1. Body mass index, regional adipose deposition, and clinical outcomes in non-ischemic dilated cardiomyopathy: a prospective cohort study.
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Huang C, Li Y, Xu Y, Zhou Y, Li W, Guo J, Wan K, Wang J, Xu Z, Zhang Q, Han Y, Sun J, and Chen Y
- Abstract
Aim: To assess the relationship between body mass index (BMI), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), epicardial adipose tissue (EAT), pericardial adipose tissue (PAT) and clinical outcomes in dilated cardiomyopathy (DCM) patients., Methods: Non-ischemic DCM patients were prospectively enrolled. Regional adipose tissue, cardiac function, and myocardial tissue characteristics were measured by cardiac magnetic resonance (CMR). The primary endpoint included all-cause mortality and heart transplantation (HTX)., Results: This study enrolled 1042 DCM patients (68% men, mean age 48 ± 15 years, mean BMI 23.9 ± 4.0 kg/m2). Underweight patients were more frequently women, had lower blood pressure, worse New York Heart Association (NYHA) class, reduced biventricular ejection fraction, and higher native T1 and extracellular volume fraction (ECV) value. Similarly, reduced regional adipose tissue was associated with adverse heart remodeling, worse cardiac function, and higher diffuse myocardial fibrosis. After a median follow-up of 41 months, primary endpoint occurred in 237 patients. BMI (HR: 0.94, 95% CI: 0.90 - 0.98, P = 0.006), VAT thickness (per 1 mm: HR 0.94, 95% CI: 0.91 - 0.97, P < 0.001), and EAT volume (per 1 mL: HR 0.96, 95% CI: 0.95 - 0.97, P < 0.001) were independent predictors of primary endpoint. EAT volume showed highest predictive value for heart failure death/HTX (C-index: 0.70). BMI was the best predictor of arrhythmia endpoint (C-index: 0.64)., Conclusions: Lower BMI and thinner regional adipose tissue represented the worse clinical phenotype and adverse remodeling, and were associated with worse clinical outcomes in patients with DCM., (© The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
- Published
- 2025
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