Spearman James V, Renker Matthias, Schoepf U Joseph, Krazinski Aleksander W, Herbert Teri L, De Cecco Carlo N, Nietert Paul J, Meinel Felix G
Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29425, USA.
Department of Internal Medicine I, Cardiology/Angiology, Giessen University, Giessen, Germany.
Eur Radiol. 2015 Nov;25(11):3372-81. doi: 10.1007/s00330-015-3765-5. Epub 2015 Apr 30.
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.
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.
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.
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.
• 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.
对越来越多评估经横断面成像量化的心外膜脂肪体积（EFV）预后价值的文献进行系统综述。
两名独立评审员使用与医学图书馆员共同制定的检索词，在PubMed和Scopus上进行系统检索。根据是否包含结局数据、是否使用心外膜脂肪体积以及是否有足够的报告用于分析来选择同行评审的文章。
共评估了411项研究，其中9项研究符合纳入标准。这些研究总共评估了10252例患者。所有9项研究均基于CT测量。7项研究评估了未根据钙化积分调整的EFV的预后价值，其中6项研究发现EFV与临床结局之间存在显著关联。7项研究评估了EFV在钙化积分之外的增量价值，其中6项研究发现存在显著关联。
大多数研究表明，EFV量化与临床结局显著相关，并且相对于冠状动脉钙化积分具有增量预后价值。未来的研究应使用125 mL的二元临界值来评估EFV，以便与其他研究保持一致。
• 心外膜脂肪体积（EFV）对不良心脏事件具有预后价值 • 需要建立EFV的标准化定量类别 • EFV的量化可以改善钙化积分的风险评估
