Importance of epicardial adipose tissue localization using cardiac magnetic resonance imaging in patients with heart failure with mid-range and preserved ejection fraction

Abstract

Background: Epicardial adipose tissue (EAT) has been implicated in the pathophysiology of heart failure (HF) with left ventricular ejection fraction (LVEF) >40%, but whether this is due to a regional or global effect of EAT remains unclear. Hypothesis: Regional EAT is associated with alterations in local cardiac structure and function. Methods: Patients with HF and LVEF >40% were studied. Cardiac Magnetic Resonance imaging was used to localize EAT surrounding the right ventricle (RV) and LV separately, using anterior- and posterior interventricular grooves as boundaries. Atrial- and ventricular EAT were differentiated using the mitral-valve position. All EAT depots were related to the adjacent myocardial structure. Results: 102 consecutive HF patients were enrolled. The majority of EAT was present around the RV (42% of total EAT, p 40%. These data support the hypothesis that regional EAT is involved in the pathophysiology of HF with LVEF >40%.