title: Pericardial fat is associated with ventricular tachyarrhythmia and mortality in patients with systolic heart failure.
abstract: OBJECTIVE
  Pericardial fat (PF) has been hypothesized to exert local pathogenic effects on nearby cardiac structures above and beyond that of systemic adiposity which might be associated with the presence of arrhythmia or even worse outcomes. The aims of this study was to characterize the relationship between PF and the prognosis in patients with systolic heart failure (HF).
  
  
  METHODS
  This is a retrospective cohort study of a cardiac magnetic resonance imaging (CMRI) database from 2004 to 2011. Fifty patients with systolic HF underwent CMRI examinations were included. We also enrolled twenty patients with HF as the control group. The cine imaging was analyzed to derive total PF volumes, left ventricular volumes and mass and left ventricular ejection fraction by using a previously validated technique. The outcomes, including ventricular tachycardia (VT), ventricular fibrillation (VF) and total mortality were obtained by reviewing medical records.
  
  
  RESULTS
  After a median follow-up of 694 days, patients with VT/VF had significant larger indexed PF volumes than those without [36.3 (32.8-43.1) ml/m(2) vs. 24.1 (20.2-27.6) ml/m(2), p = 0.001]. The mortality group also had significant larger indexed PF volumes (PF/body surface area) than those without [31.3 (22.8-38.4) ml/m(2) vs. 23.9 (19.8-27.3) ml/m(2), p = 0.010]. Indexed PF volumes were associated with the development of VT/VF (Hazard ratio, 7.510; 95% C.I, 0.901-62.582, p = 0.062) and mortality (Hazard ratio, 3.998; 95% C.I, 1.077-14.845, p = 0.038) by Cox's regression analyses.
  
  
  CONCLUSIONS
  PF is associated with the development of VT/VF and long-term overall mortality in patients with systolic HF.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.
authors.forename: Cho-Kai
authors.initials: CK
authors.lastname: Wu
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Hao-Yuan
authors.initials: HY
authors.lastname: Tsai
authors.affiliation: Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Mao-Yuan M
authors.initials: MY
authors.lastname: Su
authors.affiliation: Department of Family Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan.
authors.forename: Yi-Fan
authors.initials: YF
authors.lastname: Wu
authors.affiliation: Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.
authors.forename: Juey-Jen
authors.initials: JJ
authors.lastname: Hwang
authors.affiliation: Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Wen-Yih
authors.initials: WY
authors.lastname: Tseng
authors.affiliation: Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.
authors.forename: Jiunn-Lee
authors.initials: JL
authors.lastname: Lin
authors.affiliation: Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan. Electronic address: hspenos@yahoo.com.tw.
authors.forename: Lian-Yu
authors.initials: LY
authors.lastname: Lin
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D050154:Adiposity; D000368:Aged; D015992:Body Mass Index; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D054143:Heart Failure, Systolic / Q000401:mortality / Q000503:physiopathology*; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000401:mortality / Q000503:physiopathology*; D016896:Treatment Outcome; D014693:Ventricular Fibrillation
keywords: Adipose tissue; Magnetic resonance imaging; Pericardial fat; Ventricular fibrillation; Ventricular tachycardia