Epicardial fat in heart failure with reduced versus preserved ejection fraction

Tromp, Jasper; Bryant, Jennifer; Jin, Xuanyi; Woerden, Gijs van; Asali, Salma; Han, Yiying; Liew, Oi Wah; Ching, Jenny Chong Pek; Jaufeerally, Fazlur; Loh, Seet Yoong; Sim, David; Sheldon, Lee; Soon, Dinna; Tay, Wan Ting; Packer, Milton; Veldhuisen, Dirk J. van; Chin, Calvin Woon Loong; Richards, A. Mark; Lam, Carolyn S.P.

doi:10.1002/ejhf.2156

Cited by 44 publications

(75 citation statements)

References 8 publications

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“… 65 We did not assess the volume of EAT in this study; however, our HFpEF patient profiles are consistent with other studies in which increased EAT volumes have been measured in HFpEF patients. 66 Nevertheless, we cannot exclude the presence of a small concentration of gradients that lie beneath the sensitivity of the aptamer assay, although previous studies used an enzyme-linked immunosorbent assay–based assay. Similarly, we did not obtain myocardial biopsy specimens.…”

Section: Discussionmentioning

confidence: 95%

Characterization of Cardiac Sympathetic Nervous System and Inflammatory Activation in HFpEF Patients

Kaye

Nanayakkara

Wang

et al. 2022

JACC: Basic to Translational Science

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Section: Discussionmentioning

confidence: 95%

Characterization of Cardiac Sympathetic Nervous System and Inflammatory Activation in HFpEF Patients

Kaye

Nanayakkara

Wang

et al. 2022

JACC: Basic to Translational Science

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“…7 This ultimately determines fibrosis and stiffening of the myocardium, leading to functional impairment and adverse prognosis. 28,50 Selected HFrEF and HFpEF patients could respond to novel therapies targeting EAT metabolism and its secretory and haemodynamic features to counteract excessive lipolysis or excess adiposity. 7,26,47 Further studies are needed to understand whether EAT could represent a causal factor or the epiphenomenon of a catabolic (in HFrEF) or meta-inflammatory (in HFpEF) state caused by the disease itself.…”

Section: Clinical Perspectivesmentioning

confidence: 99%

Impact of epicardial adipose tissue on cardiovascular haemodynamics, metabolic profile, and prognosis in heart failure

Pugliese

Paneni

Mazzola

et al. 2021

European J of Heart Fail

116

134

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“…In a large multicentre study from Singapore, we recently showed that total EAT volume by magnetic resonance imaging was increased in HFrEF and HFpEF relative to controls without HF, but the EAT/left ventricular mass ratio was decreased, especially in HFrEF 6 . In this previous study, greater total EAT mass was more closely associated with extracellular volume — a marker of myocardial fibrosis — in HFpEF than in HFrEF 6 . One conflicting study reported decreased EAT volume in HFpEF relative to controls 8 .…”

Section: Figurementioning

confidence: 97%

The diverging role of epicardial adipose tissue in heart failure with reduced and preserved ejection fraction: not all fat is created equal

Tromp

Packer

Lam

2021

European J of Heart Fail

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This article refers to 'Impact of epicardial adipose tissue on cardiovascular haemodynamics, metabolic profile, and prognosis in heart failure' by N.R. Pugliese et al., published in this issue on pages 1858-1871.The (patho)physiological role of epicardial adipose tissue (EAT) in heart failure (HF) is increasingly recognized. 1 EAT shares a common microcirculation with the heart, 2 and can serve as a source of adipocytokines through its anatomical intimacy with the myocardium, contributing to focal and systemic inflammation. 2 Previous studies have highlighted the importance of EAT in HF. [3][4][5][6][7][8][9] Increased EAT was associated with incident HF in the general population, especially with HF and preserved ejection fraction (HFpEF). 9 In patients with prevalent HFpEF, EAT was increased compared to people without HF in four 4-7 out of five studies, 4-8 and associated with increased cardiac filling pressures and inflammatory cytokine concentrations. [4][5][6]8 In contrast, a single study in patients with prevalent HF and reduced ejection fraction (HFrEF) suggested that EAT was reduced compared to people without HF. 3 Unfortunately, most previous studies included patients with HFrEF 3 or HFpEF, 4,5,8 and few have investigated the role of EAT across the ejection fraction spectrum. 6,7 In this issue of the Journal, the study by Pugliese et al. 10 significantly extends prior knowledge on the role of EAT in HF by studying the association of EAT with clinical biomarkers and outcomes in patients with HFrEF and HFpEF. The authors measured EAT thickness on echocardiography in a total of 393 patients with HF (48% HFpEF) and 44 controls. The HF diagnosis in participants was corroborated by objective signs and symptoms of HF, a reduced ejection fraction or increased natriuretic peptides. All participants underwent comprehensive exercise testing with measurement of peak oxygen consumption (VO 2 max) and arterial-venous oxygen content difference (AVO 2 diff) and were followed up forThe opinions expressed in this article are not necessarily those of the Editors of the European Journal of Heart Failure or of the European Society of Cardiology.

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Epicardial fat in heart failure with reduced versus preserved ejection fraction

Cited by 44 publications

References 8 publications

Characterization of Cardiac Sympathetic Nervous System and Inflammatory Activation in HFpEF Patients

Characterization of Cardiac Sympathetic Nervous System and Inflammatory Activation in HFpEF Patients

Impact of epicardial adipose tissue on cardiovascular haemodynamics, metabolic profile, and prognosis in heart failure

The diverging role of epicardial adipose tissue in heart failure with reduced and preserved ejection fraction: not all fat is created equal

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