Association of epicardial adipose tissue with markers of cardiac remodelling and clinical outcomes in asymptomatic aortic stenosis

BACKGROUND: Previous studies have suggested an adverse role of epicardial adipose tissue (EAT) in aortic stenosis (AS), potentially mediated by direct effects on the myocardium. This study aimed to assess whether EAT volume and density are associated with cardiac remodelling and clinical outcomes in a well-phenotyped cohort of patients with initially asymptomatic AS. METHODS: In this post hoc exploratory analysis of a multicentre, prospective longitudinal study, asymptomatic patients with moderate-to-severe AS (n=136; age 68.6 (60.1, 75.3) years, 27% female) and control participants (n=39; age 59.0 (54.0, 67.0) years, 38% female) underwent echocardiography, cardiac CT and MRI. EAT volume and mean CT attenuation were measured from non-contrast cardiac CT using an automated deep learning software. The primary outcome was symptoms necessitating valve replacement, cardiovascular death or major adverse cardiac event. RESULTS: , p