Pericardial fat is associated with ventricular tachyarrhythmia and mortality in patients with systolic heart failure.
OBJECTIVE
Pericardial fat (PF) has been hypothesized to exert local pathogenic effects on nearby cardiac structures above and beyond that of systemic adiposity which might be associated with the presence of arrhythmia or even worse outcomes. The aims of this study was to characterize the relationship between PF and the prognosis in patients with systolic heart failure (HF).


METHODS
This is a retrospective cohort study of a cardiac magnetic resonance imaging (CMRI) database from 2004 to 2011. Fifty patients with systolic HF underwent CMRI examinations were included. We also enrolled twenty patients with HF as the control group. The cine imaging was analyzed to derive total PF volumes, left ventricular volumes and mass and left ventricular ejection fraction by using a previously validated technique. The outcomes, including ventricular tachycardia (VT), ventricular fibrillation (VF) and total mortality were obtained by reviewing medical records.


RESULTS
After a median follow-up of 694 days, patients with VT/VF had significant larger indexed PF volumes than those without [36.3 (32.8-43.1) ml/m(2) vs. 24.1 (20.2-27.6) ml/m(2), p = 0.001]. The mortality group also had significant larger indexed PF volumes (PF/body surface area) than those without [31.3 (22.8-38.4) ml/m(2) vs. 23.9 (19.8-27.3) ml/m(2), p = 0.010]. Indexed PF volumes were associated with the development of VT/VF (Hazard ratio, 7.510; 95% C.I, 0.901-62.582, p = 0.062) and mortality (Hazard ratio, 3.998; 95% C.I, 1.077-14.845, p = 0.038) by Cox's regression analyses.


CONCLUSION
PF is associated with the development of VT/VF and long-term overall mortality in patients with systolic HF.
['Wu|Cho-Kai|CK|', 'Tsai|Hao-Yuan|HY|', 'Su|Mao-Yuan M|MY|', 'Wu|Yi-Fan|YF|', 'Hwang|Juey-Jen|JJ|', 'Tseng|Wen-Yih|WY|', 'Lin|Jiunn-Lee|JL|', 'Lin|Lian-Yu|LY|']
D000273:Adipose Tissue D050154:Adiposity D000368:Aged D015992:Body Mass Index D016208:Databases, Factual D005260:Female D005500:Follow-Up Studies D054143:Heart Failure, Systolic D006352:Heart Ventricles D006801:Humans D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D010496:Pericardium D011379:Prognosis D012189:Retrospective Studies D012307:Risk Factors D017180:Tachycardia, Ventricular D016896:Treatment Outcome D014693:Ventricular Fibrillation
Pericardial fat Magnetic resonance imaging Ventricular tachycardia Ventricular fibrillation Adipose tissue