Peer-Reviewed Publication
J Am Coll Cardiol2026;87(25):3539-3555.June 30, 2026Journal Article
Early Prediction of Heart Failure From Routine Cardiac CT Using Radiomic Phenotyping of Epicardial Fat.
Evangelos K Oikonomou1, Kenneth Chan2, Parijat Patel2, Elizabeth Wahome2, Katerina Dangas2, Rohan Desai2, Ikboljon Sobirov2, Rohan Khera3, Steffen E Petersen4, Francesca Pugliese4, Ronak Rajani5, Edward Nicol6, Attila Kardos7, David Adlam8, Andrew D Kelion9, Nikant Sabharwal9, Nicholas Screaton10, John P Greenwood11, Jonathan Rodrigues12, Daniel Huck13, Cheerag Shirodaria14, Pete Tomlins15, Muhammad Siddique15, Yogesh Sohan15, Sam Fry16, Marly van Assen17, Ron Blankstein13, Milind Y Desai18, Stefan Neubauer2, Keith M Channon2, John Deanfield19, Charalambos Antoniades20,
1Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA; Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.
2Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.
3Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
4Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom; William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
5Department of Cardiology, Guys and St Thomas' Hospital, London, United Kingdom.
6Royal Brompton and Harefield Hospitals, London, United Kingdom; School of Biomedical Engineering and Imaging Sciences, King's College, London, United Kingdom.
7Department of Cardiology, Translational Cardiovascular Research Group, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, United Kingdom.
8Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom.
9Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom.
10Royal Papworth Hospital, Cambridge, United Kingdom.
11Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
12Royal United Hospital Bath NHS Foundation Trust, Bath, United Kingdom.
13Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
14Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom; Caristo Diagnostics, Oxford, United Kingdom.
15Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Caristo Diagnostics, Oxford, United Kingdom.
16Caristo Diagnostics, Oxford, United Kingdom.
17Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia, USA.
18Cleveland Clinic Heart and Vascular Institute, Cleveland, Ohio, USA.
19Institute of Cardiovascular Science, University College London, London, United Kingdom.
20Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom. Electronic address: charalambos.antoniades@cardiov.ox.ac.uk.
Abstract
BACKGROUND: Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot that is both a sensor and a modulator of myocardial biology and changes its composition in response to paracrine signals from the myocardium. We hypothesized that radiomic characterization of EAT from routine coronary computed tomographic angiography (CCTA) can noninvasively capture this adverse remodeling and…
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