Evidence map›Paper›PMID 40879169›Full record

ArticleEuropean heart journal. Cardiovascular Imaging2025

Sex-specific prognostic value of automated epicardial adipose tissue quantification on serial lung cancer screening chest computed tomography.

Jan M Brendel, Thomas Mayrhofer, Ibrahim Hadzic, Emilia Norton, Isabel L Langenbach, Marcel C Langenbach, Matthias Jung, Vineet K Raghu, Konstantin Nikolaou, Pamela S Douglas and 3 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European heart journal. Cardiovascular Imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Jan M BrendelCardiovascular Imaging Research Center (CIRC), Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street Suite 400, Boston, MA 02114, USA.
Thomas MayrhoferCenter for Preventive Medicine and Digital Health, University of Heidelberg, Mannheim, Germany.ORCID 0000-0001-6287-5185
Ibrahim HadzicCardiovascular Imaging Research Center (CIRC), Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street Suite 400, Boston, MA 02114, USA.
Emilia NortonCardiovascular Imaging Research Center (CIRC), Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street Suite 400, Boston, MA 02114, USA.
Isabel L LangenbachCardiovascular Imaging Research Center (CIRC), Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street Suite 400, Boston, MA 02114, USA.
Marcel C LangenbachCardiovascular Imaging Research Center (CIRC), Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street Suite 400, Boston, MA 02114, USA.
Matthias JungCardiovascular Imaging Research Center (CIRC), Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street Suite 400, Boston, MA 02114, USA.
Vineet K RaghuCardiovascular Imaging Research Center (CIRC), Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street Suite 400, Boston, MA 02114, USA.
Konstantin NikolaouDepartment of Radiology, University of Tuebingen, Tuebingen, Germany.
Pamela S DouglasDuke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
Michael T LuCardiovascular Imaging Research Center (CIRC), Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street Suite 400, Boston, MA 02114, USA.
Hugo J W L AertsRadiology and Nuclear Medicine, CARIM & GROW, Maastricht University, Maastricht, The Netherlands.
Borek FoldynaCardiovascular Imaging Research Center (CIRC), Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street Suite 400, Boston, MA 02114, USA.ORCID 0000-0002-2466-4827

Funding

ROLE OF DIETARY CONSTITUENTS ON GENE EXPRESSION IN INTESTINAL EPITHELIUMP30DK040561 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI Elizabeth Austen Lawson, Takara Leah Stanley · 1994 to 2026
$31.6M
Pericoronary adipose tissue density a novel CT-derived marker of local inflammation and coronary artery disease in people living with HIVR01HL170877 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI Borek Foldyna · 2023 to 2026
$1.7M
Deep learning to assess cardiovascular disease risk from chest imagingK01HL168231 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI Vineet Raghu · 2024 to 2026
$526k
NHLBI NIH HHS K01 HL168231NHLBI NIH HHS R01 HL170877NIDDK NIH HHS P30 DK040561NIH/NHLBI 1R01HL170877-01
6 · The paper itself

Abstract

aimsEpicardial adipose tissue (EAT) is a metabolically active fat depot associated with coronary atherosclerosis and cardiovascular (CV) risk. While EAT is a known prognostic marker in lung cancer screening, its sex-specific prognostic value remains unclear. This study investigated sex differences in the prognostic utility of serial EAT measurements on low-dose chest computed tomography (CT). METHODS AND

resultsWe analysed baseline and 2-year changes in EAT volume and density using a validated automated deep-learning algorithm in 24 008 heavy-smoking participants from the National Lung Screening Trial (NLST). Sex-stratified multivariable Cox models, adjusted for CV risk factors, body mass index (BMI), and coronary artery calcium (CAC), assessed associations between EAT and all-cause and CV mortality [median follow-up 12.3 years (IQR: 11.9-12.8), 4668 (19.4%) all-cause deaths, 1083 (4.5%) CV deaths]. Women (n = 9841; 41%) were younger, with fewer CV risk factors, lower BMI, fewer pack-years, and lower CAC than men (all P < 0.001). Baseline EAT was associated with similar all-cause and CV mortality risk in both sexes [max. aHR women: 1.70; 95% confidence interval (CI): 1.13-2.55; men: 1.83; 95% CI: 1.40-2.40, P-interaction = 0.986]. However, 2-year EAT changes predicted CV death only in women (aHR: 1.82; 95% CI: 1.37-2.49; P < 0.001), and showed a stronger association with all-cause mortality in women (aHR: 1.52; 95% CI: 1.31-1.77) than in men (aHR: 1.26; 95% CI: 1.13-1.40; P-interaction = 0.041).

conclusionIn this large lung cancer screening cohort, serial EAT changes independently predicted CV mortality in women and were more strongly associated with all-cause mortality in women than in men. These findings support routine EAT quantification on chest CT for improved sex-specific cardiovascular risk stratification.

Indexed as

Adipose TissueEarly Detection of CancerLung NeoplasmsPericardiumTomography, X-Ray ComputedAgedCause of DeathEpicardial Adipose TissueFemaleHumansMaleMiddle AgedPrognosisRisk AssessmentSex Factorsepicardial fatinflammationlow-dosemortality risksex differencewomen

Identifiers

PMID40879169
PMCPMC12571501

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.