Uncovering the Role of Epicardial Adipose Tissue in Heart Failure With Preserved Ejection Fraction

Goldman, Sarah A.; Requena-Ibanez, Juan Antonio; Devesa, Ana; Santos-Gallego, Carlos G.; Badimon, Juan José; Fuster, Valentin

doi:10.1016/j.jacadv.2023.100657

Cited by 5 publications

(3 citation statements)

References 110 publications

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“…Particularly, age-related comorbidities are discussed as contributors to poor TAVR outcomes 5 . With advancing age, there is an increase in proinflammatory processes in the body, often referred to as “inflammaging.” 6,7,33 Inflammatory processes associated with inflammaging induce structural changes in the composition of cardiac adipose tissue 34 . It is hypothesized that with the aging process, adipose tissue becomes more dysfunctional, impairing the differentiation of preadipocytes into mature adipocytes 35 .…”

Section: Discussionmentioning

confidence: 99%

CT-derived Epicardial Adipose Tissue Inflammation Predicts Outcome in Patients Undergoing Transcatheter Aortic Valve Replacement

Salam,

Al-Kassou,

Weinhold

et al. 2024

Journal of Thoracic Imaging

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Purpose: Inflammatory changes in epicardial (EAT) and pericardial adipose tissue (PAT) are associated with increased overall cardiovascular risk. Using routine, preinterventional cardiac CT data, we examined the predictive value of quantity and quality of EAT and PAT for outcome after transcatheter aortic valve replacement (TAVR). Materials and Methods: Cardiac CT data of 1197 patients who underwent TAVR at the in-house heart center between 2011 and 2020 were retrospectively analyzed. The amount and density of EAT and PAT were quantified from single-slice CT images at the level of the aortic valve. Using established risk scores and known independent risk factors, a clinical benchmark model (BMI, Chronic kidney disease stage, EuroSCORE 2, STS Prom, year of intervention) for outcome prediction (2-year mortality) after TAVR was established. Subsequently, we tested whether the additional inclusion of area and density values of EAT and PAT in the clinical benchmark model improved prediction. For this purpose, the cohort was divided into a training (n=798) and a test cohort (n=399). Results: Within the 2-year follow-up, 264 patients died. In the training cohort, particularly the addition of EAT density to the clinical benchmark model showed a significant association with outcome (hazard ratio 1.04, 95% CI: 1.01-1.07; P=0.013). In the test cohort, the outcome prediction of the clinical benchmark model was also significantly improved with the inclusion of EAT density (c-statistic: 0.589 vs. 0.628; P=0.026). Conclusions: EAT density as a surrogate marker of EAT inflammation was associated with 2-year mortality after TAVR and may improve outcome prediction independent of established risk parameters.

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Section: Discussionmentioning

confidence: 99%

CT-derived Epicardial Adipose Tissue Inflammation Predicts Outcome in Patients Undergoing Transcatheter Aortic Valve Replacement

Salam,

Al-Kassou,

Weinhold

et al. 2024

Journal of Thoracic Imaging

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“…Specifically, pericoronary EAT seems to be implicated in atherogenesis, whereas EAT accumulated around the atria is associated with atrial fibrillation and those accumulated over the right or left ventricles show association with ventricle mass. 2 , 27 , 28 …”

Section: Eat: Anatomy and Physiologymentioning

confidence: 99%

“…Indeed, EAT has been observed to contribute to atherogenesis; it has been associated with hemodynamic impairments, an enhanced ventricular interdependence, a reduced exercise capacity, and an increased risk of atrial fibrillation. 1 , 2 However, precise molecular mechanisms linking EAT to cardiovascular diseases have not yet been described. The underlying mechanisms that have most generally been hypothesized are related to inflammation exacerbation of the innate immune response, oxidative stress, endothelial damage, adipocyte stress, lipid accumulation, and glucotoxicity.…”

Section: Introductionmentioning

confidence: 99%

Exploring the role of epicardial adipose-tissue-derived extracellular vesicles in cardiovascular diseases

Rizzuto,

Gelpi,

Mangini

et al. 2024

iScience

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Predictive value of epicardial adipose tissue volume measured in diagnosis and prognosis of patients with HFPEF

Jiang,

2024

Experimental Gerontology

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Uncovering the Role of Epicardial Adipose Tissue in Heart Failure With Preserved Ejection Fraction

Cited by 5 publications

References 110 publications

CT-derived Epicardial Adipose Tissue Inflammation Predicts Outcome in Patients Undergoing Transcatheter Aortic Valve Replacement

CT-derived Epicardial Adipose Tissue Inflammation Predicts Outcome in Patients Undergoing Transcatheter Aortic Valve Replacement

Exploring the role of epicardial adipose-tissue-derived extracellular vesicles in cardiovascular diseases

Predictive value of epicardial adipose tissue volume measured in diagnosis and prognosis of patients with HFPEF

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