Epicardial adipose tissue volume was significantly higher by 21.91 cm3 (154.40 vs. 132.49 cm3, P<0.001) in hypertensive patients and strongly correlated with multiple cardiorenal complication indicators, unlike EAT density (P=0.279).
Cross-Sectional (n=257)
No
Does epicardial adipose tissue volume or density better correlate with cardiorenal complications in hypertensive patients?
Epicardial adipose tissue volume, rather than density, is significantly increased in hypertensive patients and strongly correlates with cardiorenal complications, suggesting it may serve as a valuable imaging biomarker.
Effect estimate: P<0.001 for EAT volume difference
Absolute Event Rate: 154.4% vs 132.49%
p-value: p=<0.001 for volume; 0.279 for density
Abstract Background Epicardial adipose tissue (EAT) dysfunction is closely related to a variety of cardiovascular diseases. However, controversy persists regarding the association between EAT characteristics and hypertension (HTN). The present study aims to clarify the changes of EAT volume and density in HTN patients, and explore their relationships with cardiorenal complications. Methods A total of 257 individuals were enrolled in this study for analysis, including 156 HTN patients and 101 non-HTN participants. EAT volume and density were measured using coronary computerized tomography angiography (CCTA). Cardiorenal complications were evaluated by laboratory indicators, echocardiography, and CCTA. Correlation analysis was used to examine the relationship between EAT characteristics and various cardiorenal complications. Mediation analysis was performed to test whether EAT characteristics played mediating effects between HTN and cardiorenal complications. Results Compared to non-HTN participants, HTN patients exhibited a markedly higher volume of EAT (154.40 ± 53.31 vs. 132.49 ± 45.88 cm 3 , P < 0.001). Nevertheless, there was no significant difference in density between the two groups (-80.22 ± 6.84 vs. -79.25 ± 7.16 HU, P = 0.279). Correlation analyses showed that the volume of EAT was strongly correlated with most indicators of cardiorenal complications (all P < 0.05), including severity of coronary artery disease (plaque volume, CACS, and CT-FFR), abnormal cardiac structure and function (aorta, LA, IVS, LVPW, LVEF, E/A ratio, and NT-proBNP), and renal dysfunction (BUN, serum creatinine, CysC, and eGFR), while the density of EAT was only correlated with partial indicators of cardiorenal complications. Mediation analysis found that EAT volume had significant mediating effects between HTN and cardiac complications (mediation proportions: 68.30% for plaque volume, 40.67% for CACS, 13.51% for CT-FFR, 10.63% for aorta, and 12.78% for IVS, respectively). Conclusion EAT volume, rather than density, is significantly increased in HTN patients and closely associated with cardiorenal complications. This finding provides a new perspective for preventing HTN complications by targeting the reduction of heart-specific visceral adipose tissue. Graphical Abstract
Wu et al. (Thu,) conducted a cross-sectional in Adults with hypertension (defined as SBP ≥140 mmHg and/or DBP ≥90 mmHg) versus non-hypertensive participants undergoing cardiac evaluation (n=257). Epicardial adipose tissue (EAT) volume measurement by coronary computerized tomography angiography (CCTA) vs. EAT density (CT value) was evaluated on Association of EAT volume and density with cardiorenal complications in hypertension (P<0.001 for EAT volume difference, p=<0.001 for volume; 0.279 for density). Epicardial adipose tissue volume was significantly higher by 21.91 cm3 (154.40 vs. 132.49 cm3, P<0.001) in hypertensive patients and strongly correlated with multiple cardiorenal complication indicators, unlike EAT density (P=0.279).