TY - JOUR
T1 - Epicardial Adipose Tissue and Outcome in Heart Failure With Mid-Range and Preserved Ejection Fraction
AU - van Woerden, Gijs
AU - van Veldhuisen, Dirk J
AU - Manintveld, Olivier C
AU - van Empel, Vanessa P M
AU - Willems, Tineke P
AU - de Boer, Rudolf A
AU - Rienstra, Michiel
AU - Westenbrink, B Daan
AU - Gorter, Thomas M
N1 - Funding Information:
The ventricular tachyarrhythmia detection by implantable loop recording in patients with heart failure and preserved ejection fraction study was supported by an unrestricted grant from Abbott-Netherlands to the University Medical Center Groningen. Abbott-Netherlands was neither involved in the conduction of the study, nor in the writing of this article.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/3
Y1 - 2022/3
N2 - BACKGROUND: Epicardial adipose tissue (EAT) accumulation is thought to play a role in the pathophysiology of heart failure (HF) with mid-range and preserved ejection fraction, but its effect on outcome is unknown. We evaluated the prognostic value of EAT volume measured with cardiac magnetic resonance in patients with HF with mid-range ejection fraction and HF with preserved ejection fraction.METHODS: Patients enrolled in a prospective multicenter study that investigated the value of implantable loop-recorders in HF with mid-range ejection fraction and HF with preserved ejection fraction were analyzed. EAT volume was quantified with cardiac magnetic resonance. Main outcome was the composite of all-cause mortality and first HF hospitalizations. Hazard ratios (HR) and 95% CI are described per SD increase in EAT.RESULTS: We studied 105 patients (mean age 72±8 years, 50% women, and mean left ventricular ejection fraction 53±8%). During median follow-up of 24 (17-25) months, 31 patients (30%) died or were hospitalized for HF. In univariable analysis, EAT was significantly associated with a higher risk of the composite outcome (HR, 1.76 [95% CI, 1.24-2.50], P=0.001), and EAT remained associated with outcome after adjustment for age, sex, and body mass index (HR, 1.61 [95% CI, 1.13-2.31], P=0.009), and after adjustment for New York Heart Association functional class and N-terminal of pro-brain natriuretic peptide (HR, 1.53 [95% CI, 1.04-2.24], P=0.03). Furthermore, EAT was associated with all-cause mortality alone (HR, 2.06 [95% CI, 1.26-3.37], P=0.004) and HF hospitalizations alone (HR, 1.54 [95% CI, 1.04-2.30], P=0.03).CONCLUSIONS: EAT accumulation is associated with adverse prognosis in patients with HF with mid-range ejection fraction and HF with preserved ejection fraction. This finding supports the importance of EAT in these patients with HF.REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01989299.
AB - BACKGROUND: Epicardial adipose tissue (EAT) accumulation is thought to play a role in the pathophysiology of heart failure (HF) with mid-range and preserved ejection fraction, but its effect on outcome is unknown. We evaluated the prognostic value of EAT volume measured with cardiac magnetic resonance in patients with HF with mid-range ejection fraction and HF with preserved ejection fraction.METHODS: Patients enrolled in a prospective multicenter study that investigated the value of implantable loop-recorders in HF with mid-range ejection fraction and HF with preserved ejection fraction were analyzed. EAT volume was quantified with cardiac magnetic resonance. Main outcome was the composite of all-cause mortality and first HF hospitalizations. Hazard ratios (HR) and 95% CI are described per SD increase in EAT.RESULTS: We studied 105 patients (mean age 72±8 years, 50% women, and mean left ventricular ejection fraction 53±8%). During median follow-up of 24 (17-25) months, 31 patients (30%) died or were hospitalized for HF. In univariable analysis, EAT was significantly associated with a higher risk of the composite outcome (HR, 1.76 [95% CI, 1.24-2.50], P=0.001), and EAT remained associated with outcome after adjustment for age, sex, and body mass index (HR, 1.61 [95% CI, 1.13-2.31], P=0.009), and after adjustment for New York Heart Association functional class and N-terminal of pro-brain natriuretic peptide (HR, 1.53 [95% CI, 1.04-2.24], P=0.03). Furthermore, EAT was associated with all-cause mortality alone (HR, 2.06 [95% CI, 1.26-3.37], P=0.004) and HF hospitalizations alone (HR, 1.54 [95% CI, 1.04-2.30], P=0.03).CONCLUSIONS: EAT accumulation is associated with adverse prognosis in patients with HF with mid-range ejection fraction and HF with preserved ejection fraction. This finding supports the importance of EAT in these patients with HF.REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01989299.
KW - adipose tissue
KW - heart failure
KW - magnetic resonance imaging
KW - obesity
KW - prognosis
KW - ALL-CAUSE MORTALITY
KW - PERICARDIAL FAT
KW - RISK
KW - ASSOCIATION
KW - DYSFUNCTION
KW - PROGNOSIS
KW - OBESITY
U2 - 10.1161/CIRCHEARTFAILURE.121.009238
DO - 10.1161/CIRCHEARTFAILURE.121.009238
M3 - Article
C2 - 34935412
SN - 1941-3289
VL - 15
JO - Circulation-Heart Failure
JF - Circulation-Heart Failure
IS - 3
M1 - 009238
ER -