Parisi Valentina, Conte Maddalena, Petraglia Laura, Grieco Fabrizio Vincenzo, Bruzzese Dario, Caruso Aurelio, Grimaldi Maria Gabriella, Campana Pasquale, Gargiulo Paola, Paolillo Stefania, Attena Emilio, Russo Vincenzo, Galasso Gennaro, Rapacciuolo Antonio, Perrone Filardi Pasquale, Leosco Dario
Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.
Department of Public Health, University of Naples Federico II, Naples, Italy.
Front Physiol. 2020 Feb 5;11:43. doi: 10.3389/fphys.2020.00043. eCollection 2020.
Epicardial adipose tissue (EAT) has been shown to be involved in the pathogenesis and progression of heart failure (HF). In this study we aimed to explore the predictive value of echocardiographic EAT thickness on prognosis of a selected population of HF patients.
The patient population included n. 69 consecutive patients with systolic HF referred to implantable cardioverter defibrillator (ICD) implantation for primary or secondary prevention. At the time of enrolment, echocardiographic EAT thickness was assessed in all patients along with demographic and clinical data. The study had a median follow-up time of 49.8 months. We assessed the prognostic predictive value of EAT thickness on a composite clinical and arrhythmic outcome including HF related deaths, new hospital admissions for HF worsening, and atrial and life threatening ventricular arrhythmic events. Clinical and arrhythmic outcomes were also evaluated separately.
At univariate analysis, EAT thickness significantly predicted all the three outcomes considered. Of interest, at multivariate analysis, after adjusting for known risk factor, EAT remained significantly associated to the composite [HR 1.18 (1.09-1.28); < 0.001], arrhythmic [HR 1.14 (1.03-1.25); = 0.008], and clinical [HR 1.14 (1.03-1.27); = 0.010] outcomes.
Echocardiographic assessment of EAT can predict outcome of HF patients and it is significantly associated with both arrhythmic and clinical events. These preliminary findings pave the way for future and larger studies aimed to definitively recognize the prognostic value of this novel risk marker in HF.
已证实心外膜脂肪组织（EAT）参与心力衰竭（HF）的发病机制及病情进展。在本研究中，我们旨在探讨超声心动图测量的EAT厚度对特定HF患者群体预后的预测价值。
研究对象为连续69例因一级或二级预防而接受植入式心脏复律除颤器（ICD）植入的收缩性HF患者。入组时，对所有患者进行超声心动图EAT厚度评估，并收集人口统计学和临床数据。研究的中位随访时间为49.8个月。我们评估了EAT厚度对包括HF相关死亡、因HF病情恶化再次入院以及心房和危及生命的室性心律失常事件在内的综合临床和心律失常结局的预后预测价值。还分别评估了临床和心律失常结局。
单因素分析时，EAT厚度对上述所有三种结局均有显著预测作用。有趣的是，多因素分析时，在调整已知危险因素后，EAT仍与综合结局[风险比（HR）1.18（1.09 - 1.28）；P < 0.001]、心律失常结局[HR 1.14（1.03 - 1.25）；P = 0.008]及临床结局[HR 1.14（1.03 - 1.27）；P = 0.010]显著相关。
超声心动图评估EAT可预测HF患者的结局，且与心律失常和临床事件均显著相关。这些初步研究结果为未来更大规模的研究铺平了道路，旨在明确识别这一新型风险标志物在HF中的预后价值。
