Impact of Epicardial Adipose Tissue on Right Cardiac Function and Prognosis in Pulmonary Arterial Hypertension
Although epicardial adipose tissue (EAT) is linked to effects on survival in left-sided heart failure, the association between EAT and right-sided heart failure caused by pulmonary arterial hypertension (PAH) remains unknown. What are the potential impacts of EAT volume (EATV) on right ventricular f...
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| Veröffentlicht in: | Chest 2024-05, Vol.165 (5), p.1211-1223 |
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| creator | Chen, Yusi Li, Junli Li, Fang Chen, Zheng Chen, Zhangling Luo, Jun Qiu, Haihua Chen, Wenjie Hu, Junjiao Luo, Xiaoqin Tan, Yingjie Rathinasabapathy, Anandharajan Chen, Jingyuan Li, Jiang |
| description | Although epicardial adipose tissue (EAT) is linked to effects on survival in left-sided heart failure, the association between EAT and right-sided heart failure caused by pulmonary arterial hypertension (PAH) remains unknown.
What are the potential impacts of EAT volume (EATV) on right ventricular function, biomarkers of myocardial injury, and long-term prognosis in patients with PAH?
A total of 135 age- and BMI-matched patients with PAH and 49 control participants were included in this study. EATV was quantified by using cardiac magnetic resonance and was related to clinical correlates, N-terminal pro-brain natriuretic peptide, and cardiac function. Levels of EATV associated with the risk of clinical worsening were evaluated on a continuous scale (restricted cubic splines) and by previously defined centile categories with Cox proportional hazards regression models and Kaplan-Meier survival estimates.
Compared with the control participants, patients with PAH had a lower EATV (ln [EATV], 3.2 ± 0.8 mL vs 3.5 ± 0.7 mL; P = .034). The association of EATV with right ventricular end-diastolic volume (Pnonlinear = .001), right ventricular end-diastolic volume index (P < .001), right ventricular cardiac output (P = .003), N-terminal pro-brain natriuretic peptide (P = .030), and the risk of clinical worsening (P = .014) was U shaped. Compared with individuals with middle-level EATV, multivariable-adjusted hazard ratio for clinical worsening was 6.0 (95% CI, 1.3-27.8) for the individuals with low-level EATV and 6.8 (95% CI, 1.5-30.2) for high-level EATV in patients with PAH.
Patients with PAH had a decreased EATV compared with control participants. EATV exhibited a U-shaped association with right ventricular function and biomarkers of myocardial injury in patients with PAH. Low and high levels of EATV might reduce long-term event-free survival in patients with PAH.
Chinese Clinical Trial Registry; No. ChiCTR2100049804; www.chictr.org.cn. |
