الفهرس 
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Abstract
Epicardial adipose tissue (EAT) is a metabolically active endocrine organ with distinctive properties. It is clinically related to abdominal visceral adiposity, coronary artery disease (CAD), subclinical atherosclerosis, and cardiac morphology. Increases in EAT are associated with excess visceral adiposity, inflammation, and cardiac fibrosis. EAT has been speculated to play an important role in the pathophysiology of HFpEF, but no study has directly evaluated this question. The aim of the current study was to assess epicardial adipocytes noninvasively by measuring the volume of epicardial adipose tissue, by computed tomography in patients with HF with preserved (HFpEF). This was a case control study conducted on a total of 80 subjects divided into 40 cases (Symptomatic HF patients) and 40 controls (Free of signs and symptoms of HF) at outpatient clinic and radiology department, National Heart Institute within the period from April 2019 to April 2020. This study revealed the following results: • Both groups were matched regarding all demographic and medical history. • HFpEF demonstrated significant reduction in terms of EF, Septal e´ and lateral e´ and significant increase in terms of E/e`, est. LVEDP and Tricuspid Regurge V. • CT Parameters displayed marked increase in HFpEF group compared to the control one in terms of Epicardial fat Volume only. • Diastolic dysfunction grades seemed to be no affected by patients’ characteristics and clinical history in HFpEF group. • Diastolic dysfunction grade was positively correlated with epicardial fat volume only. • HFpEF group demonstrated positive significant correlations between epicardial fat volume and est. LVEDP, E/A, Septal e´, LA Diameter and E/e`, while there were no significant correlations in terms of the remaining parameters (P>0.05). • The control group demonstrated a positive significant correlation between epicardial fat volume and LA Diameter only. • HFpEF group displayed a significant positive correlation between Epicardial fat height and LA Diameter only (P=0.02). • The control group demonstrated a significant positive correlation between Epicardial fat height and lateral e`only (P=0.03). • HFpEF group revealed a significant positive correlations between Epicardial fat Mean and both E/e` and est. LVEDP (P≤ 0.001). • The control group demonstrated no significant correlations between Epicardial fat Mean and all paramters (P>0.05). • Epicardial fat seemed to be an independent predictor for both HFpEF as well as diastolic dysfunction grade II & III with hish sensitivity and specificity. Conclusion: The current study demonstrated that, epicardial fat seemed to be increased in HFpEF cases and was associated with marked impairment of distolic dysfunction. Thus, we concluded that, epicardial fat could be used as independent predictor for both diastolic dysfunctions as well as HFpEF.