Correlation between epicardial fat volume and postmortem radiological and autopsy findings in cases of sudden death: A pilot study

Epicardial fat volume (EFV) has recently been recognized as a good predictor of multivessel coronary artery disease, and the Coronary Artery Calcium Score (CACS) is a parameter that estimates the amount of calcium in the coronary tree. Both of these parameters can be assessed non-invasively by cardiac computed tomography. Previous studies have investigated a correlation between autopsy results and radiologically calculated EFV and CACS. The present study aims to investigate a correlation between EFV and other radiological (CACS and the presence of coronary artery opacification defects on Multi-Phase Post-Mortem Computed Tomography Angiography (MPMCTA)) and autoptic (presence of coronary stenosis) findings, in order to verify whether EFV can be considered a good predictor of radiological and autoptic coronary findings. A cohort of 21 subjects who died suddenly was examined. Firstly, MPMCTA was performed, then autopsy was carried out. EFV and CACS were radiologically calculated, the detection of opacification defects on MPMCTA was investigated and the presence of coronary stenoses on autopsy was assessed. 21 deceased individuals (51 ± 10,77 years; 19 men) were evaluated. Statistically significant correlations were found between levels of EFV > 125 mL (cut-off indicated for prognostic risk stratification) and CACS > 0 (signifying the presence of coronary calcifications), opacification defects on MPMCTA, and coronary stenosis on autopsy. The volume of the epicardial fat, detected radiologically, is a promising additional tool in the assessment and risk stratification for sudden death. Further research is needed to better explore the application of radiologically calculated EFV in cases of sudden death.