Potential role of epicardial adipose tissue as a biomarker of anthracycline cardiotoxicity
Caterina Beatrice Monti, Simone Schiaffino, Maria Del Mar Galimberti Ortiz, Davide Capra, Moreno Zanardo, Elena De Benedictis, Alberto Luporini, Pietro Spagnolo, Francesco Secchi, Francesco Sardanelli
Abstract
Abstract Background We investigated the radiodensity of epicardial (EAT), subcutaneous (SAT), and visceral adipose tissue (VAT) before and after treatment with anthracyclines in a population of breast cancer (BC) patients, and in controls not treated with anthracyclines, to detect a potential role of EAT density as a biomarker of changes related to chemotherapy cardiotoxicity. Methods We reviewed BC patients treated with anthracyclines who underwent CT before (CT-t 0 ) and after (CT-t 1 ) chemotherapy, and age- and sex-matched controls who underwent two CT examinations at comparable intervals. On non-contrast scans, EAT was segmented contouring the pericardium and thresholding between -190 and -30 Hounsfield units (HU), and SAT and VAT were segmented with two 15-mm diameter regions of interest thresholded between -195 and -45 HU. Results Thirty-two female patients and 32 controls were included. There were no differences in age ( p = 0.439) and follow-up duration ( p = 0.162) between patients and controls. Between CT-t 0 and CT-t 1 , EAT density decreased in BC patients (-66 HU, interquartile range [IQR] -71 to -63 HU, to -71 HU, IQR -75 to -66 HU, p = 0.003), while it did not vary in controls ( p = 0.955). SAT density increased from CT-t 0 to CT-t 1 in BC patients (-107 HU, IQR -111 to -105 HU, to -105 HU, IQR -110 to -100 HU, p = 0.014), whereas it did not change in controls ( p = 0.477). VAT density did not vary in either BC patients ( p = 0.911) or controls ( p = 0.627). Conclusions EAT density appears to be influenced by anthracycline treatment for BC, well known for its cardiotoxicity, shifting towards lower values indicative of a less active metabolism.