Exploring the intriguing relationship: epicardial adipose tissue correlation with left atrial and left ventricular...

Area of Science:

• Cardiology
• Cardiac Physiology
• Medical Imaging

Background:

• Epicardial adipose tissue (EAT) is increasingly recognized for its role in cardiovascular health.
• Its association with heart failure (HF) necessitates understanding its impact across different HF phenotypes.

Purpose of the Study:

• To investigate the relationship between epicardial adipose tissue (EAT) and cardiac function.
• To analyze this association across heart failure with preserved ejection fraction (HFpEF), heart failure with mid-range ejection fraction (HFmrEF), and heart failure with reduced ejection fraction (HFrEF).

Main Methods:

• Echocardiographic parameters, including left ventricular (LV) global longitudinal strain (GLS) and left atrial (LA) strain, were assessed in 121 HF patients and 33 controls.
• Epicardial adipose tissue (EAT) thickness was measured.
• Multivariable linear regression analyzed correlations between EAT and cardiac function metrics, adjusting for confounders.

Main Results:

• A nonlinear relationship was found between EAT and LV ejection fraction (LVEF), GLS, and LA strain.
• EAT thickness was highest in HFpEF (7.9±0.8 mm), followed by controls (5.1±0.6 mm), HFmrEF (4.6±0.9 mm), and HFrEF (4.0±0.7 mm).
• In HFpEF, thicker EAT correlated with poorer LV and LA function, whereas in HFrEF and HFmrEF, it correlated with improved function.

Conclusions:

• Epicardial adipose tissue (EAT) thickness follows the pattern HFpEF > Control > HFmrEF > HFrEF.
• While thicker EAT is detrimental to cardiac function in HFpEF, it shows a protective association in HFrEF and HFmrEF.
• Left atrial (LA) function is more compromised in HFmrEF and HFrEF than in HFpEF.