Association of Cardiac MRI-Derived Epicardial Adipose Tissue Index With Adverse Clinical Outcomes in Heart Failure With Preserved Ejection Fraction.

IF 4.3 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Magnetic Resonance Imaging Pub Date : 2026-10-14 DOI:10.1002/jmri.70554

Siying Ma, Lujie Qian, Kaihua Lou, Qiuhui Hu, Xi Hu, Feidan Yu, Lingjie Zhang, Qi Wang, Yiyuan Gao, Hongjie Hu

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引用次数: 0

Abstract

Background: The clinical relevance of the epicardial adipose tissue index (EATI) is increasingly recognized, but its association with clinical outcomes in patients with heart failure with preserved ejection fraction (HFpEF) remains inadequately investigated.

Purpose: To evaluate the association between cardiac MRI-derived EATI and major adverse cardiovascular events (MACE) in patients with HFpEF.

Study type: Retrospective.

Population: Two hundred sixty-five patients with HFpEF (135 male; mean age 55 years).

Field strength/sequence: 1.5 T/balanced steady-state free precession.

Assessment: EATI was quantified on cardiac MRI cine images. MACE was defined as cardiac death or readmission for heart failure.

Statistical tests: Welch t-test or Mann-Whitney U test, Cox proportional hazards regression, Kaplan-Meier analysis with log-rank test, and global χ² model comparison. A p value < 0.05 was considered significant.

Results: During a median follow-up of 33 months (22-65), 42 patients experienced MACE. EATI was significantly higher in the MACE group than in the no-MACE group (33.65 ± 13.91 vs. 26.13 ± 11.28 mL/m², Z = -3.52, effect size r = -0.22). EATI was independently associated with MACE (multivariable HR = 1.04 [95% CI: 1.01-1.06]). Kaplan-Meier survival analysis confirmed that patients with low EATI had significantly higher event-free survival rate. A model combining EATI with other clinical and conventional imaging risk factors (χ² = 42.3) showed significantly improved model discrimination for identifying patients at risk of MACE compared with models with clinical variables (χ² = 26.0) or clinical and conventional imaging variables (χ² = 34.3).

Data conclusion: Cardiac MRI-derived EATI was independently associated with MACE in patients with HFpEF and showed favorable discriminatory performance compared with clinical and conventional imaging risk factors.

Evidence level: 3.

Technical efficacy: Stage 5.

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心脏mri来源的心外膜脂肪组织指数与保留射血分数的心力衰竭不良临床结果的关系。

背景：心外膜脂肪组织指数（EATI）的临床相关性日益得到认可，但其与保留射血分数（HFpEF）心力衰竭患者临床结局的关系仍未得到充分研究。目的：评估HFpEF患者心脏mri衍生的EATI与主要不良心血管事件（MACE）之间的关系。研究类型：回顾性。人群：265例HFpEF患者（男性135例，平均年龄55岁）。场强/序列：1.5 T/平衡稳态自由进动。评估：在心脏MRI影像上量化EATI。MACE定义为心源性死亡或因心力衰竭再入院。统计检验：Welch t检验或Mann-Whitney U检验、Cox比例风险回归、Kaplan-Meier分析与log-rank检验、全局χ2模型比较。结果：中位随访33个月（22-65），42例患者出现MACE。MACE组EATI显著高于无MACE组（33.65±13.91 vs. 26.13±11.28 mL/m2, Z = -3.52，效应量r = -0.22）。EATI与MACE独立相关（多变量HR = 1.04 [95% CI: 1.01-1.06]）。Kaplan-Meier生存分析证实，低EATI患者的无事件生存率明显较高。结合EATI与其他临床和常规影像学危险因素的模型（χ2 = 42.3）对MACE高危患者的识别能力明显优于单纯临床变量（χ2 = 26.0）或单纯临床和常规影像学变量（χ2 = 34.3）的模型（χ2 = 42.3）。数据结论：心脏mri来源的EATI与HFpEF患者的MACE独立相关，与临床和常规影像学危险因素相比具有良好的区别表现。证据等级：3。技术功效：第5阶段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Magnetic Resonance Imaging 医学-核医学

CiteScore

9.70

自引率

6.80%

发文量

494

审稿时长

2 months

期刊介绍： The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.