Key result
Greater epicardial fat tissue extent was associated with a lower likelihood of left ventricular systolic function recovery 30 days after TAVI (OR 0.7; 95% CI 0.50-0.98; P=0.04).
Why the study?
It was hypothesized that greater thickness of epicardial fat tissue may harm the recovery of LV systolic function in patients with severe aortic stenosis and reduced LVEF undergoing TAVI.
Does epicardial fat tissue thickness predict the recovery of left ventricular systolic function in patients with severe aortic stenosis and reduced LVEF undergoing TAVI?
Observational (n=66)
Does epicardial fat tissue thickness predict the recovery of left ventricular systolic function in patients with severe aortic stenosis and reduced LVEF undergoing TAVI?
Odds Ratio: 0.7 (95% CI 0.5–0.98)
p-value: p=0.04
Greater epicardial fat tissue thickness is associated with a lower likelihood of early left ventricular systolic function recovery after TAVI in patients with severe aortic stenosis and reduced ejection fraction.
Greater EFT may identify lower likelihood of early LV recovery post-TAVI; leaves open incremental prognostic value in prospective studies.
Background: Epicardial fat tissue (EFT) is an active organ that can affect cardiac function and structure through endocrine, paracrine, and proinflammatory mechanisms. We hypothesized that greater thickness of EFT may harm the recovery of left ventricular (LV) systolic function in patients with severe aortic stenosis (AS) and reduced LV ejection fraction (EF ≤ 50 %) undergoing transcatheter aortic valve implantation (TAVI). Methods: A sixty six patients with severe AS and 20 % ≥ LVEF ≤ 50 % who underwent TAVI were included. Patients were categorized into two groups based on LV systolic function recovery 30 days after TAVI defined by ≥ 20 % relative increase in LV Global longitudinal strain (GLS) from baseline. EFT was determined by ECG-gated contrast-enhanced multidetector computed tomography (MDCT). Results: Forty-five patients (68.0 %) showed LV systolic function recovery. EFT showed no significant correlation with the baseline LV-GLS but was associated with less likelihood of LV systolic function recovery (OR 0.7, 95 % CI 0.50 - 0.98, P = 0.04). In the multivariate analysis, higher LVMI (OR 1.05, 95 % CI 1.00-1.10, P = 0.02), lower LV-GLS (OR 0.55, 95 % CI 0.40-0.82, P = 0.002), and thinner EFT (OR 0.38, 95 % CI 0.20-0.73, P = 0.003) were independently associated with LV systolic function recovery after TAVI. Conclusion: EFT extent is associated with LV systolic function recovery in AS patients with impaired LVEF undergoing TAVI and therefore may help in risk stratification and management of these patients.
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Anwar et al. (2025) conducted an observational in Severe aortic stenosis with reduced left ventricular ejection fraction (n=66). Epicardial fat tissue (EFT) was evaluated on Left ventricular systolic function recovery 30 days after TAVI (≥ 20% relative increase in LV Global longitudinal strain from baseline) (OR 0.7, 95% CI 0.50-0.98, p=0.04). Greater epicardial fat tissue extent was associated with a lower likelihood of left ventricular systolic function recovery 30 days after TAVI (OR 0.7; 95% CI 0.50-0.98; P=0.04).
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