Key result
Excess epicardial and paracardial fat linked to worse resting cardio-mechanical interaction in HFpEF.
Why the study?
Excess pericardial fat may uniquely contribute to diastolic dysfunction and adverse cardio-mechanical interaction in HFpEF, but evidence remains limited.
Does excess pericardial fat correlate with adverse cardio-mechanical interaction and ventricular interdependence in patients with HFpEF at rest and during dynamic exercise?
Cross-Sectional (n=28)
No
Does excess pericardial fat correlate with adverse cardio-mechanical interaction and ventricular interdependence in patients with HFpEF at rest and during dynamic exercise?
Answers are grounded in this paper and cite their sources.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Our results demonstrated a moderate association between EAT and visceral adiposity but no significant associations with total body fat, diastolic function, cardiac filling pressures, or exercise capacity. Although EAT is a recognized risk factor for HFpEF, it does not appear to further affect cardiac function in patients with obesity and HFpEF. Instead, EAT might represent an additional visceral ectopic fat depot indicative of poor cardiometabolic health in this population.”
In patients with HFpEF, excess pericardial fat (both epicardial and paracardial) is strongly associated with adverse cardio-mechanical interaction and ventricular interdependence, independent of overall BMI.
Heart failure with preserved ejection fraction (HFpEF) is the fastest growing form of HF, found predominantly in older persons.The primary chronic symptom in HFpEF is severe exercise intolerance, contributing to reduced quality of life. 1 In the United States, the majority of HFpEF patients are overweight/obese.2 While numerous pathophysiological links exist between obesity and HFpEF, emerging evidence suggests that excess adiposityparticularly surrounding the heart-may uniquely contribute to diastolic dysfunction and high left sided filling pressures.3 Excess adiposity surrounding the heart may be physically constraining, and contribute to ventricular interdependence; a process of mechanical interaction between the right and left ventricle due to dynamically increased right sided pressures and the confines of the pericardial space.4 Evidence for this pathophysiology, however, remains limited to observations from a single group, using transthoracic
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Zamani et al. (2023) conducted a cross-sectional in Heart failure with preserved ejection fraction (HFpEF) (n=28). Excess pericardial fat (epicardial and paracardial) vs. Lower pericardial fat / Absence of adverse cardio-mechanical interaction was evaluated on Adverse cardio-mechanical interaction (LV eccentricity index >1.0). Excess epicardial and paracardial fat were strongly associated with adverse cardio-mechanical interaction at rest in patients with HFpEF, a relationship not exacerbated by supine exercise.
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