CMR Study Links Higher Epicardial Fat to Greater Injury After Heart Attack

Imaging of 1,168 post-PCI patients found EAT volume correlated with larger infarcts, with investigators calling for prospective validation.

Overview

Presented at EACVI 2025, the prospective multicenter study used cardiovascular magnetic resonance within 10 days of MI to quantify epicardial adipose tissue and grouped patients by volume quartiles.
Patients in the highest EAT quartile were older on average and had higher body mass index than those in the lowest quartile.
Higher EAT volume was independently associated with larger infarct size and a greater myocardial area at risk, while microvascular obstruction was lower.
Left ventricular ejection fraction showed no significant differences across EAT volume groups.
Investigators suggest CMR-derived EAT quantification could aid risk assessment, emphasizing the need for mechanistic studies and prospective validation before clinical use.