Epicardial Adipose Tissue, Functional Status, and Invasive Hemodynamics in Heart Failure With Preserved Ejection Fraction
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Epicardial adipose tissue (EAT) may play a role in the pathophysiology of heart failure (HF) with preserved ejection fraction (HFpEF). OBJECTIVES: This study examined associations between increased EAT, functional status, and invasive exercise hemodynamics in a large cohort of HFpEF patients. METHODS: All patients underwent echocardiography, 6-minute walk distance (MWD) test, Kansas City Cardiomyopathy Questionnaire, and invasive hemodynamic assessment at rest and during ergometry. EAT thickness was measured alongside the right ventricle on echocardiography, expressed in mm and patients were divided according to EAT tertiles. RESULTS: In total, 566 patients were examined with mean age 72 ± 8 years, 62% women, mean EAT thickness was 6.0 ± 2.4 mm and 11.5% had EAT ≥9 mm. With increasing EAT thickness tertiles, 6-MWD and Kansas City Cardiomyopathy Questionnaire overall summary score were significantly lower (320 [247-385] vs 315 [244-383] vs 287 [210-364] meters, P = 0.001; 51 [32-67] vs 45 [32-63] vs 41, [26-56], P = 0.003; respectively), whereas the latter was independent of body mass index (P = 0.004). At rest, invasive hemodynamics were not different across EAT tertiles. At peak exercise, patients in the highest EAT thickness tertile had higher pulmonary capillary wedge pressure and pulmonary capillary wedge pressure to right atrial pressure gradient, compared to patients in the first and second EAT thickness tertiles (36 ± 8 vs 34 ± 8 mm Hg, P = 0.009; 18 ± 7 vs 16 ± 7 mm Hg, P = 0.002, respectively). CONCLUSIONS: EAT thickness was associated with impaired quality of life, lower 6-MWD, and higher left-sided filling pressures at peak exercise. Excess EAT may therefore play an important role in functional status and exercise hemodynamics in patients with HFpEF.
Source: JACC Advances
Authors: Yoran Crum, Dirk J. van Veldhuisen, Sanjiv J. Shah, Uma Mylavarapu, Mo Hu, Jan Komtebedde, Michelle Lobeek, Elke S. Hoendermis, Sheldon E. Litwin, Scott D. Solomon, Donald E. Cutlip, Martin B. Leon, David Kaye, Leonhard Bruch, Tim Seidler, Maja Cikes, Rajeev Mohan, Scott Lilly, Nicholas Collins, Sitaramesh Emani, Stanley Chetcuti, Heiko Bugger, Eugene Kotlyar, Grant W. Reed, Robert Gordon, Deepak K. Gupta, Barry A. Borlaug, Thomas M. Gorter
Institutions: University Medical Center Groningen, University of Groningen, Northwestern University, Corvia Medical (United States), Medical University of South Carolina, Ralph H. Johnson VA Medical Center, Brigham and Women's Hospital, Beth Israel Deaconess Medical Center, NewYork–Presbyterian Hospital, Columbia University Irving Medical Center, Cardiovascular Research Foundation, Monash University, Unfallkrankenhaus Berlin, BG Kliniken, Justus-Liebig-Universität Gießen, Kerckhoff Klinik, University Hospital Centre Zagreb, University of Zagreb, The Ohio State University Wexner Medical Center, The Ohio State University, John Hunter Hospital, Christ Hospital, University of Michigan, Medical University of Graz, Cleveland Clinic, Vanderbilt University, Vanderbilt University Medical Center, Mayo Clinic
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,936
OpenAlex ID: W4413764409