Epicardial adipose tissue in patients with and without COVID-19 infection

Background: Acute COVID-19 infection frequently affects the cardiovascular system and causes acute myocardial injury. Epicardial Adipose Tissue (EAT), a visceral adipose tissue surrounding the myocardium and coronary arteries, has unique paracrine and endocrine effects, modulating the heart's i...

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Main Authors: Alexander J. Küng, Iryna Dykun, Matthias Totzeck, Raluca Mincu, Lars Michel, Clemens Kill, Oliver Witzke, Jan Buer, Tienush Rassaf, Amir A. Mahabadi
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:American Heart Journal Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666602225000515
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author Alexander J. Küng
Iryna Dykun
Matthias Totzeck
Raluca Mincu
Lars Michel
Clemens Kill
Oliver Witzke
Jan Buer
Tienush Rassaf
Amir A. Mahabadi
author_facet Alexander J. Küng
Iryna Dykun
Matthias Totzeck
Raluca Mincu
Lars Michel
Clemens Kill
Oliver Witzke
Jan Buer
Tienush Rassaf
Amir A. Mahabadi
author_sort Alexander J. Küng
collection DOAJ
description Background: Acute COVID-19 infection frequently affects the cardiovascular system and causes acute myocardial injury. Epicardial Adipose Tissue (EAT), a visceral adipose tissue surrounding the myocardium and coronary arteries, has unique paracrine and endocrine effects, modulating the heart's inflammatory environment. Systemic inflammation stimulates TNF-α and Interleukin-6 secretion from EAT, contributing to cytokine storms and intensifying systemic responses. We aimed to determine whether EAT amount differs in patients with and without acute COVID-19 infection and myocardial injury. Methods: This study analyzed the CoV-COR registry cohort, conducted at the University Hospital Essen, including patients with symptoms suggestive of COVID-19 infection. The infection was confirmed by PCR. EAT thickness was measured by two-dimensional TTE. Results: A total of 296 patients (mean age 63.6 ± 17.26 years, 55.4 % male) were included. Patients with confirmed COVID-19 infection were younger, more frequently treated with antihypertensive medication, and had higher BMI and systolic blood pressures. Univariate logistic regression showed no association between EAT and myocardial injury 0.97 (0.74; 1.28, p = 0.82). A trend towards an association was observed between increasing EAT thickness and COVID-19 infection 1.25 (0.99; 1.59, p = 0.060). Adjusting for age and gender strengthened the association, with a 48 % (1.14; 1.93, p = 0.004) increased odds of COVID-19 infection per increase in EAT thickness. Multivariable regression yielded consistent effect sizes 1.47 (1.01; 2.16, p = 0.047). Conclusion: EAT thickness is associated with the presence of an acute COVID-19 infection but not with a myocardial injury. Further research is needed to assess if systemic viral infection induces dynamic changes in EAT.
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spelling doaj-art-f82cdd47a4a341c39c53d35d1894e1242025-08-20T03:48:47ZengElsevierAmerican Heart Journal Plus2666-60222025-06-015410054810.1016/j.ahjo.2025.100548Epicardial adipose tissue in patients with and without COVID-19 infectionAlexander J. Küng0Iryna Dykun1Matthias Totzeck2Raluca Mincu3Lars Michel4Clemens Kill5Oliver Witzke6Jan Buer7Tienush Rassaf8Amir A. Mahabadi9West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr, 55, 45147 Essen, GermanyWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr, 55, 45147 Essen, GermanyWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr, 55, 45147 Essen, GermanyWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr, 55, 45147 Essen, GermanyWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr, 55, 45147 Essen, GermanyCenter for Emergency Medicine, University Hospital Essen, Essen, GermanyDepartment of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, Essen, GermanyInstitute of Medical Microbiology, University Hospital Essen, GermanyWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr, 55, 45147 Essen, GermanyWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr, 55, 45147 Essen, Germany; Corresponding author at: West German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.Background: Acute COVID-19 infection frequently affects the cardiovascular system and causes acute myocardial injury. Epicardial Adipose Tissue (EAT), a visceral adipose tissue surrounding the myocardium and coronary arteries, has unique paracrine and endocrine effects, modulating the heart's inflammatory environment. Systemic inflammation stimulates TNF-α and Interleukin-6 secretion from EAT, contributing to cytokine storms and intensifying systemic responses. We aimed to determine whether EAT amount differs in patients with and without acute COVID-19 infection and myocardial injury. Methods: This study analyzed the CoV-COR registry cohort, conducted at the University Hospital Essen, including patients with symptoms suggestive of COVID-19 infection. The infection was confirmed by PCR. EAT thickness was measured by two-dimensional TTE. Results: A total of 296 patients (mean age 63.6 ± 17.26 years, 55.4 % male) were included. Patients with confirmed COVID-19 infection were younger, more frequently treated with antihypertensive medication, and had higher BMI and systolic blood pressures. Univariate logistic regression showed no association between EAT and myocardial injury 0.97 (0.74; 1.28, p = 0.82). A trend towards an association was observed between increasing EAT thickness and COVID-19 infection 1.25 (0.99; 1.59, p = 0.060). Adjusting for age and gender strengthened the association, with a 48 % (1.14; 1.93, p = 0.004) increased odds of COVID-19 infection per increase in EAT thickness. Multivariable regression yielded consistent effect sizes 1.47 (1.01; 2.16, p = 0.047). Conclusion: EAT thickness is associated with the presence of an acute COVID-19 infection but not with a myocardial injury. Further research is needed to assess if systemic viral infection induces dynamic changes in EAT.http://www.sciencedirect.com/science/article/pii/S2666602225000515Epicardial adipose tissueCOVID-19Myocardial injuryEchocardiography
spellingShingle Alexander J. Küng
Iryna Dykun
Matthias Totzeck
Raluca Mincu
Lars Michel
Clemens Kill
Oliver Witzke
Jan Buer
Tienush Rassaf
Amir A. Mahabadi
Epicardial adipose tissue in patients with and without COVID-19 infection
American Heart Journal Plus
Epicardial adipose tissue
COVID-19
Myocardial injury
Echocardiography
title Epicardial adipose tissue in patients with and without COVID-19 infection
title_full Epicardial adipose tissue in patients with and without COVID-19 infection
title_fullStr Epicardial adipose tissue in patients with and without COVID-19 infection
title_full_unstemmed Epicardial adipose tissue in patients with and without COVID-19 infection
title_short Epicardial adipose tissue in patients with and without COVID-19 infection
title_sort epicardial adipose tissue in patients with and without covid 19 infection
topic Epicardial adipose tissue
COVID-19
Myocardial injury
Echocardiography
url http://www.sciencedirect.com/science/article/pii/S2666602225000515
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