Non-calcified Coronary Plaque Burden is Related to Epicardial Adipose Tissue and Peri-coronary Adipose Tissue Attenuation in Heart Failure With Preserved Ejection Fraction

1/5 https://e-heartfailure.orgLittle is known about the specific modes of major cardiac adverse events (MACE) and death in patients with heart failure with preserved ejection fraction (HFpEF).Although trial data suggest that death from sudden cardiac arrest and heart failure-related death account for the majority of cardiovascular mortality in HFpEF, the association between atherosclerosis, inflammation and MACE events in HFpEF has not been well characterized.Multiple markers of risk have been proposed, such as epicardial adipose tissue (EAT)-defined as all adipose tissue enclosed by the pericardium and quantified by epicardial fat volume (EFV)-and peri-coronary adipose tissue (PCAT) attenuation, defined as the intensity of the epicardial fat surrounding the coronary artery, measured on coronary computed tomography angiography (CCTA).These markers are surrogates of vascular inflammation and appear to contribute to the burden of coronary non-calcified plaques (NCPs), 1) which are considered high-risk coronary plaques and are associated with adverse cardiac events. 2,3)Moreover, EFV may contribute to the development of HFpEF. 4)As a first step in dissecting the association between EAT characteristics, NCP burden and MACE in HFpEF, we sought to characterize the association between EAT, PCAT attenuation and NCP burden in patients with HFpEF.We included participants with HFpEF and CCTA-documented nonobstructive coronary artery disease (CAD) (NCT02582021).NCP (defined as plaque with attenuation between -30 and +350 Hounsfield units [HU]), low-density non-calcified plaque (LDNCP, defined as plaque with attenuation <30 HU), EFV and PCAT attenuation were quantified using a fully automated deep learning algorithm included in research software (QFAT version 2.