Prognostic value of epicardial adipose tissue assessed by cardiac magnetic resonance in patients with ST-elevation myocardial infarction after successful revascularization

作者：Lai Wei, Chen-xu Zhao, Jian-xun Dong, Xun-han Qiu, Alex Pui Wai Lee, Heng Ge, Jun Pu · 发表于：BMC Medical Imaging · 年份：2026 · DOI：10.1186/s12880-026-02527-5 · 研究领域：Cardiovascular Disease and Adiposity、Adipokines, Inflammation, and Metabolic Diseases、Cardiovascular Function and Risk Factors

BACKGROUND: Epicardial adipose tissue (EAT) around the myocardium may play a role in coronary artery disease, yet its prognostic value in patients with ST-segment elevation myocardial infarction (STEMI) remains uncertain. METHODS: Data from 540 STEMI patients enrolled in a registry study (NCT03768453) were analyzed. Cardiac magnetic resonance (CMR) cine sequences were used to measure EAT volume. The primary endpoint was a composite of major adverse cardiovascular events (MACE). The Cox proportional hazards model was used to assess the association between EAT volume and MACE. Correlation analyses were performed to explore relationships between EAT volume and myocardial injury markers. In addition, paired t-tests were applied to compare changes in EAT volume over the 6-month follow-up. RESULTS: During a median follow-up of 4.5 years, MACE occurred in 65 patients (12.0%). Patients who experienced MACE had a significantly higher EAT volume (39.6 vs. 33.4 mL, P < 0.001) than those without MACE. EAT volume was an independent predictor of MACE after adjustment for clinical factors (HR = 1.08, 95% CI: 1.02-1.16, P = 0.037) and CMR parameters (HR = 1.04, 95% CI: 1.02-1.07, P < 0.001). EAT volume was significantly correlated with myocardial injury markers, including infarct size (r = 0.15, P = 0.001) and microvascular obstruction (r = 0.15, P = 0.001). EAT volume remained stable at the 6-month follow-up (34.6 vs. 35.6 mL, P = 0.181). CONCLUSIONS: EAT measured non-invasively by CMR is a...