Epicardial Adipose Tissue on Cardiac CT Across Heart Failure Subtypes.

PURPOSE: This study evaluated epicardial adipose tissue (EAT) distribution in patients with different heart failure (HF) subtypes using contrast-enhanced cardiac computed tomography (CT), and explores its impact on clinical parameters and prognosis.

MATERIALS AND

METHODS

We retrospectively analyzed 67 heart failure patients treated at our institution from January 2021 to December 2022. Patients were divided into: group A, heart failure with preserved ejection fraction (HFpEF, n=35); and group B, heart failure with mid-range and reduced ejection fraction (HFmrEF and HFrEF, n=32). In addition, 34 non-heart failure patients were included as controls (group C). Epicardial adipose tissue volume (EATV) and fat attenuation index (FAI) were measured using contrast-enhanced cardiac CT.

RESULTS

Group A showed the highest EATV, while group B had lower EATV than controls (65.37±19.51 vs. 48.88±15.38 vs. 60.10±10.19 cm3, P<0.001). EAT correlated negatively with NT-proBNP in HFrEF/HFmrEF patients, but positively in HFpEF patients. Both HF groups had significantly higher FAI than controls, and FAI correlated positively with C-reactive protein levels.

CONCLUSION

EAT accumulation associates with elevated NT-proBNP in HFpEF, while lower EAT suggests higher NT-proBNP in HFmrEF/HFrEF. Increased FAI in heart failure patients correlates with higher C-reactive protein levels.