Epicardial fat volume and its association with cardiac arrhythmias in CT coronary angiography

Purpose:
This retrospective study aimed to investigate the epicardial fat volume in cardiac computed tomography (CT), its relationship with cardiac arrhythmias, and its correlation with the coronary artery disease reporting and data system (CAD-RADS) score.

Material and methods:
Ninety-six patients who underwent CT coronary angiography (CTCA) were included in this study. Patient data, including demographic information, clinical history, and imaging data were collected retrospectively. Epicardial fat volume was quantified using a standardised algorithm, the CAD-RADS scoring system was applied to assess the extent of coronary artery disease (CAD). Descriptive statistics, correlation analyses, and receiver operating characteristics methods were used.

Results:
The study found a significant correlation between epicardial fat volume and CAD-RADS score (r² = 0.31; p < 0.001), indicating the known influence of epicardial fat on CAD risk. Moreover, patients with higher epicardial fat volumes were more likely to experience cardiac tachyarrhythmia (p < 0.001). Receiver operating characteristic analysis established a threshold value of 123 cm³ for epicardial fat volume to predict tachyarrhythmia with 80% sensitivity (AUC = 0.69).

Conclusions:
In this study a volume of at least 123 cm³ epicardial fat in native coronary calcium scans is associated with cardiac tachyarrhythmia. In these patients, careful selection of suitable imaging protocols is advised.