Sidhu Gurwinder S, Rabkin Simon W
Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Department of Medicine, Division of Cardiology, University of British Columbia, Vancouver, BC V5Z 1M9, Canada.
J Clin Med. 2024 Sep 18;13(18):5533. doi: 10.3390/jcm13185533.
The role of epicardial adipose tissue (EAT) in heart failure with preserved ejection fraction (HFpEF) remains to be defined. A consecutive series of outpatients with chronic heart failure-heart failure with reduced ejection fraction (HFrEF) and HFpEF and/or diastolic dysfunction-had EAT assessed by echocardiographic measurement and related to indices of cardiac structure and function. Epicardial fat thickness was significantly ( < 0.05) greater in HFpEF ( = 141) with a mean of 6.7 ± 1.6 mm compared with a mean of 5.1 ± 1.0 mm in HFrEF ( = 40). After adjusting for the relationship with BMI, in HFpEF, epicardial fat was significantly ( < 0.05) negatively correlated with left ventricular internal diameter end diastole (LVIDd), left ventricular internal diameter end systole (LVIDs), left ventricular (LV) end-diastolic volume (EDV) index, lateral e', septal e', right atrial (RA) volume index, and hemoglobin (Hgb). The association with Hgb was no longer significant after adjusting for the effect of age. HFpEF was associated with smaller LVIDd, LVIDs, LV EDV indexes, and left atrial (LA) and RA volume indexes. Epicardial fat is significantly ( < 0.05) greater in HFpEF than HFrEF. Epicardial fat is associated with smaller cardiac chamber sizes in HFpEF suggesting that epicardial fat acts as a constraint to cardiac dilation.
心外膜脂肪组织（EAT）在射血分数保留的心力衰竭（HFpEF）中的作用仍有待明确。对一系列连续性的慢性心力衰竭门诊患者——射血分数降低的心力衰竭（HFrEF）以及HFpEF和/或舒张功能障碍患者——通过超声心动图测量评估其EAT，并将其与心脏结构和功能指标相关联。与HFrEF（n = 40）平均5.1±1.0 mm相比，HFpEF（n = 141）的心外膜脂肪厚度显著更大（P<0.05），平均为6.7±1.6 mm。在调整与BMI的关系后，在HFpEF中，心外膜脂肪与左心室舒张末期内径（LVIDd）、左心室收缩末期内径（LVIDs）、左心室（LV）舒张末期容积（EDV）指数、侧壁e'、室间隔e'、右心房（RA）容积指数和血红蛋白（Hgb）显著负相关（P<0.05）。在调整年龄影响后，与Hgb的关联不再显著。HFpEF与较小的LVIDd、LVIDs、LV EDV指数以及左心房（LA）和RA容积指数相关。HFpEF的心外膜脂肪显著（P<0.05）大于HFrEF。HFpEF的心外膜脂肪与较小的心腔大小相关，提示心外膜脂肪对心脏扩张起到限制作用。
