Related Experiment Video
Updated: Sep 9, 2025
09:20
Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
6.6K
Epicardial Adipose Tissue, Functional Status, and Invasive Hemodynamics in Heart Failure With Preserved Ejection
Yoran Crum1, Dirk J van Veldhuisen1, Sanjiv J Shah2
1University of Groningen, University Medical Centre Groningen, Department of Cardiology, Groningen, The Netherlands.
JACC. Advances
|September 2, 2025
Summary
Increased epicardial adipose tissue (EAT) in heart failure with preserved ejection fraction (HFpEF) patients is linked to reduced exercise capacity and poorer quality of life. Higher EAT also correlates with elevated filling pressures during peak exercise.
Area of Science:
- Cardiology
- Cardiovascular Research
- Medical Imaging
Background:
- Epicardial adipose tissue (EAT) is implicated in the pathophysiology of heart failure with preserved ejection fraction (HFpEF).
- Understanding the role of EAT in HFpEF is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the association between increased epicardial adipose tissue (EAT) and functional status in HFpEF patients.
- To examine the relationship between EAT and invasive exercise hemodynamics in a large cohort of HFpEF patients.
Main Methods:
- Echocardiography was used to measure EAT thickness in 566 HFpEF patients.
- Functional status was assessed using the 6-minute walk distance (MWD) test and Kansas City Cardiomyopathy Questionnaire (KCCQ).
- Invasive hemodynamic assessment was performed at rest and during exercise, with patients stratified by EAT tertiles.
Main Results:
- Higher EAT thickness tertiles were associated with significantly lower 6-MWD and KCCQ scores.
- Resting hemodynamics did not differ across EAT tertiles.
- At peak exercise, the highest EAT tertile showed increased pulmonary capillary wedge pressure (PCWP) and PCWP to right atrial pressure gradient.
Conclusions:
- Epicardial adipose tissue thickness is linked to impaired quality of life and reduced exercise capacity in HFpEF.
- Elevated left-sided filling pressures during peak exercise are associated with increased EAT.
- Excess EAT may significantly contribute to the functional limitations and hemodynamic changes observed in HFpEF.
Related Concept Videos
01:29Heart Failure II: Pathophysiology
37
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
37
01:17Pathophysiology of Heart Failure
1.8K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.8K
01:30Heart Failure IV: Classification and Diagnostic Evaluation
32
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
32
01:30Heart Failure VII: Nursing Interventions
139
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
139
01:30Cardiomyopathy II: Dilated Cardiomyopathy
21
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
21
01:27Heart Failure I: Introduction
52
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
52