title: Epicardial fat volume in patients with left ventricular systolic dysfunction.
abstract: Epicardial adipose tissue has been linked to cardiovascular metabolism and inflammation and has been shown to predict prevalence and progression of coronary artery disease. Only limited data are available on the role of epicardial fat in patients with heart failure (HF). We analyzed cardiac adiposity and its relation to markers of morbidity and clinical outcome in patients with normal and impaired left ventricular (LV) function. Epicardial fat volume (EFV) and coronary artery calcium were measured in 381 patients (210 women and 171 men, mean age 55 ± 10 years) who underwent low-dose computed tomography. HF was defined by LV ejection fraction (EF) <55%. Three hundred twenty-one patients had an EF >55% (mean 63 ± 6) and 60 patients had an EF <55% (mean 41 ± 12). Subgroup analysis was performed according to degree of LV dysfunction in patients with HF (LVEF 35% to 55% or <35%). Mean EFVs were 114.5 ± 98.5 cm(3) in patients with normal EF and 83.5 ± 67.1 cm(3) in those with decreased EF (p <0.05). Mean EFVs were 96.1 ± 73.9 cm(3) in patients with moderate HF and 52.2 ± 29.7 cm(3) in patients with severe HF (p <0.05). Subgroup analysis revealed a persistently smaller EFV in patients with HF regardless of coronary artery calcium scores, markers of renal function, lipid metabolism, fasting blood glucose, or body mass index. In conclusion, our data demonstrate a stepwise decrease in EFV in patients with impaired cardiac function.
authors.affiliation: Division of Cardiology, Department of Medicine, New York-Presbyterian Hospital/Columbia University Medical Center, New York, USA.
authors.forename: Tuba
authors.initials: T
authors.lastname: Khawaja
authors.forename: Christine
authors.initials: C
authors.lastname: Greer
authors.forename: Aalap
authors.initials: A
authors.lastname: Chokshi
authors.forename: Nelson
authors.initials: N
authors.lastname: Chavarria
authors.forename: Samir
authors.initials: S
authors.lastname: Thadani
authors.forename: Meaghan
authors.initials: M
authors.lastname: Jones
authors.forename: Kenneth
authors.initials: K
authors.lastname: Schaefle
authors.forename: Ketan
authors.initials: K
authors.lastname: Bhatia
authors.forename: J Elias
authors.initials: JE
authors.lastname: Collado
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Einstein
authors.forename: P Christian
authors.initials: PC
authors.lastname: Schulze
mesh_terms: D052436:Adipose Tissue, White / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011379:Prognosis; D012016:Reference Values; D013318:Stroke Volume / Q000502:physiology; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology