Epicardial adipose tissue as a prognostic marker in acute pulmonary embolism

Background Epicardial adipose tissue (EAT) has been established as a quantitative imaging biomarker associated with disease severity in coronary heart disease. Our aim was to use this prognostic marker derived from computed tomography pulmonary angiography (CTPA) for the prediction of mortality and prognosis in patients with acute pulmonary embolism. Methods The clinical database was retrospectively screened for patients with acute pulmonary embolism between 2015 and 2021. Overall, 513 patients (216 female, 42.1%) were included in the analysis. The study end-point was 30-day mortality. Epicardial adipose tissue was measured on the diagnostic CTPA in a semiquantitative manner. The volume and density of EAT were measured for every patient. Results Overall, 60 patients (10.4%) died within the 30-day observation period. The mean EAT volume was 128.3 ± 65.0 cm 3 in survivors and 154.6 ± 84.5 cm 3 in nonsurvivors ( p = 0.02). The density of EAT was −79.4 ± 8.3 HU in survivors and −76.0 ± 8.4 HU in nonsurvivors ( p = 0.86), and EAT density was associated with 30-day mortality (odds ratio [OR] = 1.07; 95% confidence interval [CI]: 1.03; 1.1, p