Associations of adipose tissue depots with cardiac resynchronization therapy response and clinical outcomes: A CRT-HF Clinic substudy.


Journal

Journal of cardiology
ISSN: 1876-4738
Titre abrégé: J Cardiol
Pays: Netherlands
ID NLM: 8804703

Informations de publication

Date de publication:
27 Sep 2024
Historique:
received: 12 06 2024
revised: 17 09 2024
accepted: 23 09 2024
medline: 30 9 2024
pubmed: 30 9 2024
entrez: 29 9 2024
Statut: aheadofprint

Résumé

The region of adipose deposition is an important determinant in the outcomes of patients with heart failure (HF). However, the impact of regional adiposity on HF patients undergoing cardiac resynchronization therapy (CRT) remains unclear. A retrospective cohort analysis was conducted on 95 patients from a single-center study, assessing post-CRT outcomes. Multi-slice body composition measurements of chest computed tomography before CRT placement were used for adipose quantification. Patients were stratified based on subcutaneous adiposity, intramuscular adiposity, and hepatic steatosis. Subcutaneous adiposity correlated with higher CRT response rates (44.4 % in subcutaneous adiposity vs 16.7 % in subcutaneous adipopenia, p = 0.009), while intramuscular adiposity was associated with increased pre-frailty (adjusted OR 14.17, 95 % CI 2.24-89.57, p = 0.005). The higher response to CRT in patients with subcutaneous adiposity may be secondary to preferred subcutaneous over ectopic adipose fat deposition, which is potentially protective against cardiomyocyte dysfunction. Thus, intramuscular adiposity could potentially serve as a prognostic tool for frailty in HF patients.

Sections du résumé

BACKGROUND BACKGROUND
The region of adipose deposition is an important determinant in the outcomes of patients with heart failure (HF). However, the impact of regional adiposity on HF patients undergoing cardiac resynchronization therapy (CRT) remains unclear.
METHODS METHODS
A retrospective cohort analysis was conducted on 95 patients from a single-center study, assessing post-CRT outcomes. Multi-slice body composition measurements of chest computed tomography before CRT placement were used for adipose quantification. Patients were stratified based on subcutaneous adiposity, intramuscular adiposity, and hepatic steatosis.
RESULTS/CONCLUSION CONCLUSIONS
Subcutaneous adiposity correlated with higher CRT response rates (44.4 % in subcutaneous adiposity vs 16.7 % in subcutaneous adipopenia, p = 0.009), while intramuscular adiposity was associated with increased pre-frailty (adjusted OR 14.17, 95 % CI 2.24-89.57, p = 0.005). The higher response to CRT in patients with subcutaneous adiposity may be secondary to preferred subcutaneous over ectopic adipose fat deposition, which is potentially protective against cardiomyocyte dysfunction. Thus, intramuscular adiposity could potentially serve as a prognostic tool for frailty in HF patients.

Identifiants

pubmed: 39343194
pii: S0914-5087(24)00192-8
doi: 10.1016/j.jjcc.2024.09.011
pii:
doi:

Types de publication

Letter

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Ltd.

Auteurs

Maximilian C Volk (MC)

Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.

Saeid Mirzai (S)

Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA; Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

Ian Persits (I)

Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.

Kunaal S Sarnaik (KS)

Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Laurie Ann Moennich (LA)

Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.

Po-Hao Chen (PH)

Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.

John Rickard (J)

Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.

W H Wilson Tang (WHW)

Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: tangw@ccf.org.

Classifications MeSH