Evolutional change in epicardial fat and its correlation with myocardial diffuse fibrosis in heart failure patients

• Published in: Journal of clinical lipidology Vol. 11; no. 6; pp. 1421 - 1431
• Main Authors: Wu, Cho-Kai, Tsai, Hao-Yuan, Su, Mao-Yuan M., Wu, Yi-Fan, Hwang, Juey-Jen, Lin, Jiunn-Lee, Lin, Lian-Yu, Chen, Jien-Jiun
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2017
• Subjects: Adipose Tissue - diagnostic imaging; Adipose Tissue - pathology; Aged; Body Fat Distribution; Cardiac magnetic resonance imaging; Cardiomyopathies - diagnostic imaging; Cardiomyopathies - metabolism; Cardiomyopathies - physiopathology; Endomyocardial Fibrosis - diagnostic imaging; Endomyocardial Fibrosis - physiopathology; Epicardial fat; Female; Heart failure; Heart Failure - diagnostic imaging; Heart Failure - physiopathology; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Myocardial fibrosis; Pericardium - diagnostic imaging; Pericardium - physiopathology; Ventricular Function, Left - physiology; Heart failure; Myocardial fibrosis; Cardiac magnetic resonance imaging; Epicardial fat
• ISSN: 1933-2874; 1876-4789
• DOI: 10.1016/j.jacl.2017.08.018

The aim of this study was to characterize the characteristics of epicardial fat (EAT) in different stage heart failure (HF) patients and its relationship between cardiac fibrosis. EAT is visceral adipose tissue that possesses inflammatory properties. Inflammation and obesity are associated with cardiac fibrosis, but the relationship between cardiac fibrosis and EAT is unknown. EAT volume was measured using cardiac magnetic resonance imaging (CMR) in 180 subjects: 58 patients with systolic HF, 63 patients with HF and preserved ejection fraction, and 59 patients without HF. CMR derived myocardial extracellular volume (ECV) was used for fibrosis quantification. Patients with systolic HF had significantly more EAT compared with patients with HF and preserved ejection fraction or the control group (patients without HF) (indexed EAT volume [mL/m2], 27.0 [22.7–31.6] vs 25.6 [21.4–31.2] and 24.2 [21.0–27.6], P < .05). The adjusted EAT amount was associated with ECV completely independent of age, hypertension, diabetes, etiology of HF, left ventricular ejection fraction, CMR–late gadolinium enhancement (LGE), left ventricular mass index, and left ventricular end-diastolic volume index (correlation coefficient: 0.49; 95% confidence interval: 0.12–0.86, P < .01). Increased CMR ECV was more associated with EAT in those with advanced age, male sex, LGE on magnetic resonance imaging–LGE images, and less left ventricular end-diastolic volume index. EAT volume is highly associated with CMR ECV independent of traditional risk factors and left ventricular mass or volume. Whether EAT plays a role in the long-term prognosis of HF requires future investigation. •Adjusted (index) epicardial fat (EAT) is independent associated with global fibrosis.•Patients with systolic heart failure (HF) had largest EAT volume comparing to patients with HF and preserved ejection fraction and the controls.•This is the largest prospective HF cohort study for evolutional change of cardiac magnetic resonance imaging–EAT and global fibrosis.