| doi_str_mv | 10.1016/j.chest.2023.11.039 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2896806583</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0012369223058312</els_id><sourcerecordid>2896806583</sourcerecordid><originalsourceid>FETCH-LOGICAL-c354t-e6a7d959e0e607c05f9fda8749d4a42b2b8e1bd0a3a415271c7bdb54986cdc1f3</originalsourceid><addsrcrecordid>eNp9kEtPxCAUhYnROOPjF5gYlm5aofTFwsVk4mOSSTRG14TCrcOkhQqtif9exlGXroDLOefe-yF0QUlKCS2vt6naQBjTjGQspTQljB-gOeWMJqzI2SGaE0KzhJU8m6GTELYkvikvj9GM1SQnpGBzZFf9INWIXYtvB6Ok10Z2eKHN4ALgFxPCBNhZ_GzeNiNefv8rfDdZNZpYllbjJ-_erAsmYGPx09T1zkr_iRd-BL8Le_gcIN5tiIYzdNTKLsD5z3mKXu9uX5YPyfrxfrVcrBMVRx8TKGWlecGBQEkqRYqWt1rWVc51LvOsyZoaaKOJZDKnRVZRVTW6KXJel0or2rJTdLXPHbx7nyIl0ZugoOukBTcFkdW8rElZ1CxK2V6qvAvBQysGb_q4gaBE7ECLrfgGLXagBaUigo6uy58GU9OD_vP8ko2Cm70A4pofBrwIyoBVoI0HNQrtzL8NvgArCJFZ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2896806583</pqid></control><display><type>article</type><title>Impact of Epicardial Adipose Tissue on Right Cardiac Function and Prognosis in Pulmonary Arterial Hypertension</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Chen, Yusi ; Li, Junli ; Li, Fang ; Chen, Zheng ; Chen, Zhangling ; Luo, Jun ; Qiu, Haihua ; Chen, Wenjie ; Hu, Junjiao ; Luo, Xiaoqin ; Tan, Yingjie ; Rathinasabapathy, Anandharajan ; Chen, Jingyuan ; Li, Jiang</creator><creatorcontrib>Chen, Yusi ; Li, Junli ; Li, Fang ; Chen, Zheng ; Chen, Zhangling ; Luo, Jun ; Qiu, Haihua ; Chen, Wenjie ; Hu, Junjiao ; Luo, Xiaoqin ; Tan, Yingjie ; Rathinasabapathy, Anandharajan ; Chen, Jingyuan ; Li, Jiang</creatorcontrib><description>Although epicardial adipose tissue (EAT) is linked to effects on survival in left-sided heart failure, the association between EAT and right-sided heart failure caused by pulmonary arterial hypertension (PAH) remains unknown.
What are the potential impacts of EAT volume (EATV) on right ventricular function, biomarkers of myocardial injury, and long-term prognosis in patients with PAH?
A total of 135 age- and BMI-matched patients with PAH and 49 control participants were included in this study. EATV was quantified by using cardiac magnetic resonance and was related to clinical correlates, N-terminal pro-brain natriuretic peptide, and cardiac function. Levels of EATV associated with the risk of clinical worsening were evaluated on a continuous scale (restricted cubic splines) and by previously defined centile categories with Cox proportional hazards regression models and Kaplan-Meier survival estimates.
Compared with the control participants, patients with PAH had a lower EATV (ln [EATV], 3.2 ± 0.8 mL vs 3.5 ± 0.7 mL; P = .034). The association of EATV with right ventricular end-diastolic volume (Pnonlinear = .001), right ventricular end-diastolic volume index (P < .001), right ventricular cardiac output (P = .003), N-terminal pro-brain natriuretic peptide (P = .030), and the risk of clinical worsening (P = .014) was U shaped. Compared with individuals with middle-level EATV, multivariable-adjusted hazard ratio for clinical worsening was 6.0 (95% CI, 1.3-27.8) for the individuals with low-level EATV and 6.8 (95% CI, 1.5-30.2) for high-level EATV in patients with PAH.
Patients with PAH had a decreased EATV compared with control participants. EATV exhibited a U-shaped association with right ventricular function and biomarkers of myocardial injury in patients with PAH. Low and high levels of EATV might reduce long-term event-free survival in patients with PAH.
