Epicardial Adipose Tissue Thickness and Preserved Ejection Fraction Heart Failure

Area of Science:

• Cardiology
• Obesity Medicine
• Medical Imaging

Background:

• Preserved ejection fraction heart failure (PEHF) and obesity frequently coexist.
• The precise role of obesity in PEHF pathogenesis remains unclear.
• Visceral adiposity is a key pathogenic factor in obesity, but its assessment is not routine.

Purpose of the Study:

• To review the rationale for assessing epicardial adiposity thickness (EAT) in PEHF patients with elevated body mass index (BMI).
• To explore EAT as a routinely available imaging marker for obesity-related cardiovascular impact.

Main Methods:

• Review of existing literature on obesity, PEHF, visceral adiposity, and epicardial adiposity.
• Focus on echocardiography-based assessment of EAT.

Main Results:

• BMI poorly correlates with visceral and epicardial adiposity.
• Both visceral and epicardial adiposity increase with PEHF progression.
• EAT may accelerate coronary artery disease, impair left ventricular diastolic function and sub-endocardial perfusion.

Conclusions:

• EAT, assessed via echocardiography, is a more accessible marker than visceral adiposity for PEHF patients with obesity.
• EAT may serve as a valuable tool for monitoring therapeutic response in this patient population.