Increased epicardial adipose tissue volume may adversely affect outcomes in patients undergoing transcatheter aortic valve implantation.

Abstract

Introduction: Epicardial adipose tissue (EAT) influences the development of cardiovascular diseases through the secretion of inflammatory cytokines. Transcatheter aortic valve implantation (TAVI) is one of the most commonly used methods for treating severe aortic stenosis in adults.

Aim: Given the role of inflammatory cytokines in the progression of aortic stenosis, we investigated the impact of EAT on the outcomes of patients undergoing TAVI.

Material and methods: The medical records of 334 patients who underwent TAVI for symptomatic severe aortic stenosis between March 2018 and December 2022 were evaluated after applying the exclusion criteria. Major adverse cardiac and cerebrovascular endpoints (MACCE) were defined according to the Valvular Academic Research Consortium criteria. The patients were divided into two groups: those with and without MACCE.

Results: Mean EAT volume was higher in patients with MACCE than those without MACCE (120.7 ±43.9 vs. 96.1 ±39.8, p < 0.001). Univariate Cox proportional-risk analysis revealed that creatinine and albumin levels, mean systolic pulmonary artery pressure, and EAT volume were significantly associated with MACCE. Multivariate Cox proportional-hazard analysis showed that EAT volume (hazard ratio (HR) = 1.012; 95% confidence interval (CI): 1.006-1.018; p < 0.001) and albumin level (HR = 0.925; 95% CI: 0.866-0.987; p = 0.018) were significantly independently associated with MACCE.

Conclusions: The EAT volume and 1-year outcomes may be related in patients undergoing TAVI for severe aortic stenosis.