Epicardial Adipose Tissue and Invasive Hemodynamics in Heart Failure With Preserved Ejection Fraction

Gorter, Thomas M.; Woerden, Gijs van; Rienstra, Michiel; Dickinson, Michael G.; Hummel, Yoran M.; Voors, Adriaan A.; Hoendermis, Elke S.; Veldhuisen, Dirk J. van

doi:10.1016/j.jchf.2020.06.003

Cited by 74 publications

(95 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hypothetically, the RV and atria may be more susceptible to EAT infiltration compared to the LV, as they are much thinner. For instance, it was recently observed that increased EAT was associated with higher RV filling pressures at rest, but not higher with LV filling pressures 7 . Our observation that EAT seems more strongly related to RV hypertrophy, than to LV hypertrophy, supports this hypothesis.…”

Section: Discussionsupporting

confidence: 82%

“…HF with mid‐range EF [HFmrEF] and preserved EF [HFpEF]) is an emerging heart disease with poor prognosis for which currently no evidence based therapies exists 1–4 . Epicardial adipose tissue (EAT) is increasingly recognized as a potential culprit in the pathophysiology of HF patients with LVEF >40% 5–7 …”

Section: Introductionmentioning

confidence: 99%

“…This is at least partially due to myocardial infiltration of EAT, which disrupts myocardial ultrastructure and promotes fibrosis 9 . In contrast, the accumulation of EAT has also been associated with increased cardiac filling pressures suggesting that it increases the mechanical load on the myocardium 6,7,10 …”

Section: Introductionmentioning

confidence: 99%

“…The total EAT volume is markedly increased in HFmrEF and HFpEF patients compared to healthy controls, and is associated with disease severity 5,7 . However, as these associations were established with measures of global EAT volume, it is unknown if the effects of EAT in this population are explained by regional or global effects of EAT on the myocardium 9 .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Importance of epicardial adipose tissue localization using cardiac magnetic resonance imaging in patients with heart failure with mid‐range and preserved ejection fraction

Woerden

Veldhuisen

Gorter

et al. 2021

Clinical Cardiology

Self Cite

View full text Add to dashboard Cite

Background Epicardial adipose tissue (EAT) has been implicated in the pathophysiology of heart failure (HF) with left ventricular ejection fraction (LVEF) >40%, but whether this is due to a regional or global effect of EAT remains unclear. Hypothesis Regional EAT is associated with alterations in local cardiac structure and function. Methods Patients with HF and LVEF >40% were studied. Cardiac Magnetic Resonance imaging was used to localize EAT surrounding the right ventricle (RV) and LV separately, using anterior‐ and posterior interventricular grooves as boundaries. Atrial‐ and ventricular EAT were differentiated using the mitral‐valve position. All EAT depots were related to the adjacent myocardial structure. Results 102 consecutive HF patients were enrolled. The majority of EAT was present around the RV (42% of total EAT, p < .001). RV‐EAT showed a strong association with increased RV mass (β = 0.60, p < .001) and remained associated with RV mass after adjusting for total EAT, sex, N‐terminal prohormone of brain natriuretic peptide (NT‐proBNP), renal function and blood glucose. LV‐EAT showed a similar association with LV mass in univariable analysis, albeit less pronounced (β = 0.24, p = .02). Atrial EAT was increased in patients with atrial fibrillation compared to those without atrial fibrillation (30 vs. 26 ml/m2, p = .04), whereas ventricular EAT was similar (74 vs. 75 ml/m2, p = .9). Conclusions Regional EAT is strongly associated with local cardiac structure and function in HF patients with LVEF >40%. These data support the hypothesis that regional EAT is involved in the pathophysiology of HF with LVEF >40%.

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Importance of epicardial adipose tissue localization using cardiac magnetic resonance imaging in patients with heart failure with mid‐range and preserved ejection fraction

Woerden

Veldhuisen

Gorter

et al. 2021

Clinical Cardiology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Легочная гипертензия часто развивается у пациентов с левожелудочковой ХСН, в том числе у 40-80% больных с СФВ ЛЖ [37]. Увеличение давления заполнения ЛЖ при ХСН с СФВ приводит к венозному застою в легких и вторичной легочной гипертензии, сопровождающейся прогрессирующей симптоматикой и ухудшением прогноза.…”

Section: дисфункция легочных сосудов/застой в легочных венахunclassified

Chronic Heart Failure With Preserved Ejection Fraction: Treatment in Conditions of Limited Evidence

Григорьевич

Борисенко

Середа

2018

Kuban. nauсh. med. vestnik

View full text Add to dashboard Cite

show abstract

The value of echocardiographic measurement of epicardial adipose tissue in heart failure patients

et al. 2022

Self Cite

View full text Add to dashboard Cite

Aims Epicardial adipose tissue (EAT) is increasingly recognized as an important factor in the pathophysiology of heart failure (HF). Cardiac magnetic resonance (CMR) imaging is the gold-standard imaging modality to evaluate EAT size, but in contrast to echocardiography, CMR is costly and not widely available. We investigated EAT thickness on echocardiography in relation to EAT volume on CMR, and we assessed the agreement between observers for measuring echocardiographic EAT. Methods and resultsPatients with HF and left ventricular ejection fraction >40% were enrolled. All patients underwent CMR imaging and transthoracic-echocardiography. EAT volume was quantified on CMR short-axis cine-stacks. Echocardiographic EAT thickness was measured on parasternal long-axis and short-axis views. Linear regression analyses were used to assess the association between EAT volume on CMR and EAT thickness on echocardiography. Intraclass correlation coefficient (ICC) was used to assess the interobserver agreement as well as the intraobserver agreement. EAT on CMR and echocardiography was evaluated in 117 patients (mean age 71 ± 10 years, 49% women and mean left ventricular ejection fraction 54 ± 7%). Mean EAT volume on CMR was 202 ± 64 mL and ranged from 80 to 373 mL. Mean EAT thickness on echocardiography was 3.8 ± 1.5 mm and ranged from 1.7 to 10.2 mm. EAT volume on CMR and EAT thickness on echocardiography were significantly correlated (junior-observer: r = 0.62, P < 0.001, senior-observer: r = 0.33, P < 0.001), and up to one-third of the variance in EAT volume was explained by EAT thickness (R 2 = 0.38, P < 0.001). The interobserver agreement between junior and senior observers for measuring echocardiographic EAT was modest [ICC, 0.65 (95% confidence interval (CI) 0.47-0.77], whereas the intraobserver agreement was good (ICC 0.98, 95% CI 0.84-0.99). Conclusions There was a modest correlation between EAT volume on CMR and EAT thickness on echocardiography. Limited agreement between junior and senior observers for measuring echocardiographic EAT was observed. EAT thickness on echocardiography is limited in estimating EAT volume.

show abstract

Epicardial Adipose Tissue and Invasive Hemodynamics in Heart Failure With Preserved Ejection Fraction

Cited by 74 publications

References 32 publications

Importance of epicardial adipose tissue localization using cardiac magnetic resonance imaging in patients with heart failure with mid‐range and preserved ejection fraction

Importance of epicardial adipose tissue localization using cardiac magnetic resonance imaging in patients with heart failure with mid‐range and preserved ejection fraction

Chronic Heart Failure With Preserved Ejection Fraction: Treatment in Conditions of Limited Evidence

The value of echocardiographic measurement of epicardial adipose tissue in heart failure patients

Contact Info

Product

Resources

About