Association of epicardial adipose tissue on magnetic resonance imaging with cardiovascular outcomes: Quality over quantity?
Franz Duca, Katharina Mascherbauer, Carolina Donà, Matthias Koschutnik, Christina Binder, Christian Nitsche, Kseniya Halavina, Dietrich Beitzke, Christian Loewe, Philipp E. Bartko, Elisabeth Waldmann, Julia Mascherbauer, Christian Hengstenberg, Andreas Kammerlander
Abstract
OBJECTIVE: Epicardial adipose tissue (EAT) quantity is associated with poor cardiovascular outcomes. However, the quality of EAT may be of incremental prognostic value. Cardiac magnetic resonance (CMR) is the gold standard for tissue characterization but has never been applied for EAT quality assessment. We aimed to investigate EAT quality measured on CMR T1 mapping as a predictor of poor outcomes in an all-comer cohort. METHODS: We investigated the association of EAT area and EAT T1 times (EAT-T1) with a composite endpoint of nonfatal myocardial infarction, heart failure hospitalization, and all-cause death. RESULTS: and 268 ms, respectively. On linear regression, EAT-T1 was not associated with markers of obesity, dyslipidemia, or comorbidities such as diabetes (p > 0.05 for all). During a follow-up of 57.7 months, a total of 280 (29.0%) events occurred. EAT-T1 was independently associated (adjusted hazard ratio per SD: 1.202; 95% CI: 1.022-1.413; p = 0.026) with the composite endpoint when adjusted for established clinical risk. CONCLUSIONS: EAT quality (as assessed via CMR T1 times), but not EAT quantity, is independently associated with a composite endpoint of nonfatal myocardial infarction, heart failure hospitalization, and all-cause death.