Epicardial Fat Volume (CT Quantification): Explanation and Clinical Context Epicardial fat volume (EFV) represents the total volume of adipose tissue located between the myocardium and the visceral layer of the pericardium, quantifiable via non-contrast or contrast-enhanced cardiac CT.
EFV is calculated by summing the areas of epicardial fat on each slice (cm²) multiplied by the slice thickness (cm) and the number of slices. This provides an estimate of the total epicardial fat in cm³.
High EFV has been strongly associated with coronary artery disease, metabolic syndrome, atrial fibrillation, and other cardiovascular outcomes.
Clinical interpretation uses sex-specific reference ranges, typically <125 cm³ for men and <90 cm³ for women, though ranges may vary depending on population and CT protocol.
EFV quantification can improve cardiovascular risk stratification, complementing traditional risk scores and imaging findings.
Reference:
1. Iacobellis G, et al. “Epicardial Fat: Emerging Role in Cardiovascular Disease.” Nat Rev Cardiol. 2015;12:399–409. doi:10.1038/nrcardio.2015.25
2. Ding J, et al. “Epicardial Fat and Coronary Artery Calcification: The Multi-Ethnic Study of Atherosclerosis (MESA).” Obesity (Silver Spring). 2009;17:606–611. doi:10.1038/oby.2008.573