Valvular & structural heart disease
Epicardial adipose tissue, myocardial remodelling and adverse outcomes in asymptomatic aortic stenosis: a post hoc analysis of a randomised controlled trial
Authors' conclusion
Epicardial adipose tissue volume does not associate with aortic stenosis severity or its progression but does correlate with blood and imaging biomarkers of impaired myocardial health. The latter may explain the association of epicardial adipose tissue volume with an increased risk of all-cause mortality in patients with asymptomatic aortic stenosis. Clinicaltrials.gov ( NCT02132026 ).
Study context
- Population
- Patients with asymptomatic mild-to-severe aortic stenosispatients participating in a prospective clinical trial
- Participants
- 124 patients
- Comparison
- Association of baseline epicardial adipose tissue (CT angiography) with aortic stenosis severity and progression, myocardial remodelling and function, and mortality
- Primary endpoint
- All-cause mortality
- Follow-up
- Median 48 (IQR 26-73) months
Methodological detailsprospective clinical trial, fully automated deep learning-enabled software
- Prospective clinical trial
- Fully automated deep learning-enabled software
Primary result
As reported in the abstract
All-cause mortality
Estimate (95% CI)P value
Epicardial adipose tissue volumemultivariable, adjusted for age, body mass index and left ventricular ejection fraction
HR 1.82(1.10–3.03)
P = 0.021Plasma cardiac troponin concentrationmultivariable, adjusted for age, body mass index and left ventricular ejection fraction
HR 1.47(1.13–1.90)
P = 0.004Epicardial adipose tissue volume >90 mm 33-4 times higher risk of death
adjusted HR 3.74(1.08–12.96)
P = 0.037- Patients who died
- 23 (18%)
Further findings
Aortic stenosis severity and disease progression (echocardiography or CT)
- Neither epicardial adipose tissue volume nor attenuation correlated
- P > 0.05 for all
Correlations of epicardial adipose tissue volume with biomarkers
- Plasma cardiac troponin concentration
- r=0.23, p=0.009
- Left ventricular mass
- r=0.46, p<0.001
- Ejection fraction
- r=−0.28, p=0.002
- Global longitudinal strain
- r=0.28, p=0.017
- Left atrial volume
- r=0.39, p<0.001
Original publication
Epicardial adipose tissue, myocardial remodelling and adverse outcomes in asymptomatic aortic stenosis: a post hoc analysis of a randomised controlled trial. Heart. Published 6 March 2025. doi:10.
Summarised from the published abstract; every number is checked against it