Epicardial adipose tissue volume and density are associated with heart failure with improved ejection fraction.

Autor: Yang CD; Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, People's Republic of China., Quan JW; Institute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, People's Republic of China., Tay GP; Institute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, People's Republic of China., Feng S; Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, People's Republic of China., Yuan H; Institute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, People's Republic of China., Amuti A; Institute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, People's Republic of China., Tang SY; Institute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, People's Republic of China., Wu XR; Institute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, People's Republic of China., Yuan RS; Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, People's Republic of China., Lu L; Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, People's Republic of China.; Institute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, People's Republic of China., Zhang RY; Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, People's Republic of China.; Institute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, People's Republic of China., Wang XQ; Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, People's Republic of China. wangxq@shsmu.edu.cn.; Institute of Cardiovascular Disease, Shanghai Jiao-Tong University School of Medicine, Shanghai, People's Republic of China. wangxq@shsmu.edu.cn.
Jazyk: angličtina
Zdroj: Cardiovascular diabetology [Cardiovasc Diabetol] 2024 Aug 03; Vol. 23 (1), pp. 283. Date of Electronic Publication: 2024 Aug 03.
DOI: 10.1186/s12933-024-02376-y
Abstrakt: Background: Heart failure (HF) with improved ejection fraction (EF, HFimpEF) is a distinct HF subtype, characterized by left ventricular (LV) reverse remodeling and myocardial functional recovery. Multiple cardiometabolic factors are implicated in this process. Epicardial adipose tissue (EAT), emerging as an endocrine and paracrine organ, contributes to the onset and progression of HF. However, the relation between EAT and the incidence of HFimpEF is still unclear.
Methods: A total of 203 hospitalized HF patients with reduced EF (HFrEF, LVEF ≤ 40%) who underwent coronary CT angiography (CCTA) during index hospitalization were consecutively enrolled between November 2011 and December 2022. Routine follow-up and repeat echocardiograms were performed. The incidence of HFimpEF was defined as (1) an absolute LVEF improvement ≥ 10% and (2) a second LVEF > 40% (at least 3 months apart). EAT volume and density were semiautomatically quantified on non-enhanced series of CCTA scans.
Results: During a median follow-up of 8.6 (4.9 ~ 13.3) months, 104 (51.2%) patients developed HFimpEF. Compared with HFrEF patients, HFimpEF patients had lower EAT volume (115.36 [IQR 87.08 ~ 154.78] mL vs. 169.67 [IQR 137.22 ~ 218.89] mL, P < 0.001) and higher EAT density (-74.92 ± 6.84 HU vs. -78.76 ± 6.28 HU, P < 0.001). Multivariate analysis showed lower EAT volume (OR: 0.885 [95%CI 0.822 ~ 0.947]) and higher density (OR: 1.845 [95%CI 1.023 ~ 3.437]) were both independently associated with the incidence of HFimpEF. Subgroup analysis revealed that the association between EAT properties and HFimpEF was not modified by HF etiology.
Conclusions: This study reveals that lower EAT volume and higher EAT density are associated with development of HFimpEF. Therapies targeted at reducing EAT quantity and improving its quality might provide favorable effects on myocardial recovery in HF patients.
(© 2024. The Author(s).)
Databáze: MEDLINE
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