P12 Role of CT measured epicardial adipose tissue in moderate to severe aortic stenosis

<p>Introduction Epicardial adipose tissue (EAT) exerts paracrine effects on the myocardium. More lipid-laden adipocytes, with lower attenuation on computed tomography (CT), are associated with greater pro-inflammatory activity. We aim to compare EAT in patients with aortic stenosis (AS) and healthy controls and explore correlations with cardiac remodelling.</p> <p><br></p> <p>Methods Asymptomatic patients with AS and controls were prospectively recruited and underwent non-contrast cardiac CT, magnetic resonance imaging (MRI) and transthoracic echocardiography (TTE). Fully automated volumetric quantification of EAT with an attenuation of -190 to -30 Hounsfield units (HU) was performed. A cut off of -90HU determined higher and lower attenuation adipose tissue.</p> <p><br></p> <p>Results 124 patients with AS (max. velocity 3.88±0.57m/s, aortic valve area index 0.57±0.15 cm2/m2) and 39 controls were included. Mean EAT attenuation was significantly lower in AS compared to controls (-75.94±5.47 vs -69.93±5.4 HU, p<0.001). Indexed total (53.21±21.78 vs 41.72±18.2 cm3/m2, p=0.003) and low attenuation (16.92 [8.48, 22.53] vs 9.4 [5.7, 13.5]cm3/m2, p <0.001) EAT volumes were significantly higher in AS compared to controls.</p> <p><br></p> <p>On univariate analysis, indexed total and low attenuation EAT volumes were associated with measures of diastolic dysfunction: longitudinal (r=-0.266, p=0.004 and r=-0.220, p=0.017) and circumferential peak early diastolic strain rate (r -0.245, p=0.008 and r=-0.203, p=0.029) on CMR and E/e’ (r=0.194, p=0.034 and r=0.192, p=0.036) on TTE, but not independent of age, BMI and AS severity.</p> <p><br></p> <p>Conclusion Total and low attenuation indexed EAT volumes were higher in AS compared to controls and associated with diastolic dysfunction, but not independent of age, BMI and AS severity.</p>