Introduction:
Cachexia, as a miscellaneous phenomenon in heart failure (HF) with a prevalence of 10-15%, is associated with morbidity and mortality. Inflammation has been postulated as the hallmark factor in cachexia pathogenesis. Epicardial Fat Thickness (EFT) is the source of inflammatory mediators and has a close relationship with various cardiac diseases. Beyond other imaging modalities, echocardiography can be a simple and useful method in the evaluation of this tissue. In this study we objected to determine the relation of EFT and cardiac cachexia in heart failure
MATERIALS AND METHODS:
Our study consisted of totally 100 patients with heart failure with low ejection fraction (EF <30%) with BMI <25 kg/m2; 50 patients with cachectic HF and 50 patients with non-cachectic HF as the control group. The diagnosis of cachexia was based on the criteria as defined by Ewans WJ et al. (2008). EFT was measured with transthoracic echocardiography at systole in parasternal long axis view.
RESULTS:
In patients with cachectic HF (mean age 56.7±13.3, %44 male). EFT were higher than the control group (mean age 58.4±15.0, % 48 male).As a confounding factor; BMI was not different between groups (21.8±2.7 vs. 22.1±3.1, p=0.12).In correlation analysis of EFT with components of cachexia,EFT was significantly positively correlated with CRP (β=0.357 p<0.001) and negatively correlated with hand grip strength (β=-0.292, p=0.003), hemoglobin (β=-0,313 p=0.002) and albumin levels (β=-0.322 p=0.001). In multivariate analysis, EFT was an independent predictor of cardiac cachexia (OR:2.213, 95% CI:1.341-3.652, P=0.002).
DISCUSSION:
EFT, as an indicator of cardiac inflammatory status, seems to be an important predictor of cardiac cachexia. This noninvasive, simple measurement may guide us at risk stratification of patients with heart failure.