Universidade Federal Fluminense , Niterói , RJ - Brasil.
Arq Bras Cardiol. 2022 Mar;118(3):625-633. doi: 10.36660/abc.20200755.
Epicardial adipose tissue (EAT) is increased in comorbidities common in heart failure (HF). In this sense, EAT could potentially mediate effects that lead to an impaired cardiac function.
This meta-analysis aims to investigate if the amount of EAT in all-types of HF and each HF phenotype is significantly different from control patients.
This meta-analysis followed the Meta-analysis Of Observational Studies in Epidemiology guidelines. The search was performed in the MEDLINE, Embase, and Lilacs databases until November 2020. Two authors performed screening, data extraction, and quality assessment. A p-value <0.05 was defined as statistically significant.
Eight observational studies were included, comprehending 1,248 patients in total, from which 574 were controls, 415 had HF with reduced ejection fraction (HFrEF) and 259 had HF with mid-range or preserved ejection fraction (HFmrEF or HFpEF). The amount of EAT was not different between all types of HF and the control group (SMD = -0.66, 95% CI: -1.54 to 0.23, p =0.14). Analyzing each HF phenotype separately, patients with HFrEF had a reduced EAT when compared to the controls (SMD= -1.27, 95% CI: - 1.87 to -0.67, p <0.0001), while patients with HFmrEF or HFpEF showed an increased EAT when compared to controls (SMD= 1.24, 95% CI: 0.99 to 1.50, p <0.0001).
The amount of EAT was not significantly different between all types of HF and the control group. In patients with HFrEF, the EAT volume was reduced, whereas in HFpEF and HFmrEF, the amount of EAT was significantly increased. PROSPERO registration number: CRD42019134441.
心外膜脂肪组织（EAT）在心力衰竭（HF）常见的合并症中增加。从这个意义上说，EAT 可能潜在地介导导致心脏功能受损的效应。
本荟萃分析旨在研究所有类型 HF 和每种 HF 表型的 EAT 量是否与对照患者显著不同。
本荟萃分析遵循观察性研究荟萃分析的流行病学指南。搜索范围包括 MEDLINE、Embase 和 Lilacs 数据库，截至 2020 年 11 月。两位作者进行了筛选、数据提取和质量评估。p 值<0.05 定义为具有统计学意义。
共纳入 8 项观察性研究，共纳入 1248 例患者，其中 574 例为对照组，415 例为射血分数降低的心力衰竭（HFrEF）患者，259 例为射血分数中间值或保留的心力衰竭（HFmrEF 或 HFpEF）患者。EAT 的数量在所有类型的 HF 与对照组之间没有差异（SMD=-0.66，95%CI：-1.54 至 0.23，p=0.14）。分别分析每种 HF 表型，与对照组相比，HFrEF 患者的 EAT 减少（SMD=-1.27，95%CI：-1.87 至-0.67，p<0.0001），而 HFmrEF 或 HFpEF 患者的 EAT 增加（SMD=1.24，95%CI：0.99 至 1.50，p<0.0001）。
EAT 的数量在所有类型的 HF 与对照组之间没有显著差异。在 HFrEF 患者中，EAT 体积减少，而在 HFpEF 和 HFmrEF 患者中，EAT 量显著增加。PROSPERO 注册号：CRD42019134441。
