Quantification of Epicardial Fat Volume as a Novel Cardiovascular Risk Marker in Asymptomatic Subjects for Early Detection of Cardiovascular Disease

Epicardial fat volume (EFV), also known as epicardial adipose tissue (EAT), sometimes acts as a protector against heart problems; however, in excess volume was found to be associated with cardiovascular structural and functional abnormalities. This study aims to establish a threshold between normal and abnormal values for EFV/EAT in asymptomatic subjects, as well as to assess whether excess EFV/EAT is associated with significant structural and functional abnormalities, including coronary artery calcium score (CACS). A total of 220 asymptomatic patients, were screened utilizing Early Cardiovascular Disease Risk Score (ECVDRS), and CT for CACS and EFV/EAT quantification. Out of the 220 subjects, 69 had a 0 CACS and were included in this analysis. These 69 were then further categorized into 3 groups: Group 1 (Normal subjects; n=20) with ECVDRS < 3, and ACC/AHA risk score < 5%; Group 2 (n= 16) with elevated EFV/EAT and no abdominal visceral obesity; Group 3 (n=33) with elevated EFV/EAT and abdominal visceral obesity. The average EFV/EAT was identified to be 69 cm3 +/- 20 in females and 68 cm3 +/- 15 in males among Group 1, which indicate the normal values for EFV/EAT. It was also found that elevated EFV/EAT without (Group 2) or with (Group 3) abdominal visceral adiposity was associated with significant vascular abnormalities, as compared to the normal group among these populations of asymptomatic patients with 0 CACS. Elevated EFV/EAT is a novel cardiovascular risk marker regardless of gender, which might be the culprit for major cardiovascular risk factors.