Visceral Adiposity May Predict Mortality Risk in HFpEF

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The study covered in this summary was published on ResearchSquare.com as a preprint and has not yet been peer reviewed.

Key Takeaway

  • All-cause mortality rate in the high visceral fat area (VFA) group was significantly higher than in the low VFA group.

Why This Matters

  • Assessing VFA at baseline is meaningful to risk stratification and prognostic assessment in patients with heart failure with preserved ejection fraction (HFpEF).

Study Design

  • This was a prospective cohort study of patients with HFpEF recruited from the First Affiliated Hospital of Chongqing Medical University from September 2020 to January 2022.

  • A total of 297 inpatients diagnosed with HFpEF were considered for this study. Patients with severe liver insufficiency (elevated liver enzymes: 3 times over upper reference limit or liver cirrhosis), severe kidney insufficiency (eGFR <30 mL/min/1.73m2), history of autoimmune disease, cancer diagnosis at the beginning of the study, or left ventricular ejection fraction less than 50% at any time were excluded from this study.

  • The primary outcome was all-cause mortality.

  • VFA was measured through the multifrequency bioelectrical impedance analyzer.

  • The thickness of epicardial adipose tissue (EAT) and pericardial adipose tissue (PAT) was measured by echocardiography.

Key Results

  • A total of 172 patients with an average age of 72 years were analyzed, of which 59.9% were female, 66% had hypertension, and 40% had atrial fibrillation.

  • Patients were divided into the low VFA group (VFA <148.3 cm2) or high VFA group (VFA ≥148.3 cm2) based on the optimal prognostic cutoff.

  • The median follow-up was 13 months (395.5 days) (interquartile range: 207.5 – 535.5 days), during which 7 patients died.

  • The all-cause mortality rate in the high VFA group was significantly higher than in the low VFA group (6 deaths vs 1 death; log-rank P < .0001).

  • Patients with higher VFA were older, had higher body mass index (BMI), and higher rates of preexisting hypertension and atrial fibrillation.

  • Age, smoking, BMI, H2PEFF score, and VFA were significantly associated with higher mortality in HFpEF, whereas PAT thickness, EAT thickness, waist/hip ratio, body fat mass, and abdominal obesity were not.

  • In the fully adjusted model, VFA remained significantly associated with all-cause mortality (hazard ratio, 1.048; 95% CI, 1.005 – 1.092; P = .026).

 Limitations

  • This was a single-center, small sample size study.

  • Rigorous regression analysis was unattainable due to the small number of events.

  • Results of the analysis may have bias not identified and resolved.

  • Only patients with signs or symptoms of heart failure were included, which may have excluded some asymptomatic individuals or individuals falsely diagnosed with HFpEF as a result of dyspnea that was not owing to cardiac origin.

Disclosures

  • This work was supported by the National Natural Science Foundation of China; Chongqing Science and Technology Joint Project 2021; Basic Science and Foreword Technology Research Project; Chongqing Returnees Stay and Create Fund 2020, Chongqing High-end Talent Fund; China Cardiovascular Health Alliance-Access Research Fund; and the Chongqing Science and Health Union Medical Research Project.

  • The authors declare no conflicts of interest.

This is a summary of a preprint research study, “Visceral adiposity : A potential marker for mortality risk in heart failure with preserved ejection fraction?” written by Jin Zhao, from The First Affiliated Hospital of Chongqing Medical University, and colleagues on ResearchSquare, provided to you by Medscape. This study has not yet been peer reviewed. The full text of the study can be found on ResearchSquare.com.

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