The relationship between epicardial adipose tissue and mortality in systemic sclerosis patients: 10-year follow-up...

Systemic sclerosis (SSc) is a connective tissue disease with cardiac involvement characterized by autoimmunity, vascular damage, and fibrosis. Recent studies suggest that epicardial adipose tissue (EAT) may be associated with poor cardiovascular outcomes in patients with SSc and cardiovascular comorbidities. Our aim in this study was to investigate the relationship between epicardial adipose tissue thickness and mortality in patients with systemic sclerosis.

Sixty patients who presented to cardiology and rheumatology outpatient clinics between January 2013 and December 2015 were retrospectively included in the study. Based on 10-year follow-up results, patients were divided into two groups: those who died and those who survived (30 patients in each group).

In Pearson correlation analyses, we found a positive correlation between EAT and mean pulmonary arterial pressure and right ventricular myocardial performance index, and a negative correlation between tricuspid annular plane systolic excursion and aortic propagation velocity. It was significantly associated with all-cause mortality (p < 0.001) and was an independent predictor in multivariable Cox regression analysis (HR = 1.120; 95% CI = 1.050-1.195; p < 0.001). In ROC analyses, a cut-off value of 6.05 mm predicted mortality with 80% sensitivity and 70% specificity (AUC = 0.783, p < 0.001).

Based on the results of our study, we believe that EAT may predict mortality in SSc patients. Adding EAT, which can be measured noninvasively and with standard echocardiography in SSc patients, to routine assessments may provide clinicians with valuable predictive information for patient management.