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Alternative anthropometric measures remain limited in assessing the actual amount and distribution of visceral adiposity. We hypothesize that epicardial and pericardial adipose tissue (EAT and PAT) are easily obtainable on standard echocardiography and provide prognostic value in patients with HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In total, 572 patients with HF with reduced, mildly reduced and preserved ejection fraction (HFrEF, HFmrEF, and HFpEF, respectively) were included. EAT (the adipose tissue between the myocardium and the visceral layer of the pericardium) and PAT (the adipose tissue outside the parietal layer of the pericardium) thickness were measured on echocardiography and expressed in mm. Patients were followed for the combined outcome of all-cause mortality and HF hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean age was 67\u202f\u00b1\u200914\u00a0years, 38% were women, 346 had HFrEF, 100 had HFmrEF and 126 had HFpEF. Mean body mass index (BMI) was 27\u202f\u00b1\u20096\u202fkg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , mean EAT thickness 4.8\u202f\u00b1\u20092.1\u202fmm, and mean PAT thickness 5.7\u202f\u00b1\u20092.8\u202fmm. During a\u00a0median follow-up of 3.2\u202f\u00b1\u20091.9\u00a0years, both EAT and PAT thickness were associated with an increased risk for the combined outcome [HR 1.15 (95% CI 1.03\u20131.30),\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.006 and HR 1.25 (95% CI 1.10\u20131.41),\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090.001, respectively], whereas BMI was not. In a\u00a0multivariable model, only PAT thickness remained associated with poor outcome [HR 1.49 per SD (95% CI 1.10\u20132.03),\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.011].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Increased PAT thickness, more than EAT, assessed on routine echocardiography, may serve as a\u00a0valuable prognostic marker in chronic HF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12471-026-02077-z","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:17:32Z","timestamp":1789546652000},"page":"369-379","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic value of epicardial and pericardial adipose tissue in patients with chronic heart failure"],"prefix":"10.1007","volume":"34","author":[{"given":"Yoran","family":"Crum","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk J.","family":"van Veldhuisen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Lobeek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriaan A.","family":"Voors","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Rienstra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Gorter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"2077_CR1","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/S2213-8587(24)00316-4","volume":"13","author":"F Rubino","year":"2025","unstructured":"Rubino\u00a0F, Cummings\u00a0DE, Mingrone\u00a0G, et\u00a0al. 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The Conflict of Interest statement for author Dirk J. van Veldhuisen was given incorrectly as \u201cD.J. van Veldhuisen reports board membership fees\/travel expenses from Johnson Johnson and Novartis\u201d. Since this information is outdated for more than 5 years, the statement has been updated to declare that the author has no competing interests.","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 November 2026","order":8,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":9,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":10,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s12471-026-02093-z","URL":"https:\/\/doi.org\/10.1007\/s12471-026-02093-z","order":11,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The University Medical Centre Groningen, which employs all the authors of this article, has received research grants and\/or consultancy fees from Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Cytokinetics, Merck, Myokardia, Novartis, Novonordisk and Roche Diagnostics. A.A.\u00a0Voors has received consultancy fees from Myokardia, Bayer, AstraZeneca, Merck and Boehringer Ingelheim. M.\u00a0Rienstra reports unrestricted grants fromZonMW, the Dutch Heart Foundation; DECISIONproject 848090001, the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation; RACE\u00a0V (CVON 2014\u20139), RED-CVD (CVON2017-11) and the Top Sector Life Sciences  Health to the Dutch Heart Foundation (PPP Allowance; CVON-AI (2018B017)). ICVGreports grants from the Dutch Heart Foundation (CVON RACE\u00a0V, grant 2014-09). The UMCG, which employs M.\u00a0Rienstra has received consultancy fees from Bayer and InCarda Therapeutics. T.M.\u00a0Gorter is supported by the Mandema-Stipend of the Junior Scientific Masterclass 2020-10 of the University Medical Centre Groningen. Y.\u00a0Crum, M.\u00a0Lobeek, and D.J.\u00a0van Veldhuisen declare that they have no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}