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Epicardial Fat in Heart Failure with Preserved Ejection Fraction Compared with Reduced Ejection Fraction
Gurwinder S Sidhu1, Simon W Rabkin1,2
1Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Journal of Clinical Medicine
|September 28, 2024
Summary
Epicardial fat is significantly greater in heart failure with preserved ejection fraction (HFpEF) compared to heart failure with reduced ejection fraction (HFrEF). Increased epicardial fat is linked to smaller cardiac chambers in HFpEF.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Science
Background:
- The specific role of epicardial adipose tissue (EAT) in heart failure with preserved ejection fraction (HFpEF) requires further elucidation.
- Understanding EAT's contribution is crucial for developing targeted therapies for HFpEF.
Purpose of the Study:
- To investigate the relationship between epicardial adipose tissue (EAT) and cardiac structure and function in patients with HFpEF.
- To compare EAT measurements between HFpEF and heart failure with reduced ejection fraction (HFrEF) patients.
Main Methods:
- Echocardiographic assessment of epicardial fat thickness in outpatients diagnosed with chronic heart failure (HFpEF, HFrEF, or diastolic dysfunction).
- Correlation analysis of EAT measurements with various cardiac structure and function indices, including chamber dimensions and volumes.
- Statistical adjustments for Body Mass Index (BMI) and age to refine the observed associations.
Main Results:
- Epicardial fat thickness was significantly greater in HFpEF patients (6.7 ± 1.6 mm) compared to HFrEF patients (5.1 ± 1.0 mm).
- In HFpEF, increased EAT was significantly negatively correlated with left ventricular internal diameter (LVIDd, LVIDs), LV end-diastolic volume index, and atrial/right atrial volume indices.
- These associations, except for hemoglobin, remained significant after adjusting for BMI.
Conclusions:
- Epicardial fat is significantly more abundant in HFpEF patients than in HFrEF patients.
- Elevated epicardial fat in HFpEF is associated with smaller cardiac chamber dimensions, suggesting it may impede cardiac dilation.
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