Scripties UMCG - Rijksuniversiteit Groningen
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Epicardial Adipose Tissue in Heart Failure with Preserved Ejection Fraction

(2017) Woerden, G. van

Heart failure (HF) is an increasing health problem with a high morbidity and mortality. Patients can present either with HF with reduced ejection fraction (HFrEF) or with HF with preserved ejection fraction (HFpEF). In contrast to patients with HFrEF,
to date no specific therapies have been proven to reduce mortality in HFpEF. The underlying heterogeneous nature of HFpEF has been proposed as an important cause of the current lack of effective treatment strategies in HFpEF and it is also suggested that each HFpEF phenotype may require specific treatment strategies. Obesity is rather common in HFpEF, and obesity has been identified as a distinct phenotype within the HFpEF spectrum. Recently, epicardial adipose tissue (EAT) has gained increasing interest for its possible adverse impact on the myocardium. The close anatomical relationship between EAT and the myocardium provides the hypothesis that local inflammatory processes regulated by EAT may drive adverse myocardial remodeling in HFpEF. In the present study, we investigated the extent and location of EAT using cardiac magnetic resonance (CMR) in patients with HFpEF. We then explored the association between EAT and myocardial structural and functional changes, comorbidities and biomarkers in HFpEF patients, and contrasted them with control subjects without HF.

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