Pericardial Fat an Independent Risk Factor for Heart Failure
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Pericardial fat is associated with a heightened risk for heart failure, particularly in women, new research suggests.

Obesity is a well-established risk factor for heart failure (HF). However, implications of pericardial fat on incident HF is unclear.

This study sought to examine the association between pericardial fat volume (PFV) and newly diagnosed HF.

This study ascertained PFV using cardiac computed tomography in 6,785 participants (3,584 women and 3,201 men) without pre-existing cardiovascular disease from the MESA (Multi-Ethnic Study of Atherosclerosis). Cox proportional hazards regression was used to evaluate PFV as continuous and dichotomous variable, maximizing the J-statistic.

-- In 90,686 person-years (median: 15.7 years; interquartile range: 11.7 to 16.5 years), 385 participants (5.7%; 164 women and 221 men) developed newly diagnosed HF. PFV was lower in women than in men.

-- In multivariable analyses, every 1-SD (42 cm3) increase in PFV was associated with a higher risk of HF in women than in men.

-- High PFV (more than 70 cm3 in women; more than 120 cm3 in men) conferred a 2-fold greater risk of HF in women and a 53% higher risk in men.

-- In sex-stratified analyses, greater risk of HF remained robust with additional adjustment for anthropometric indicators of obesity, abdominal subcutaneous or visceral fat or biomarkers of inflammation and hemodynamic stress and was similar among Whites, Blacks, Hispanics, and Chinese.

-- Elevated PFV predominantly augmented the risk of HF with preserved ejection fraction rather than reduced ejection fraction.

Conclusively, in this large, community-based, ethnically diverse, prospective cohort study, pericardial fat was associated with an increased risk of HF, particularly HF with preserved ejection fraction, in women and men.