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Observational Study
. 2025 Nov;41(11):2255-2263.
doi: 10.1007/s10554-025-03535-2. Epub 2025 Oct 9.

Association between epicardial adipose tissue and transfusion-dependent β-thalassemia

Michele Malagù  1 , Federico Marchini  2 , Filomena Longo  3 , Marco Zuin  2 , Giovanni Orazio  2 , Andrea Capanni  2 , Maria Letizia Berloni  2 , Federica Frascaro  2 , Elisabetta Tonet  2 , Alberto Cossu  4 , Martina Culcasi  3 , Beatrice Bonsi  3 , Cristina Balla  2 , Francesco Vitali  2 , Matteo Bertini  2
Affiliations
Observational Study

Association between epicardial adipose tissue and transfusion-dependent β-thalassemia

Michele Malagù et al. Int J Cardiovasc Imaging. 2025 Nov.

Abstract

Background: Epicardial adipose tissue (EAT) is a fat depot with secretive and neuromodulative properties, involved in the pathogenesis of cardiovascular diseases. Transfusion-dependent β-thalassemia (TDβT) is an inherited disorder characterized by chronic anemia and at risk for the development of several comorbidities. Patients with TDβT have a higher incidence of cardiovascular diseases compared to the general population.

Methods: The aim of this study was to evaluate EAT thickness in a cohort of patients with TDβT (study group), compared to age- and sex-balanced patients with no TDβT (control group). Secondary endpoint included evaluation of differences in the regional distribution of EAT between patients with or without cardiovascular disease (NCT05508932).

Results: Overall, 272 patients were enrolled, of whom 136 in study group and 136 in control group. EAT thickness was significantly higher in the study group at left atrium, left atrioventricular groove and right atrioventricular groove compared to control group (4.2 vs. 3.0, 12.2 vs. 10.0 and 13.0 vs. 11.0 mm, respectively, p < 0.05 for all). Multivariable analysis confirmed an independent association between EAT and TDβT. The regional distribution of EAT showed significant differences between patients with or without atrial fibrillation, diabetes mellitus, stroke or heart failure.

Conclusions: Patients with TDβT have higher values of EAT compared to controls with no TDβT.

Keywords: Arrhythmia; Atrial fibrillation; Cardiac; Epicardial fat; Hemoglobinopathy; Magnetic resonance.

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Conflict of interest statement

Declarations. Conflict of interest: the authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Epicardial adipose tissue at magnetic resonance imaging. (A) Patient with transfusion-dependent β-thalassemia. (B) Patient with no history of thalassemia
See this image and copyright information in PMC

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