Exploring the impact of metabolic comorbidities on epicardial adipose tissue in heart failure with preserved ejection fraction
Authors' conclusion
EAT assessed by CMR was significantly higher in HFpEF patients compared to controls and pre-HF patients, irrespective of diabetes and BMI. EAT was moderately associated with HFpEF status. HFpEF patients with elevated EAT exhibited a marked diabetic, ischemic, and inflammatory profile, highlighting the potential role of drugs targeting EAT.
Study context
- Population
- Controls, pre-HF and HFpEF patients from a Belgian cohort enrolled December 2015 to June 2017, and pre-HF patients from the Beta3-LVH cohort
- Participants
- 104 / 16 / 26 / 191
- Exposure
- Epicardial adipose tissue (EAT) in HFpEF vs pre-HF vs controls
- HFpEFn = 104
- Pre-HFn = 16
- Controlsn = 26reference
- Pre-HF (Beta3-LVH)n = 191
- Outcome
- Biventricular EAT volume measured by CMR in end-diastolic short-axis cine stacks
Methodological detailsmatched controls, cardiovascular magnetic resonance (CMR)
- Matched controls
- CMR
Main finding
As reported in the abstract
HFpEF vs Pre-HF: P < 0.001 · HFpEF vs Pre-HF (Beta3-LVH): P < 0.001
Observational data: associations, not effects.
Further findings
Markers of HFpEF status (multivariable logistic regression and random forest)
- EAT, NT-proBNP and H2FPEF score identified as strong markers of HFpEF status
- Belgian cohort
Correlations of EAT
- H2FPEF score
- r = 0.41, p = 0.003
- Body mass index (BMI)
- r = 0.30, p < 0.001
- High-sensitive troponin T
- r = 0.41, p < 0.001
- NT-proBNP
- r = 0.37, p < 0.001
- sST2
- r = 0.30, p < 0.001
- E/e' ratio
- r = 0.33, p < 0.001
- LV global longitudinal strain
- r = 0.35, p < 0.001
Diabetes prevalence and BMI, pre-HF vs HFpEF
- Did not differ between pre-HF and HFpEF, in contrast to AF
Factors associated with elevated EAT in HFpEF
- Diabetes, ischemic cardiomyopathy and elevated sST2 independently associated with elevated EAT
Composite of mortality or first heart failure (HF) hospitalization in HFpEF
- Increased EAT not associated with prognosis, in contrast with diabetes and BMI
Original publication
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