Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Eur J Heart Fail. 2018 Nov;20(11):1559-1566. doi: 10.1002/ejhf.1283. Epub 2018 Aug 1.
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.
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/m vs. 77 mL/m , 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/m , P =0.03, and 120 vs. 97 mL/m , 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).
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.
脂肪组织和炎症可能在射血分数轻度降低或保留的心力衰竭（HF）患者的病理生理学中起作用。因此，我们研究了射血分数保留的心力衰竭（HFpEF）和中等范围射血分数的心力衰竭（HFmrEF）患者的心外膜脂肪，并将其与合并症、血浆生物标志物和心脏结构相关联。
共有 64 名左心室射血分数>40%的 HF 患者和 20 名对照者接受了常规心脏磁共振检查。在心外膜的短轴电影堆栈上对心外膜脂肪体积进行量化，并将其与临床相关因素、与炎症和心肌损伤相关的生物标志物以及心脏磁共振上的心脏功能和收缩性相关联。HF 患者和对照者的年龄、性别和体重指数相当。HF 患者的总心外膜脂肪量明显高于对照者（107 mL/m 与 77 mL/m ，P <0.0001）。有心房颤动和/或 2 型糖尿病的 HF 患者比没有这些合并症的 HF 患者有更多的心外膜脂肪（116 与 100 mL/m ，P =0.03 和 120 与 97 mL/m ，P =0.001）。HF 患者的肌酸激酶-MB、肌钙蛋白 T 和糖化血红蛋白与心外膜脂肪量呈正相关（R =0.37，P =0.006；R =0.35，P =0.01 和 R =0.42，P =0.002）。
尽管体重指数相似，但与对照者相比，HF 患者的心外膜脂肪更多。心外膜脂肪量与心房颤动和 2 型糖尿病的存在以及与心肌损伤相关的生物标志物相关。这些发现的临床意义尚不清楚，但需要进一步研究。
