Epicardial adipose tissue discovery: better prevention of atrial metabolic cardiomyopathy with MRI

IHU ICAN research teams have successfully demonstrated the feasibility of isolating and measuring pure epicardial adipose tissue (TAE) from the atrioventricular grooves using routine cardiovascular magnetic resonance imaging (MRI), in order to better assess atrial cardiomyopathy and perhaps ultimately identify the risk of atrial fibrillation earlier.

Les résultats ont été publiés le 14 juin 2024 par European Heart Journal – Imaging Methods and Practicdans la publication scientifique The Adipose Tissue Confined in the Atrio-Ventricular Groove can be used to Assess Atrial Epicardial Adipose Tissue and Atrial Dysfunction during Cardiac Magnetic Resonance Imaging”.

See the scientific publication

Epicardial adipose tissue (EAT): a biomarker of atrial fibrillation (AF) that is difficult to isolate

Epicardial adipose tissue (EAT) is attracting growing interest in medical research, to better understand and treat cardiovascular diseases, and more broadly cardiometabolic diseases.

  • The TAE is an ectopic adipose tissue in contact with the myocardium (heart muscle), which surrounds the coronary arteries.
  • In particular, it is used as a biomarker for atrial fibrillation (AF), the 1st cardiac cause of vascular embolic accidents (strokes), leading to significant morbidity and mortality in the population.

However, the use of epicardial adipose tissue as a biomarker in this setting remains limited, as it is difficult to isolate from other paracardiac adipose tissues.

Teams at IHU ICAN have therefore conducted a research project to test the feasibility and value of measuring pure epicardial adipose tissue contained in the atrioventricular groove (GEAT), using cardiovascular magnetic resonance imaging (MRI), in patients with distinct metabolic disorders.

Method and results of the research project

  • The ICAN Imaging platform performed cardiovascular MRI on 100 patients from the MetaCardis cohort (INSERM), with criteria for obesity, metabolic syndrome and type 2 diabetes, and on age- and sex-matched healthy controls.
  • A strong correlation between atrioventricular groove adipose tissue (AVSAT) volume and atrial epicardial adipose tissue (EAT) was obtained. AVSAT volume was higher in the 3 groups of patients with metabolic disorders and allowed them to be identified from controls after adjustment for body mass.
  • Thanks to the logistic regression and machine learning methods used by the ICAN I/O platform, an algorithm has also been created to identify patients with type 2 diabetes.

The results suggest that atrioventricular groove adipose tissue, measured during routine MRI examination, can serve as a surrogate for atrial TEA, and be integrated into a multiparametric imaging biomarker to improve the assessment and early detection of atrial cardiomyopathy in diabetic patients.

This innovative strategy also opens up new avenues for early identification of the risk of atrial fibrillation, particularly in patients with type 2 diabetes, obesity and metabolic syndrome.

The actors involved in the project

  • Jonathan Bialobroda, Intern in Cardiology, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University
  • Khaoula Bouazizi,Operational manager of the ICAN Imaging platform, IHU ICAN, Research engineer, Biomedical Imaging Laboratory (LIB), Inserm
  • Maharajah Ponnaiah,ICAN Data I/O Platform Manager, IHU ICAN
  • Nadjia Kachenoura,Team leader, Biomedical Imaging Laboratory (LIB), Sorbonne University, Inserm, CNRS
  • Etienne Charpentier, Cardiovascular imaging radiologist, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne University
  • Mohamed Zarai, Medical imaging engineer (MRI and CT-Scan), Software developer, IHU ICAN
  • Pr Karine Clement, Team leader Nutriomics unit, PU-PH, Nutrition Department, Hôpital de la Pitié-Salpêtrière, AP-HP, IHU ICAN
  • Pr Fabrizio Andreelli, Nutriomics Unit, Diabetology and Metabolism Department, Hôpital de la Pitié-Salpêtrière, AP-HP, IHU ICAN
  • Pr Judith Aron-Wisnewsky, Nutriomics Unit, Nutrition Department, Hôpital de la Pitié-Salpêtrière, AP-HP, IHU ICAN
  • Pr Stéphane Hatem,Director of ICAN, Cardiologist, Hôpital de la Pitié-Salpêtrière, AP-HP
  • Pr Alban Redheuil, Head of ICAN Imaging, IHU ICAN, PU-PH, Institut de Cardiologie, Hôpital de la Pitié-Salpêtrière, AP-HP, Laboratoire d’Imagerie Biomédicale (LIB), Sorbonne Université, Inserm, CNRS