Exploring the impact of metabolic comorbidities on epicardial adipose tissue in heart failure with preserved ejection fraction.
Menghoum N., Badii MC., Leroy M., Parra M., Roy C., Lejeune S., Vancraeynest D., Pasquet A., Brito D., Casadei B., Depoix C., Filippatos G., Gruson D., Edelmann F., Ferreira VM., Lhommel R., Mahmod M., Neubauer S., Persu A., Piechnik S., Hellenkamp K., Ikonomidis I., Krakowiak B., Pieske B., Pieske-Kraigher E., Pinto F., Ponikowski P., Senni M., Trochu J-N., Van Overstraeten N., Wachter R., Gerber BL., Balligand J-L., Beauloye C., Pouleur A-C.
Heart failure (HF) with preserved ejection fraction (HFpEF) is increasingly prevalent worldwide due to aging and comorbidities. Epicardial adipose tissue (EAT), favored by diabetes and obesity, was shown to contribute to HFpEF pathophysiology and is an emerging therapeutic target. This study explored the relationship between ventricular EAT measured by cardiovascular magnetic resonance (CMR), metabolic factors, and imaging characteristics in controls, pre-HF patients, and HFpEF patients. Patients from a Belgian cohort enrolled from December 2015 to June 2017 were categorized by HF stage: pre-HF (n = 16), HFpEF (n = 104) and compared to matched controls (n = 26) and to pre-HF (n = 191) from the Beta3-LVH cohort. Biventricular EAT volume was measured in end-diastolic short-axis cine stacks. In the Belgian cohort, associations between EAT, HF stage, and various biological and imaging markers were explored. The clinical endpoint was a composite of mortality or first HF hospitalization in the HFpEF group. EAT significantly differed between groups, with higher values in HFpEF patients compared to pre-HF and controls (72.4 ± 20.8ml/m2vs. 55.0 ± 11.8ml/m2 and 48 ± 8.9ml/m2, p