Epicardial adipose tissue as a prognostic marker in acute pulmonary embolism

Abstract

Background: Epicardial adipose tissue (EAT) has been established as a quantitative imaging biomarker associated with disease severity in coronary heart disease. Our aim was to use this prognostic marker derived from computed tomography pulmonary angiography (CTPA) for the prediction of mortality and prognosis in patients with acute pulmonary embolism. Methods: The clinical database was retrospectively screened for patients with acute pulmonary embolism between 2015 and 2021. Overall, 513 patients (216 female, 42.1%) were included in the analysis. The study end-point was 30-day mortality. Epicardial adipose tissue was measured on the diagnostic CTPA in a semiquantitative manner. The volume and density of EAT were measured for every patient. Results: Overall, 60 patients (10.4%) died within the 30-day observation period. The mean EAT volume was 128.3± 65.0cm3 in survivors and 154.6± 84.5cm3 in nonsurvivors (p= 0.02). The density of EAT was −79.4± 8.3HU in survivors and −76.0± 8.4HU in nonsurvivors (p= 0.86), and EAT density was associated with 30-day mortality (odds ratio [OR]= 1.07; 95% confidence interval [CI]: 1.03; 1.1, p< 0.001) but did not remain statistically significant in multivariable analysis. No association was identified between EAT volume and 30-day mortality (OR= 1.0; 95% CI: 1.0; 1.0, p= 0.48). Conclusion: There might be an association between EAT density and mortality in patients with acute pulmonary embolism. Further studies are needed to elucidate the prognostic relevance of EAT parameters in patients with acute pulmonary embolism.