Epicardial adipose tissue associated with right cardiac chamber remodelling in patients with connective tissue disease evaluated by cardiac magnetic resonance: a cross-sectional study.

AIM: The present study aimed to evaluate the relationship between epicardial adipose tissue (EAT) and right cardiac chamber remodelling in connective tissue disease (CTD) patients and to investigate the value of EAT in CTD-associated pulmonary hypertension (CTD-PH) patients.

MATERIALS AND

METHODS

A total of 134 CTD patients and 64 age- and sex-matched controls who underwent cardiac magnetic resonance (CMR) examination were retrospectively enrolled. Systolic pulmonary arterial pressure (sPAP) measured by transthoracic echocardiography was recorded. Based on combined PH, patients were divided into two subgroups: CTD-PH and CTD-nonPH. Right heart strain parameters and EAT thickness and volume were measured using CVI42 (version 5.13.9, Circle Cardiovascular Imaging Inc., Calgary, Canada). Bootstrapping was used to analyse the mediating effect of right cardiac chamber remodelling between EAT volume index (EATVI) and sPAP in CTD patients. Logistic regression was used to explore the correlations between EAT and CTD-PH.

RESULTS

CTD-PH patients had significantly higher EATVI (43.82 [36.00, 61.27] ml/m2 vs. 30.13 [24.06, 41.38] ml/m2, P<0.001) and more pronounced right cardiac chamber remodelling than controls. There was a mediating effect between EAT and pulmonary artery pressure in right ventricular myocardial mass index and right atrial conduit function. Multivariate logistic regression showed that EATVI remained an independent association for CTD-PH after adjustment for clinical factors.

CONCLUSION

EAT is significantly increased in CTD-PH patients with more pronounced right cardiac chamber remodelling, which may be one of the valuable parameters for risk stratification of CTD patients.