Epicardial adipose tissue volume and density are associated with heart failure with improved ejection fraction

• Published in: Cardiovascular diabetology 2024-08, Vol.23 (1), p.283-11, Article 283
• Main Authors: Yang, Chen Die, Quan, Jin Wei, Tay, Guan Poh, Feng, Shuo, Yuan, He, Amuti, Abulikemu, Tang, Si Yi, Wu, Xin Rui, Yuan, Ruo Sen, Lu, Lin, Zhang, Rui Yan, Wang, Xiao Qun
• Format: Article
• Language: English
• Subjects: Adipose tissue; Adiposity; Aged; Angiography; Body fat; Body mass index; Cardiac arrhythmia; Cardiovascular disease; Cholesterol; Computed Tomography Angiography; Congestive heart failure; Coronary Angiography; Diabetes; Ejection fraction; Epicardial adipose tissue; Epicardial Adipose Tissue - diagnostic imaging; Epicardial Adipose Tissue - physiopathology; Female; Heart attacks; Heart failure; Heart Failure - diagnostic imaging; Heart Failure - physiopathology; Heart failure with improved ejection fraction; Heart failure with reduced ejection fraction; Hemoglobin; Hospitals; Humans; Hypertension; Male; Medical imaging; Metabolism; Middle Aged; Multivariate analysis; Myocardial recovery; Paracrine signalling; Pericardium; Pericardium - diagnostic imaging; Pericardium - physiopathology; Predictive Value of Tests; Prognosis; Pulmonary arteries; Recovery of Function; Retrospective Studies; Risk Factors; Software; Stroke Volume; Time Factors; Ultrasonic imaging; Variance analysis; Ventricular Function, Left; Ventricular Remodeling
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-024-02376-y

Heart failure (HF) with improved ejection fraction (EF, HFimpEF) is a distinct HF subtype, characterized by left ventricular (LV) reverse remodeling and myocardial functional recovery. Multiple cardiometabolic factors are implicated in this process. Epicardial adipose tissue (EAT), emerging as an endocrine and paracrine organ, contributes to the onset and progression of HF. However, the relation between EAT and the incidence of HFimpEF is still unclear. A total of 203 hospitalized HF patients with reduced EF (HFrEF, LVEF ≤ 40%) who underwent coronary CT angiography (CCTA) during index hospitalization were consecutively enrolled between November 2011 and December 2022. Routine follow-up and repeat echocardiograms were performed. The incidence of HFimpEF was defined as (1) an absolute LVEF improvement ≥ 10% and (2) a second LVEF > 40% (at least 3 months apart). EAT volume and density were semiautomatically quantified on non-enhanced series of CCTA scans. During a median follow-up of 8.6 (4.9 ~ 13.3) months, 104 (51.2%) patients developed HFimpEF. Compared with HFrEF patients, HFimpEF patients had lower EAT volume (115.36 [IQR 87.08 ~ 154.78] mL vs. 169.67 [IQR 137.22 ~ 218.89] mL, P