Left ventricular (LV) ejection fraction (LVEF) is the most widely used prognostic marker in cardiovascular diseases. LV global function index (LVGFI) is a novel marker which incorporates the total LV structure in the assessment of LV cardiac performance. We evaluated the prognostic significance of LVGFI, measured by cardiovascular magnetic resonance (CMR), in predicting mortality and ICD therapies in a real-world (ICD) population with secondary ICD prevention indication, to detect a high-risk group among these patients. In total, 105 patients with cardiac MRI prior to the ICD implantation were included (mean age 56 ± 16 years old; 76% male). Using the MRI data for each patient LVGFI was determined and a cut-off for the LVGFI value was calculated. Patients were followed up every four to six months in our or clinics in proximity. Data on the occurrence of heart failure symptoms and or mortality, as well as device therapies and other vital parameters, were collected. Follow up duration was 37 months in median. The mean LVGFI was 24.5%, the cut off value for LVGFI 13.5%. According to the LVGFI Index patient were divided into 2 groups, 86 patients in the group with the higher LVGFI und 19 patients in the lower group. The LVGFI correlates significantly with the LVEF (r = 0.642, p < 0.001). In Kaplan–Meier analysis, a lower LVGFI ( I, the initial device or a medication (each p = n.s.). Further, in Kaplan–Meier analysis no association was evident between the LVGFI and adequate ICD therapy (p = n.s.). In secondary prevention ICD patients reduced LVGFI was shown as an independent predictor for mortality and rehospitalization, but not for ICD therapies. We were able to identify a high-risk collective among these patients, but further investigation is needed to evaluate LVGFI compared to ejection fraction, especially in patients with an elevated risk for adverse cardiac events.

Aim: Our study aimed to evaluate epicardial adipose tissue (EAT) thickness in old adults, identify potential factors influencing it, and explore the association between EAT and left ventricular hypertrophy (LVH) in the older adult population. Methods: We analyzed cross-sectional data from the population-based AugUR study, including subjects aged ≥70 years. Cardiac geometry and EAT thickness were measured by echocardiography. Results: Among 988 participants aged 70–95 years (55.8% men), LVH was present in 368 individuals (37.2%). EAT thickness was similar between women and men (mean ± standard deviation: 4.1 ± 2.0 mm vs. 4.2 ± 1.9 mm, p = 0.29) but increased with age group (70–79 years: 4.0 ± 1.8 mm, >79 years 4.5 ± 2.0 mm, p < 0.001). Linear regression models of potential risk factors influencing EAT thickness showed associations with age [ β = 0.038 mm per year; 95% confidence interval (CI) = 0.014–0.063, p < 0.05], body mass index (BMI) ( β = 0.097 mm per kg/m ² , 95% CI = 0.070–0.124, p < 0.05), and low-density lipoprotein-cholesterol (LDL, β = 0.008 mm per mg/dL, 95% CI = 0.004–0.012, p < 0.05). Given the reported causal relationship between EAT and LVH in experimental studies, multivariable regression models were performed to evaluate the association between EAT thickness and left ventricular mass index (LVMi). EAT thickness was associated with LVMi independent of sex, age, BMI, LDL, smoking, hypertension, diabetes, and chronic kidney disease (LVMi ß = 2.43 g/m ² /mm, 95% CI 1.26–3.59, p = <0.001; LVH OR = 1.36/mm, 95% CI 1.01–1.84, p < 0.05). This association was strong in men but not in women. Conclusion: EAT thickness continues to increase with age beyond 69 years. Age, BMI, and LDL-cholesterol are associated with increasing EAT thickness. Our study strengthens the experimental hypothesis of a link between EAT and LVH by translational, population-based data. However, this association is more pronounced in men than in women.