Heart failure & cardiomyopathies
Incremental prognostic value of epicardial adipose tissue volume and thickness assessed by cardiac MRI in hypertrophic cardiomyopathy
Authors' conclusion
EATVI and regional fat thickness derived from CMR independently predict adverse outcomes in HCM and improve risk stratification. Comprehensive EAT assessment may serve as a promising imaging biomarker for personalized management.
Study context
- Population
- Hypertrophic cardiomyopathy (HCM) patients who underwent cardiac magnetic resonance (CMR) between 2018 and 2024
- Participants
- 457 HCM patients
- Exposure
- Epicardial adipose tissue (EAT) parameters assessed by CMR for prediction of major adverse cardiovascular events (MACE)
- Outcome
- MACE
- Follow-up
- Median 27.5 months (interquartile range 15.6-47.6)
Main finding
As reported in the abstract
MACE occurred
18.1%
Observational data: associations, not effects.
Further findings
EATVI as predictor of MACE (multivariable Cox regression)
| Comparison | Hazard ratio (95% CI) | P value | |
|---|---|---|---|
| EATVIIndependent predictor | 1.03 (1.01–1.05) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
| Outcome | Patients with MACE | Patients without MACE |
|---|---|---|
| EATVI | mean 72.21 (SD 14.21) mL/m² | mean 56.71 (SD 10.36) mL/m² |
- EATVI: P < 0.001
Regional fat thickness
- Increased regional fat thickness in patients with MACE
- P < 0.05
Discrimination of clinical-CMR model with EATVI
- C-statistic
- 0.82-0.84
- P
- P = 0.002
- Enhanced calibration and greater net clinical benefit on decision-curve analysis
EATVI appended to 2014 European Society of Cardiology (ESC) HCM Risk-SCD model
- C-statistic 0.80 vs. 0.71
- P < 0.001
- Improved calibration
Event-free survival by EATVI quartiles and 62.5 mL/m² cutoff (Kaplan-Meier)
- ESC-defined low-risk subgroup: curves separated significantly
- log-rank P < 0.05
- Progressively worse event-free survival with higher EATVI
Time-dependent receiver operating characteristic analyses
- Stable predictive performance
Original publication
Summarised from the published abstract; every number is checked against it