title: The relationship between epicardial fat volume and incident coronary artery calcium.
abstract: BACKGROUND
  Epicardial fat volume (EFV) has been associated with prevalent but not incident coronary artery calcium. However, the relationship between EFV and development of incident coronary calcium (incCC) has not been reported.
  
  
  OBJECTIVE
  We evaluated the relationship between epicardial fat volume and the development of coronary artery calcium over 3-5 years.
  
  
  METHODS
  From 1248 subjects who underwent 2 serial noncontrast cardiac CT scans 3-5 years (median, 4 years) apart to measure coronary calcium score of 0 who subsequently developed incident coronary calcium (incCC(+)) were matched to 106 controls in whom coronary calcium score remained 0 (incCC(-)). EFV was calculated by determination of the pericardial contour, followed by identification of fat voxels with the use of validated software (QFAT). Baseline EFV and EFV indexed to body surface area (EFVi) and subsequent EFV and EFVi changes were compared between incCC(-) and incCC(+) populations. A significant EFV increase was defined as a ≥10% and ≥25% increase from the baseline value.
  
  
  RESULTS
  Baseline EFVi was similar between the 2 groups [EFVi, 40.9 ± 17.9 cm³ (median, 38.3 cm³) in incCC(-) vs 40.3 ± 16.3 cm³ (median, 37.0 cm³) in incCC(+); P = 0.96]. On the follow-up CT, EFVi increased in 74.5% of incCC(-) and in 76.4% of incCC(+) (P = 0.75). EFVi changes between the 2 groups were similar [4.9 ± 8.9 cm³ (median, 4.9 cm³) in incCC(-) vs 4.2 ± 8.0 cm³) (median, 3.5 cm³) in incCC(+); P = 0.67]. On multivariate analysis, after adjusting for cardiovascular risk factors, incCC was not related to an increase in EFVi at a 10% or 25% level.
  
  
  CONCLUSIONS
  In very low-risk subjects with a coronary calcium score of 0, baseline EFVi and change in EFVi after 3-5 years were not related to the development of incidental coronary artery calcium.
authors.affiliation: Department of Cardiac Imaging, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Otaki
authors.forename: Ronak
authors.initials: R
authors.lastname: Rajani
authors.forename: Victor Y
authors.initials: VY
authors.lastname: Cheng
authors.forename: Heidi
authors.initials: H
authors.lastname: Gransar
authors.forename: Rine
authors.initials: R
authors.lastname: Nakanishi
authors.forename: Haim
authors.initials: H
authors.lastname: Shmilovich
authors.forename: Ryo
authors.initials: R
authors.lastname: Nakazato
authors.forename: Sean W
authors.initials: SW
authors.lastname: Hayes
authors.forename: Louise E J
authors.initials: LE
authors.lastname: Thomson
authors.forename: John D
authors.initials: JD
authors.lastname: Friedman
authors.forename: Piotr J
authors.initials: PJ
authors.lastname: Slomka
authors.forename: Nathan D
authors.initials: ND
authors.lastname: Wong
authors.forename: Alan
authors.initials: A
authors.lastname: Rozanski
authors.forename: Leslee
authors.initials: L
authors.lastname: Shaw
authors.forename: Matthew
authors.initials: M
authors.lastname: Budoff
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
authors.forename: Damini
authors.initials: D
authors.lastname: Dey
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D002140:California; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010496:Pericardium; D011237:Predictive Value of Tests; D011379:Prognosis; D011857:Radiographic Image Interpretation, Computer-Assisted; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000000981:diagnostic imaging* / Q000209:etiology