial Adipose Tissue Assessed by Magnetic Resonance Imaging. 2024; 12890.
https://doi.org/10.1111/joim.12890
7. Gourdy P, Darmon P, Dievart F, Halimi JM, Guerci B. Combining glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) in patients with type 2 diabetes mellitus (T2DM). Cardiovasc Diabetol 2023; 22(1): 79.
https://doi.org/10.1186/s12933-023-01798-4
8. Bonaventura A, Carbone S, Dixon DL, Abbate A, Montecucco F. Pharmacologic strategies to reduce cardiovascular disease in type 2 diabetes mellitus: focus on SGLT ‐2 inhibitors and GLP ‐1 receptor agonists. J Intern Med 2019; 286(1): 16–31.
9. Romano AD, La Marca A, Villani R, Sangineto M, Manuppelli V, Brunetti ND, et al. Exploring the Relationship between Epicardial Fat Thickness and Coronary Revascularization: Implications for Cardiovascular Health. J Clin Med 2024; 13(1):247. https://doi.org/10.3390/jcm13010247
10. Sato T, Aizawa Y, Yuasa S, Kishi S, Fuse K, Fujita S, et al. The effect of dapagliflozin treatment on epicardial adipose tissue volume. Cardiovasc Diabetol 2018; 17(1): 6.
https://doi.org/10.1186/s12933-017-0658-8
11. Vianello E. Inflammation in Coronary Artery Disease (Cad): The Role Of Epicardial Adipose Tissue (EAT). 2014 Available from: https://tesidottorato.depositolegale.it/handle/20.500.14242/71769. [Accessed 2025 Oct 23]
12. Guglielmo M, Lin A, Dey D, Baggiano A, Fusini L, Muscogiuri G, et al. Epicardial fat and coronary artery disease: role of cardiac imaging. Atherosclerosis 2021; 321: 30–38.
https://doi.org/10.1016/j.atherosclerosis.2021.02.008
13. Braescu L, Gaspar M, Buriman D, Aburel OM, Merce AP, Bratosin F, et al. The role and implications of epicardial fat in coronary atherosclerotic disease. J Clin Med 2022; 11(16): 4718.
https://doi.org/10.3390/jcm11164718
14. Jin X, Gao B, Zheng J, Wu X, Zhang N, Zhu L, et al. Impact of epicardial adipose tissue volume on hemodynamically significant coronary artery disease in Chinese patients with known or suspected coronary artery disease. Front Cardiovasc Med 2023; 10: 1088961.
https://doi.org/10.3389/fcvm.2023.1088961
15. Abdelaziz HMM, Hamdi M, Mahfouz EME, Zidan SGE din I, Hatata A, Elfadl HGA. Epicardial fat volume assessment via cardiac computed tomography: a novel indicator in heart failure with preserved ejection fraction. Egypt J Radiol Nucl Med 2025; 56(1): 20.
https://doi.org/10.1186/s43055-025-01434-z
16. Mirrazeghi SF, Shabahang S, Vakilpour A, Salari A, Hassanipour S, Gholipour M. The Relationship between Epicardial Fat Tissue Thickness and Risk of Frequent Premature Ventricular Contractions. Pak Heart J 2021; 54(3): 249–253.
https://doi.org/10.47144/phj.v54i3.2112
17. Isomitdinov B, Mustaev M, Khayatova M, Jakaj G, Whiteford J, Oo AY. Fluctuations of epicardial adipose tissue and cardiovascular health: A useful biomarker? A comprehensive review. J Cardiovasc Thorac Res 2025; 17(2): 80.
https://doi.org/10.34172/jcvtr.025.33332
18. Tang N, Li KM, Li HR, Zhang QD, Hao J, Qi CM. Advances in the diagnosis and management of post-percutaneous coronary intervention coronary microvascular dysfunction: Insights into pathophysiology and metabolic risk interactions. World J Cardiol 2025; 17(2): 103950.
https://doi.org/10.4330/wjc.v17.i2.103950
19. Chong B, Jayabaskaran J, Ruban J, Goh R, Chin YH, Kong G, et al. Epicardial Adipose Tissue Assessed by Computed Tomography and Echocardiography Are Associated With Adverse Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. Circ Cardiovasc Imaging 2023; 16(5): 15985.
https://doi.org/10.1161/CIRCIMAGING.123.015985
20. Malecki-Ketchell A. Acute coronary syndrome. Nurs Acutely Ill Adult 2016; 140.
https://doi.org/10.1057/978-1-137-46552-8_7
21. Shang J, Guo Y, Ma Y, Hou Y. Cardiac computed tomography radiomics: a narrative review of current status and future directions. Quant Imaging Med Surg 2022; 12(6): 3436.
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Copyright (c) 2026 Syed Sajiddain Syed, Muhammad Nadir Khan, Azhar Ali Chauhdry, Muhammad Waleed Ghous, Gulzar Ali
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