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Prognostic value of epicardial fat volume measurements by computed tomography: a systematic review of the literature

  • Cardiac
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To perform a systematic review of the growing body of literature evaluating the prognostic value of epicardial fat volume (EFV) quantified by cross-sectional imaging.

Methods

Two independent reviewers performed systematic searches on both PubMed and Scopus using search terms developed with a medical librarian. Peer-reviewed articles were selected based on the inclusion of outcome data, utilization of epicardial fat volume and sufficient reporting for analysis.

Results

A total of 411 studies were evaluated with nine studies meeting the inclusion criteria. In all, the studies evaluated 10,252 patients. All nine studies were based on CT measurements. Seven studies evaluated the prognostic value of EFV unadjusted for calcium score, and six of these studies found a significant association between EFV and clinical outcomes. Seven studies evaluated the incremental value of EFV beyond calcium scoring, and six of these studies found a significant association.

Conclusions

The majority of studies suggest that EFV quantification is significantly associated with clinical outcomes and provides incremental prognostic value over coronary artery calcium scoring. Future research should use a binary cutoff of 125 mL for evaluation of EFV to provide consistency with other research.

Key Points

• Epicardial fat volume (EFV) has prognostic value for adverse cardiac events

• Establishment of standardized quantitative categories for EFV is needed

• Quantification of EFV could improve risk assessment with calcium scoring

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Abbreviations

CAC:

Coronary artery calcium scoring

CT:

Computed tomography

EFV:

Epicardial fat volume

HR:

Hazard ratio

MACE:

Major adverse cardiac event

OR:

Odds ratio

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Acknowledgments

The scientific guarantor of this publication is U. Joseph Schoepf, MD. The authors of this manuscript declare relationships with the following companies: UJS is a consultant for and receives research support from Bayer, Bracco, GE and Siemens. Dr. Nietert was funded by the National Center for Advancing Translational Sciences (Award Number UL1TR000062); the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Advancing Translational Sciences or the National Institutes of Health. The other authors have no potential conflicts of interest to disclose. The authors state that this work has not received any funding. One of the authors (Paul J. Nietert) has significant statistical expertise. Institutional Review Board approval is not required for a systematic review. Written informed consent is not required for a systematic review. Some study subjects or cohorts have been previously reported in the individual studies, which are summarized in this systematic review. The findings of the systematic review have not been previously reported. Methodology: retrospective, diagnostic or prognostic study, multicenter study.

Author information

Authors and Affiliations

  1. Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29425, USA

    James V. Spearman, Matthias Renker, U. Joseph Schoepf, Aleksander W. Krazinski, Carlo N. De Cecco & Felix G. Meinel

  2. Department of Internal Medicine I, Cardiology/Angiology, Giessen University, Giessen, Germany

    Matthias Renker

  3. Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA

    U. Joseph Schoepf

  4. Department of Library Science and Informatics, Medical University of South Carolina, Charleston, SC, USA

    Teri L. Herbert

  5. Department of Radiological Sciences, Oncology and Pathology, University of Rome ‘Sapienza’ – Polo Pontino, Latina, Italy

    Carlo N. De Cecco

  6. Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA

    Paul J. Nietert

  7. Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany

    Felix G. Meinel

Authors
  1. James V. Spearman
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  2. Matthias Renker
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Correspondence to U. Joseph Schoepf.

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Spearman, J.V., Renker, M., Schoepf, U.J. et al. Prognostic value of epicardial fat volume measurements by computed tomography: a systematic review of the literature. Eur Radiol 25, 3372–3381 (2015). https://doi.org/10.1007/s00330-015-3765-5

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  • DOI: https://doi.org/10.1007/s00330-015-3765-5

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