Prognostic Value of Epicardial Adipose Tissue in Heart Failure With Mid‐Range and Preserved Ejection Fraction: A Multicenter Study
Background Epicardial adipose tissue (EAT) accumulation is thought to play a role in the pathophysiology of heart failure (HF) with mid‐range ejection fraction and HF with preserved ejection fraction, but its effect on outcome is unknown. Methods and Results A total of 692 patients with HF with mid‐...
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Wiley
2024-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.036789 |
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| author | Wenxian Wang Yan Gao Jian Wang Congshan Ji Hui Gu Xianshun Yuan Shifeng Yang Ximing Wang |
| author_facet | Wenxian Wang Yan Gao Jian Wang Congshan Ji Hui Gu Xianshun Yuan Shifeng Yang Ximing Wang |
| author_sort | Wenxian Wang |
| collection | DOAJ |
| description | Background Epicardial adipose tissue (EAT) accumulation is thought to play a role in the pathophysiology of heart failure (HF) with mid‐range ejection fraction and HF with preserved ejection fraction, but its effect on outcome is unknown. Methods and Results A total of 692 patients with HF with mid‐range ejection fraction or HF with preserved ejection fraction who underwent cardiovascular magnetic resonance at 2 medical centers in China between October 2016 and October 2022 were included in this study. EAT volume and extracellular volume were calculated using cardiovascular magnetic resonance. The main outcome was the composite of all‐cause mortality and first HF hospitalization. Of 692 participants, 41.3% were women. The mean age, body mass index, left ventricular ejection fraction, and EAT volume were 57.0 years, 27.2 kg/m2, 50.0%, and 67.1 mL/m2, respectively. During a median follow‐up of 34 months, 169 patients (24.4%) died or were hospitalized for HF. EAT volume exhibited a strong unadjusted association with the composite outcome (hazard ratio per 1 mL/m2 [HR], 1.57 [95% CI, 1.40–1.76], P<0.001). After fully adjusting, EAT remained associated with the outcome (HR, 1.62 [95% CI, 1.42–1.86], P<0.001). We constructed a baseline multivariable model including comorbidities, New York Heart Association functional class, extracellular volume, age, body mass index, left ventricular ejection fraction, and N‐terminal pro‐brain natriuretic peptide. Addition of EAT volume to the baseline multivariable model significantly improved model performance (C statistic improvement: 0.711–0.760; P<0.001). Conclusions EAT accumulation is associated with an adverse prognosis in patients with HF with mid‐range ejection fraction and those with HF with preserved ejection fraction. In addition, EAT provides incremental prognostic value beyond left ventricular ejection fraction and New York Heart Association class. |
| format | Article |
| id | doaj-art-fbccd926438e4f92a61ef07f5c3736a7 |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-fbccd926438e4f92a61ef07f5c3736a72025-08-20T02:49:39ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-12-01132410.1161/JAHA.124.036789Prognostic Value of Epicardial Adipose Tissue in Heart Failure With Mid‐Range and Preserved Ejection Fraction: A Multicenter StudyWenxian Wang0Yan Gao1Jian Wang2Congshan Ji3Hui Gu4Xianshun Yuan5Shifeng Yang6Ximing Wang7School of Medical Imaging, Binzhou Medical University Yantai Shandong P. R. ChinaDepartment of Radiology Shandong Provincial Hospital, Shandong University Jinan Shandong ChinaDepartment of Radiology Central Hospital Affiliated to Shandong First Medical University Jinan Shandong ChinaDepartment of Radiology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan Shandong ChinaDepartment of Radiology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan Shandong ChinaDepartment of Radiology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan Shandong ChinaDepartment of Radiology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan Shandong ChinaDepartment of Radiology Shandong Provincial Hospital, Shandong University Jinan Shandong ChinaBackground Epicardial adipose tissue (EAT) accumulation is thought to play a role in the pathophysiology of heart failure (HF) with mid‐range ejection fraction and HF with preserved ejection fraction, but its effect on outcome is unknown. Methods and Results A total of 692 patients with HF with mid‐range ejection fraction or HF with preserved ejection fraction who underwent cardiovascular magnetic resonance at 2 medical centers in China between October 2016 and October 2022 were included in this study. EAT volume and extracellular volume were calculated using cardiovascular magnetic resonance. The main outcome was the composite of all‐cause mortality and first HF hospitalization. Of 692 participants, 41.3% were women. The mean age, body mass index, left ventricular ejection fraction, and EAT volume were 57.0 years, 27.2 kg/m2, 50.0%, and 67.1 mL/m2, respectively. During a median follow‐up of 34 months, 169 patients (24.4%) died or were hospitalized for HF. EAT volume exhibited a strong unadjusted association with the composite outcome (hazard ratio per 1 mL/m2 [HR], 1.57 [95% CI, 1.40–1.76], P<0.001). After fully adjusting, EAT remained associated with the outcome (HR, 1.62 [95% CI, 1.42–1.86], P<0.001). We constructed a baseline multivariable model including comorbidities, New York Heart Association functional class, extracellular volume, age, body mass index, left ventricular ejection fraction, and N‐terminal pro‐brain natriuretic peptide. Addition of EAT volume to the baseline multivariable model significantly improved model performance (C statistic improvement: 0.711–0.760; P<0.001). Conclusions EAT accumulation is associated with an adverse prognosis in patients with HF with mid‐range ejection fraction and those with HF with preserved ejection fraction. In addition, EAT provides incremental prognostic value beyond left ventricular ejection fraction and New York Heart Association class.https://www.ahajournals.org/doi/10.1161/JAHA.124.036789epicardial adipose tissueheart failureheart failure with preserved ejection fractionprognosis |
| spellingShingle | Wenxian Wang Yan Gao Jian Wang Congshan Ji Hui Gu Xianshun Yuan Shifeng Yang Ximing Wang Prognostic Value of Epicardial Adipose Tissue in Heart Failure With Mid‐Range and Preserved Ejection Fraction: A Multicenter Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease epicardial adipose tissue heart failure heart failure with preserved ejection fraction prognosis |
| title | Prognostic Value of Epicardial Adipose Tissue in Heart Failure With Mid‐Range and Preserved Ejection Fraction: A Multicenter Study |
| title_full | Prognostic Value of Epicardial Adipose Tissue in Heart Failure With Mid‐Range and Preserved Ejection Fraction: A Multicenter Study |
| title_fullStr | Prognostic Value of Epicardial Adipose Tissue in Heart Failure With Mid‐Range and Preserved Ejection Fraction: A Multicenter Study |
| title_full_unstemmed | Prognostic Value of Epicardial Adipose Tissue in Heart Failure With Mid‐Range and Preserved Ejection Fraction: A Multicenter Study |
| title_short | Prognostic Value of Epicardial Adipose Tissue in Heart Failure With Mid‐Range and Preserved Ejection Fraction: A Multicenter Study |
| title_sort | prognostic value of epicardial adipose tissue in heart failure with mid range and preserved ejection fraction a multicenter study |
| topic | epicardial adipose tissue heart failure heart failure with preserved ejection fraction prognosis |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.036789 |
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