Clinical Report: Evaluation of Intrathoracic Visceral Fat Deposits via CT

Overview

This study investigates the relationship between intrathoracic visceral fat deposits and the incidence of heart failure (HF) in asymptomatic adults. Findings indicate that epicardial adipose tissue (EAT) and peri-aortic root fat (PARF) are independently associated with new-onset HF, particularly with preserved ejection fraction (HFpEF).

Background

Heart failure (HF) is a significant global health issue, affecting millions and with a rising prevalence of HF with preserved ejection fraction (HFpEF). Obesity is a major modifiable risk factor for HFpEF, and emerging evidence suggests that specific intrathoracic visceral adipose tissue (VAT) depots may play a critical role in its pathogenesis. Understanding these associations can aid in early risk stratification and intervention strategies.

Data Highlights

Key Findings

• EAT and PARF are independently associated with incident HF, predominantly HFpEF.
• Higher tertiles of intrathoracic VAT volumes correlate with increased HF incidence.
• The optimal cutoff for EAT volume associated with HF is 71.37 cm3.
• The optimal cutoff for PARF volume associated with HF is 23.50 cm3.
• Men show greater accumulation of intrathoracic VAT with increasing BMI.
• EAT volume increases more steeply in individuals who develop HF.

Clinical Implications

The findings suggest that quantifying EAT and PARF using cardiac CT may provide valuable insights for early identification of individuals at risk for HF. This could facilitate timely interventions to mitigate the progression of heart failure, particularly in asymptomatic populations.

Conclusion

EAT and PARF may serve as novel imaging biomarkers for early risk stratification in heart failure, emphasizing the importance of monitoring intrathoracic fat deposits in asymptomatic individuals.

Related Resources & Content

1. Frontiers | Quantitative CT Assessment of Intrathoracic Visceral Fat Depots and Their Association with Incident Heart Failure in Asymptomatic Adults
2. European Radiology — Assessment of Lipomatous Hypertrophy of the Interatrial Septum and Its Relationship with Pericardial Adipose Tissue Biomarkers via Computed Tomography
3. Clinical Research in Cardiology — Real-time cardiovascular magnetic resonance imaging for the non-invasive assessment of heart failure with preserved ejection fraction: outcomes from the HFpEF stress trial
4. Clinical Research in Cardiology — Association of Elevated Epicardial Adipose Tissue with Left Atrial Mechanical Impairment in Heart Failure Patients with Mildly Reduced and Preserved Ejection Fraction
5. Focus on Heart Failure | HFpEF: Where We Stand in 2025 - American College of Cardiology
6. Hernia — Adipose Tissue Distribution in Patients with Primary and Recurrent Incisional Hernias
7. Focus on Heart Failure | HFpEF: Where We Stand in 2025 - American College of Cardiology
8. Frontiers | Quantitative CT Assessment of Intrathoracic Visceral Fat Depots and Their Association with Incident Heart Failure in Asymptomatic Adults
9. Pericoronary adipose tissue attenuation on CCTA as a marker of cardiovascular risk: A systematic review and meta-analysis - PubMed