Chinese Clinical Trial Registry; No. ChiCTR2100049804; www.chictr.org.cn.</description><identifier>ISSN: 0012-3692</identifier><identifier>ISSN: 1931-3543</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1016/j.chest.2023.11.039</identifier><identifier>PMID: 38040053</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Biomarkers - blood ; Case-Control Studies ; epicardial adipose tissue ; Epicardial Adipose Tissue - diagnostic imaging ; Female ; Heart Failure - physiopathology ; Humans ; long-term prognosis ; Magnetic Resonance Imaging, Cine - methods ; Male ; Middle Aged ; Natriuretic Peptide, Brain - blood ; Peptide Fragments - blood ; Pericardium - diagnostic imaging ; Prognosis ; pulmonary arterial hypertension ; Pulmonary Arterial Hypertension - mortality ; Pulmonary Arterial Hypertension - physiopathology ; right ventricular function ; Ventricular Dysfunction, Right - diagnostic imaging ; Ventricular Dysfunction, Right - physiopathology ; Ventricular Function, Right - physiology</subject><ispartof>Chest, 2024-05, Vol.165 (5), p.1211-1223</ispartof><rights>2023 The Author(s)</rights><rights>Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c354t-e6a7d959e0e607c05f9fda8749d4a42b2b8e1bd0a3a415271c7bdb54986cdc1f3</cites><orcidid>0000-0003-4904-6635</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38040053$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Yusi</creatorcontrib><creatorcontrib>Li, Junli</creatorcontrib><creatorcontrib>Li, Fang</creatorcontrib><creatorcontrib>Chen, Zheng</creatorcontrib><creatorcontrib>Chen, Zhangling</creatorcontrib><creatorcontrib>Luo, Jun</creatorcontrib><creatorcontrib>Qiu, Haihua</creatorcontrib><creatorcontrib>Chen, Wenjie</creatorcontrib><creatorcontrib>Hu, Junjiao</creatorcontrib><creatorcontrib>Luo, Xiaoqin</creatorcontrib><creatorcontrib>Tan, Yingjie</creatorcontrib><creatorcontrib>Rathinasabapathy, Anandharajan</creatorcontrib><creatorcontrib>Chen, Jingyuan</creatorcontrib><creatorcontrib>Li, Jiang</creatorcontrib><title>Impact of Epicardial Adipose Tissue on Right Cardiac Function and Prognosis in Pulmonary Arterial Hypertension</title><title>Chest</title><addtitle>Chest</addtitle><description>Although epicardial adipose tissue (EAT) is linked to effects on survival in left-sided heart failure, the association between EAT and right-sided heart failure caused by pulmonary arterial hypertension (PAH) remains unknown.
What are the potential impacts of EAT volume (EATV) on right ventricular function, biomarkers of myocardial injury, and long-term prognosis in patients with PAH?
A total of 135 age- and BMI-matched patients with PAH and 49 control participants were included in this study. EATV was quantified by using cardiac magnetic resonance and was related to clinical correlates, N-terminal pro-brain natriuretic peptide, and cardiac function. Levels of EATV associated with the risk of clinical worsening were evaluated on a continuous scale (restricted cubic splines) and by previously defined centile categories with Cox proportional hazards regression models and Kaplan-Meier survival estimates.
Compared with the control participants, patients with PAH had a lower EATV (ln [EATV], 3.2 ± 0.8 mL vs 3.5 ± 0.7 mL; P = .034). The association of EATV with right ventricular end-diastolic volume (Pnonlinear = .001), right ventricular end-diastolic volume index (P < .001), right ventricular cardiac output (P = .003), N-terminal pro-brain natriuretic peptide (P = .030), and the risk of clinical worsening (P = .014) was U shaped. Compared with individuals with middle-level EATV, multivariable-adjusted hazard ratio for clinical worsening was 6.0 (95% CI, 1.3-27.8) for the individuals with low-level EATV and 6.8 (95% CI, 1.5-30.2) for high-level EATV in patients with PAH.
Patients with PAH had a decreased EATV compared with control participants. EATV exhibited a U-shaped association with right ventricular function and biomarkers of myocardial injury in patients with PAH. Low and high levels of EATV might reduce long-term event-free survival in patients with PAH.
