Relation of epicardial fat thickness to the severity of heart failure in patients with nonischemic dilated cardiomyopathy

Echocardiography. 2015 May;32(5):740-8. doi: 10.1111/echo.12796. Epub 2014 Nov 24.

Abstract

Background: The aim of this study was to assess whether epicardial fat thickness (EFT) is associated with the severity of heart failure in patients with nonischemic dilated cardiomyopathy (NICMP).

Methods: The study group was composed of 93 patients with NICMP and38 age- and sex-matched healty individuals as the control group. The EFT was identified during end-systole at the point on the free wall of the right ventricle.

Results: Patients with NICMP had significantly lower mean EFT than those in the control group (4.1 ± 0.8 vs. 6.1 ± 1.8 mm, P < 0.001). EFT was thinnest in patients with New York Heart Association (NYHA) functional class III or IV (3.5 ± 0.5, P < 0.001). There was a significant correlation between EFT, left ventricle EF (r = 0.540 P < 0.001), and B-type natriuretic peptide (BNP) (r = -0.695, P < 0.001) values in patients with NICMP. In addition, when EFT was corrected for BMI, EFT/BMI was lower in patients with NYHA functional class III-IV than patients with NYHA class I-II and control group (0.13 ± 0.01, 0.16 ± 0.02, 0.23 ± 0.04, respectively; P < 0.001). There was a significant correlation between EFT/BMI, left ventricle EF (r = 0.489, P < 0.001), and BNP (r = -0.549, P < 0.001) in patients with NICMP. In multivariate regression analysis, EFT (P = 0.009), BNP (P = 0.039), and left atrium volume index (P = 0.039) were independently associated with impaired functional status.

Conclusion: Echocardiographic EFT is an inexpensive, simple, and readily available marker that may be used to asses the severity of chronic heart failure in patients with NICMP.

Keywords: dilated cardiomyopathy; echocardiography; ejection fraction; heart failure.

MeSH terms

  • Adipose Tissue / diagnostic imaging*
  • Body Mass Index
  • Cardiomyopathy, Dilated / blood
  • Cardiomyopathy, Dilated / complications
  • Cardiomyopathy, Dilated / diagnostic imaging*
  • Female
  • Heart Failure / blood
  • Heart Failure / complications
  • Heart Failure / diagnostic imaging*
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Pericardium / diagnostic imaging*
  • Retrospective Studies
  • Severity of Illness Index
  • Ultrasonography

Substances

  • Natriuretic Peptide, Brain