Fat around the heart is an important marker in patients with heart failure

Doctor Shaun Khanna, University of New South Wales

Postgraduate Scholarship

Years funded: 2026 - 2028

Heart failure (HF) occurs when the heart can’t pump blood efficiently to meet the body’s demands, leading to fatigue, fluid retention, and poor circulation. A growing area of research suggests that epicardial adipose tissue (EAT), a layer of fat surrounding the heart, contributes to HF progression. My project aims to investigate EAT levels non-invasively by cardiac computed tomography, to determine how EAT levels influence heart function in patients with HF, the role of EAT in HF recovery and the association between EAT (as an imaging biomarker) and therapeutic response with novel cardiometabolic agents (anti-diabetic drugs and weight loss drugs).

My research project will be performed as two studies. Study 1: Cross Sectional Observational Study: Using retrospective patient data, I will assess the differences in EAT metrics across heart failure (HF) populations in comparison to healthy controls and those with coronary artery disease, taking into consideration patient demographics, clinical parameters and echocardiographic indices. I will also compare the degree of heart failure recovery on follow-up with the baseline levels of EAT. Study 2: Prospective Cohort Observational Study: Over a 12-month period, I will follow newly diagnosed HF patients who undergo echocardiography and cardiac computed tomography (CCT) at diagnosis. I will track EAT and heart function change throughout this period with 3 monthly echocardiography. A 1:1 matched analysis will occur at 12 months comparing patients who have persistently poor heart function with those that have improved with novel / cardiometabolic therapies, and at this time an extensive analysis on EAT indices will be conducted. I will also assess the impact of these cardiometabolic therapies on temporal EAT change in HF populations.

This project will provide the first CCT-based analysis assessing EAT metrics in HF populations by; (a) comparing with other patients (b) longitudinally tracking the changes in EAT in HF populations (c) evaluating the role of EAT in predicting HF recovery and (d) evaluating the role of cardiometabolic therapies in relationship to EAT levels. This research has the potential to transform our understanding of EAT as a modifiable risk biomarker in HF populations. By targeting EAT as a non-invasive modifiable risk factor, cardiometabolic therapies may have superior benefit in specific subpopulations. This CCT based study will provide clinicians with a better mechanistic link between EAT and HF. My findings will be shared through presentations at scientific meetings / journal publications and consumer panels ensuring they contribute to advancing HF therapeutics.