Chinese Clinical Trial Registry; No. ChiCTR2100049804; www.chictr.org.cn.</description><subject>Adult</subject><subject>Biomarkers - blood</subject><subject>Case-Control Studies</subject><subject>epicardial adipose tissue</subject><subject>Epicardial Adipose Tissue - diagnostic imaging</subject><subject>Female</subject><subject>Heart Failure - physiopathology</subject><subject>Humans</subject><subject>long-term prognosis</subject><subject>Magnetic Resonance Imaging, Cine - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Peptide Fragments - blood</subject><subject>Pericardium - diagnostic imaging</subject><subject>Prognosis</subject><subject>pulmonary arterial hypertension</subject><subject>Pulmonary Arterial Hypertension - mortality</subject><subject>Pulmonary Arterial Hypertension - physiopathology</subject><subject>right ventricular function</subject><subject>Ventricular Dysfunction, Right - diagnostic imaging</subject><subject>Ventricular Dysfunction, Right - physiopathology</subject><subject>Ventricular Function, Right - physiology</subject><issn>0012-3692</issn><issn>1931-3543</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtPxCAUhYnROOPjF5gYlm5aofTFwsVk4mOSSTRG14TCrcOkhQqtif9exlGXroDLOefe-yF0QUlKCS2vt6naQBjTjGQspTQljB-gOeWMJqzI2SGaE0KzhJU8m6GTELYkvikvj9GM1SQnpGBzZFf9INWIXYtvB6Ok10Z2eKHN4ALgFxPCBNhZ_GzeNiNefv8rfDdZNZpYllbjJ-_erAsmYGPx09T1zkr_iRd-BL8Le_gcIN5tiIYzdNTKLsD5z3mKXu9uX5YPyfrxfrVcrBMVRx8TKGWlecGBQEkqRYqWt1rWVc51LvOsyZoaaKOJZDKnRVZRVTW6KXJel0or2rJTdLXPHbx7nyIl0ZugoOukBTcFkdW8rElZ1CxK2V6qvAvBQysGb_q4gaBE7ECLrfgGLXagBaUigo6uy58GU9OD_vP8ko2Cm70A4pofBrwIyoBVoI0HNQrtzL8NvgArCJFZ</recordid><startdate>202405</startdate><enddate>202405</enddate><creator>Chen, Yusi</creator><creator>Li, Junli</creator><creator>Li, Fang</creator><creator>Chen, Zheng</creator><creator>Chen, Zhangling</creator><creator>Luo, Jun</creator><creator>Qiu, Haihua</creator><creator>Chen, Wenjie</creator><creator>Hu, Junjiao</creator><creator>Luo, Xiaoqin</creator><creator>Tan, Yingjie</creator><creator>Rathinasabapathy, Anandharajan</creator><creator>Chen, Jingyuan</creator><creator>Li, Jiang</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4904-6635</orcidid></search><sort><creationdate>202405</creationdate><title>Impact of Epicardial Adipose Tissue on Right Cardiac Function and Prognosis in Pulmonary Arterial Hypertension</title><author>Chen, Yusi ; Li, Junli ; Li, Fang ; Chen, Zheng ; Chen, Zhangling ; Luo, Jun ; Qiu, Haihua ; Chen, Wenjie ; Hu, Junjiao ; Luo, Xiaoqin ; Tan, Yingjie ; Rathinasabapathy, Anandharajan ; Chen, Jingyuan ; Li, Jiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c354t-e6a7d959e0e607c05f9fda8749d4a42b2b8e1bd0a3a415271c7bdb54986cdc1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Biomarkers - blood</topic><topic>Case-Control Studies</topic><topic>epicardial adipose tissue</topic><topic>Epicardial Adipose Tissue - diagnostic imaging</topic><topic>Female</topic><topic>Heart Failure - physiopathology</topic><topic>Humans</topic><topic>long-term prognosis</topic><topic>Magnetic Resonance Imaging, Cine - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Peptide Fragments - blood</topic><topic>Pericardium - diagnostic imaging</topic><topic>Prognosis</topic><topic>pulmonary arterial hypertension</topic><topic>Pulmonary Arterial Hypertension - mortality</topic><topic>Pulmonary Arterial Hypertension - physiopathology</topic><topic>right ventricular function</topic><topic>Ventricular Dysfunction, Right - diagnostic imaging</topic><topic>Ventricular Dysfunction, Right - physiopathology</topic><topic>Ventricular Function, Right - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Yusi</creatorcontrib><creatorcontrib>Li, Junli</creatorcontrib><creatorcontrib>Li, Fang</creatorcontrib><creatorcontrib>Chen, Zheng</creatorcontrib><creatorcontrib>Chen, Zhangling</creatorcontrib><creatorcontrib>Luo, Jun</creatorcontrib><creatorcontrib>Qiu, Haihua</creatorcontrib><creatorcontrib>Chen, Wenjie</creatorcontrib><creatorcontrib>Hu, Junjiao</creatorcontrib><creatorcontrib>Luo, Xiaoqin</creatorcontrib><creatorcontrib>Tan, Yingjie</creatorcontrib><creatorcontrib>Rathinasabapathy, Anandharajan</creatorcontrib><creatorcontrib>Chen, Jingyuan</creatorcontrib><creatorcontrib>Li, Jiang</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Yusi</au><au>Li, Junli</au><au>Li, Fang</au><au>Chen, Zheng</au><au>Chen, Zhangling</au><au>Luo, Jun</au><au>Qiu, Haihua</au><au>Chen, Wenjie</au><au>Hu, Junjiao</au><au>Luo, Xiaoqin</au><au>Tan, Yingjie</au><au>Rathinasabapathy, Anandharajan</au><au>Chen, Jingyuan</au><au>Li, Jiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Epicardial Adipose Tissue on Right Cardiac Function and Prognosis in Pulmonary Arterial Hypertension</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>2024-05</date><risdate>2024</risdate><volume>165</volume><issue>5</issue><spage>1211</spage><epage>1223</epage><pages>1211-1223</pages><issn>0012-3692</issn><issn>1931-3543</issn><eissn>1931-3543</eissn><abstract>Although epicardial adipose tissue (EAT) is linked to effects on survival in left-sided heart failure, the association between EAT and right-sided heart failure caused by pulmonary arterial hypertension (PAH) remains unknown.
What are the potential impacts of EAT volume (EATV) on right ventricular function, biomarkers of myocardial injury, and long-term prognosis in patients with PAH?
A total of 135 age- and BMI-matched patients with PAH and 49 control participants were included in this study. EATV was quantified by using cardiac magnetic resonance and was related to clinical correlates, N-terminal pro-brain natriuretic peptide, and cardiac function. Levels of EATV associated with the risk of clinical worsening were evaluated on a continuous scale (restricted cubic splines) and by previously defined centile categories with Cox proportional hazards regression models and Kaplan-Meier survival estimates.
Compared with the control participants, patients with PAH had a lower EATV (ln [EATV], 3.2 ± 0.8 mL vs 3.5 ± 0.7 mL; P = .034). The association of EATV with right ventricular end-diastolic volume (Pnonlinear = .001), right ventricular end-diastolic volume index (P < .001), right ventricular cardiac output (P = .003), N-terminal pro-brain natriuretic peptide (P = .030), and the risk of clinical worsening (P = .014) was U shaped. Compared with individuals with middle-level EATV, multivariable-adjusted hazard ratio for clinical worsening was 6.0 (95% CI, 1.3-27.8) for the individuals with low-level EATV and 6.8 (95% CI, 1.5-30.2) for high-level EATV in patients with PAH.
Patients with PAH had a decreased EATV compared with control participants. EATV exhibited a U-shaped association with right ventricular function and biomarkers of myocardial injury in patients with PAH. Low and high levels of EATV might reduce long-term event-free survival in patients with PAH.
Chinese Clinical Trial Registry; No. ChiCTR2100049804; www.chictr.org.cn.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38040053</pmid><doi>10.1016/j.chest.2023.11.039</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-4904-6635</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Biomarkers - blood Case-Control Studies epicardial adipose tissue Epicardial Adipose Tissue - diagnostic imaging Female Heart Failure - physiopathology Humans long-term prognosis Magnetic Resonance Imaging, Cine - methods Male Middle Aged Natriuretic Peptide, Brain - blood Peptide Fragments - blood Pericardium - diagnostic imaging Prognosis pulmonary arterial hypertension Pulmonary Arterial Hypertension - mortality Pulmonary Arterial Hypertension - physiopathology right ventricular function Ventricular Dysfunction, Right - diagnostic imaging Ventricular Dysfunction, Right - physiopathology Ventricular Function, Right - physiology |
| title | Impact of Epicardial Adipose Tissue on Right Cardiac Function and Prognosis in Pulmonary Arterial Hypertension |
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