Epicardial fat in heart failure patients with mid-range and preserved ejection fraction
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Abstract Aims Adipose tissue and inflammation may play a role in the pathophysiology of patients with heart failure (HF) with mildly reduced or preserved ejection fraction. We therefore investigated epicardial fat in patients with HF with preserved (HFpEF) and mid-range ejection fraction (HFmrEF), and related this to co-morbidities, plasma biomarkers and cardiac structure. Methods and results A total of 64 HF patients with left ventricular ejection fraction >40% and 20 controls underwent routine cardiac magnetic resonance examination. Epicardial fat volume was quantified on short-axis cine stacks covering the entire epicardium and was related to clinical correlates, biomarkers associated with inflammation and myocardial injury, and cardiac function and contractility on cardiac magnetic resonance. HF patients and controls were of comparable age, sex and body mass index. Total epicardial fat volume was significantly higher in HF patients compared to controls (107 mL/m2 vs. 77 mL/m2, P <0.0001). HF patients with atrial fibrillation and/or type 2 diabetes mellitus had more epicardial fat than HF patients without these co-morbidities (116 vs. 100 mL/m2, P =0.03, and 120 vs. 97 mL/m2, P =0.001, respectively). Creatine kinase-MB, troponin T and glycated haemoglobin in patients with HF were positively correlated with epicardial fat volume (R =0.37, P =0.006; R =0.35, P =0.01; and R =0.42, P =0.002, respectively). Conclusion Heart failure patients had more epicardial fat compared to controls, despite similar body mass index. Epicardial fat volume was associated with the presence of atrial fibrillation and type 2 diabetes mellitus and with biomarkers related to myocardial injury. The clinical implications of these findings are unclear, but warrant further investigation.
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Total EAT volume is significantly higher, particularly in T2DM patients, in HF patients with mid-range and preserved EF when compared to well-matched controls with similar BMI.
“A total EAT volume significantly higher, particularly in T2DM patients, was found in HF patients with mid-range and preserved EF when compared to well-matched controls with similar BMI.”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [104]
Epicardial fat is positively associated with biomarkers of myocardial damage such as creatine kinase-MB and troponin T.
“In addition, epicardial fat was positively associated with biomarkers of myocardial damage such as creatine kinase-MB, troponin T [104].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [104]
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- Authors
- van Woerden, G., Gorter, T. M., Westenbrink, B. D., Willems, T. P., van Veldhuisen, D. J., & Rienstra, M.
- Affiliations
- Department of Cardiology, University of Groningen, University Medical Center Groningen , Groningen ,
- University Medical Center Groningen (NL)
- Corresponding author
- Rienstra, Michiel
- Venue
- European Journal of Heart Failure
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-08-01
- Volume
- 20
- Issue
- 11
- Pages
- 1559-1566
- ISSN
- 1388-9842 (ISSN-L)
- 1879-0844
- PMC
- PMC6607508
- OpenAlex
- W2886821858
- Cited by
- 265
- References
- 34
- Citations by year
- 2026: 12 · 2025: 38 · 2024: 40 · 2023: 45 · 2022: 35 · 2021: 36 · 2020: 34 · 2019: 21 · 2018: 3
- FWCI
- 17.75
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Journal of Heart Failure (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by-nc)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc)
- Funders
- Abbott Netherlands
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Keywords
- epicardial adipose tissue, heart failure with preserved ejection fraction, heart failure with mildly reduced ejection fraction, adipose tissue, inflammation, atrial fibrillation, type 2 diabetes, myocardial injury biomarkers, troponin T, creatine kinase-MB, HbA1c, cardiac magnetic resonance, cardiac structure
- MeSH terms
- Adipose Tissue, Aged, Echocardiography, Female, Heart Failure, Humans, Male, Peptide Fragments, Pericardium, Prognosis, Stroke Volume, Biomarkers, Ventricular Function, Left, Magnetic Resonance Imaging, Cine, Natriuretic Peptide, Brain, Troponin T
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