Heart failure & cardiomyopathiesCohort study
Epicardial adipose tissue is associated with impaired outcomes in genotype-positive hypertrophic cardiomyopathy
- Retrospective cohort study
Authors' conclusion
EAT accumulation is associated with phenotype severity and independently associated with the incidence of MVA and HF events in genotype-positive HCM patients.
Study context
- Population
- Genotype-positive hypertrophic cardiomyopathy patients with CMR
- Participants
- 282 patients
- Exposure
- High vs low epicardial adipose tissue volume
- Outcome
- Malignant ventricular arrhythmias (sustained VT, VF, appropriate ICD shock, SCD or death of unknown cause) and HF events (HF hospitalization, heart transplantation or HF-related mortality)
- Follow-up
- 62 [32-96] months
Main finding
As reported in the abstract
Association of EAT volume with MVA and HF events
EAT volume vs Low EATHazard ratio (95% CI)P value
MVA; multivariable Cox
1.04(1.02–1.06)
P < 0.001HF events; multivariable Cox
1.05(1.03–1.08)
P < 0.001Observational data: associations, not effects.
Further findings
Maximal wall thickness
P < 0.001
LV outflow tract obstruction
P < 0.001
| Outcome | High EAT | Low EAT | P value |
|---|---|---|---|
| Late gadolinium enhancement extent | 6.1% (range 0.0–14.0) | 1.0% (range 0.0–6.2) | P < 0.001 |
Discrimination of epicardial adipose tissue (EAT) volume
- C-statistic for malignant ventricular arrhythmias (MVA)
- 0.79, p<0.001
- C-statistic for heart failure (HF) events
- 0.79, p<0.001
- Better than hypertrophic cardiomyopathy (HCM) sudden cardiac death (SCD) risk score for MVA (C-statistic comparison)
- P = 0.011
Original publication
Epicardial adipose tissue is associated with impaired outcomes in genotype-positive hypertrophic cardiomyopathy. Eur J Heart Fail. Published 22 May 2026. doi:10.1093/ejhf/xuag179
Summarised from the published abstract; every number is checked against it