Exploring the intriguing relationship: epicardial adipose tissue correlation with left atrial and left ventricular function across different heart failure types.

BACKGROUND

The association between epicardial adipose tissue (EAT) and heart failure has garnered significant attention. The objective of this study is to investigate the relationship between EAT and cardiac function across various heart failure phenotypes.

METHODS

The study cohort included 33 cases in the control group and 121 cases in the heart failure group, stratified into subgroups: 40 with heart failure with reduced ejection fraction (HFrEF), 38 with heart failure with mid-range ejection fraction (HFmrEF), and 43 with heart failure with preserved ejection fraction (HFpEF). Researchers collected epicardial adipose tissue thickness, clinical data, and echocardiographic parameters from all participants. Left ventricular (LV) systolic function was assessed using global longitudinal strain (GLS), and left atrial (LA) function was evaluated using LA strain during reservoir, conduit, and contraction phases. Fitted curves illustrating the relationship between EAT and LV ejection fraction (LVEF), as well as GLS and LA strain, were constructed. Multivariable linear regression was employed to analyze the correlation between EAT and GLS, LASr, LAScd, and LASct after adjusting for confounding factors.

RESULTS

A nonlinear relationship was observed between EAT and LVEF, GLS, LASr, LAScd, and LASct. EAT thickness varied across groups: HFpEF (7.9±0.8 mm)>Control (5.1±0.6 mm)>HFmrEF (4.6±0.9 mm)>HFrEF (4.0±0.7 mm). After adjusting for age, gender, BMI, and relevant medical history, the correlation coefficients between EAT and GLS were 0.21, 0.17, and -0.12 in HFrEF, HFmrEF, and HFpEF groups, respectively. In the HFrEF group, EAT showed positive correlations with LASr and LAScd (0.1 and 0.1), and negative correlations with LASr, LAScd, and LASct in the HFpEF group (-0.03, -0.06, and -0.07).

CONCLUSIONS

EAT thickness follows the order: HFpEF>Control>HFmrEF>HFrEF. Thicker EAT in HFpEF is associated with poorer LV and LA function, while the opposite trend is observed in HFrEF and HFmrEF. LA function is more compromised in HFmrEF and HFrEF compared to HFpEF.