Epicardial Adipose Tissue Changes during Statin Administration in Relation to the Body Mass Index: A Longitudinal Cardiac CT Study

Featured Application: This study proposes an epicardial adipose tissue (EAT) analysis using an advanced computer-assisted approach in a population of patients undergoing Cardiac CT (CCT) during statin administration, in relation to the body mass index (BMI). The epicardial adipose tissue (EAT) is the visceral fat located between the myocardium and the pericardium. We aimed to perform a longitudinal evaluation of the epicardial adipose tissue using an advanced computer-assisted approach in a population of patients undergoing Cardiac CT (CCT) during statin administration, in relation to their body mass index (BMI). We retrospectively enrolled 95 patients [mean age 62 +/- 10 years; 68 males (72%) and 27 females (28%)] undergoing CCT for suspected coronary artery disease during statin administration. CCT was performed at two subsequent time points. At the second CCT, EAT showed a mean density increase (-75.59 +/- 7.0 HU vs. -78.18 +/- 5.3 HU, p < 0.001) and a volume decrease (130 +/- 54.3 cm(3) vs.142.79 +/- 56.9 cm(3), p < 0.001). Concerning coronary artery EAT thickness, a reduction was found at the origin of the right coronary artery (13.26 +/- 5.2 mm vs. 14.94 +/- 5.8, p = 0.001) and interventricular artery (8.22 +/- 3.7 mm vs. 9.13 +/- 3.9 mm, p = 0.001). The quartile (Q) attenuation percentage (%) distribution of EAT changed at the second CCT. The EAT % distribution changed by the BMI in Q1 (p = 0.015), Q3 (p = 0.001) and Q4 (p = 0.043) at the second CCT, but the normal-BMI and overweight/obese patients showed a similar response to statin therapy in terms of quartile distribution changes. In conclusion, statins may determine significant changes in EAT quantitative and qualitative characteristics detected by CCT; the BMI influences the EAT composition, but statins determine a similar response in quartile distribution's variation, irrespective of the BMI.