title: Prognostic implications of epicardial fat volume quantification in acute pericarditis.
abstract: BACKGROUND
  The pathophysiology of acute pericarditis remains largely unknown, and biomarkers are needed to identify patients susceptible to complications. As adipose tissue has a pivotal role in cardiovascular disease pathogenesis, we hypothesized that quantification of epicardial fat volume (EFV) provides prognostic information in patients with acute pericarditis.
  
  
  METHODS
  Fifty (n = 50) patients with first diagnosis of acute pericarditis were enrolled in this study. Patients underwent a cardiac computerized tomography (CT) scan to quantify EFV on a dedicated workstation. Patients were followed up in hospital for atrial fibrillation (AF) development and up to 18 months for the composite clinical endpoint of development of constrictive, recurrent or incessant pericarditis or poor response to nonsteroidal anti-inflammatory drugs.
  
  
  RESULTS
  Patients presenting with chest pain had lower EFV vs. patients without chest pain (167·2 ± 21·7 vs. 105·1 ± 11·1 cm3, respectively, P < 0·01); EFV (but not body mass index) was strongly positively correlated with pericardial effusion size (r = 0·395, P = 0·007) and associated with in-hospital AF. At follow-up, patients that reached the composite clinical endpoint had lower EFV (P < 0·05). After adjustment for age, EFV was associated with lower odds ratio for the composite clinical endpoint point of poor response to NSAIDs or the development of constrictive, recurrent or incessant pericarditis during follow-up (per 20 cm3increase in EFV: OR = 0·802 [0·656-0·981], P < 0·05).
  
  
  CONCLUSIONS
  We report for the first time a significant association of EFV with the clinical features and the outcome of patients with acute pericarditis. Measurement of EFV by CT may have important prognostic implications in these patients.
authors.affiliation: 1st Cardiology Department, Hippokration Hospital, Athens Medical School, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Lazaros
authors.affiliation: 1st Cardiology Department, Hippokration Hospital, Athens Medical School, Athens, Greece.|Division of Cardiovascular Medicine, University of Oxford, Oxford, UK.
authors.forename: Alexios S
authors.identifier: http://orcid.org/0000-0001-9137-0143
authors.initials: AS
authors.lastname: Antonopoulos
authors.affiliation: 1st Cardiology Department, Hippokration Hospital, Athens Medical School, Athens, Greece.|Division of Cardiovascular Medicine, University of Oxford, Oxford, UK.
authors.forename: Evangelos K
authors.initials: EK
authors.lastname: Oikonomou
authors.affiliation: 1st Cardiology Department, Hippokration Hospital, Athens Medical School, Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Vasileiou
authors.affiliation: 1st Cardiology Department, Hippokration Hospital, Athens Medical School, Athens, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Oikonomou
authors.affiliation: Radiology Department, Hippokration Hospital, Athens, Greece.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Stroumpouli
authors.affiliation: 1st Cardiology Department, Hippokration Hospital, Athens Medical School, Athens, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Karavidas
authors.affiliation: Division of Cardiovascular Medicine, University of Oxford, Oxford, UK.
authors.forename: Charalambos
authors.initials: C
authors.lastname: Antoniades
authors.affiliation: 1st Cardiology Department, Hippokration Hospital, Athens Medical School, Athens, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tousoulis
mesh_terms: D000208:Acute Disease; D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000473:pathology*; D000359:Aftercare; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000209:etiology / Q000473:pathology; D002637:Chest Pain / Q000209:etiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000473:pathology; D010493:Pericarditis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Acute pericarditis; adipose tissue; computer tomography imaging; epicardial fat