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Pericardial fat, intrathoracic fat, and measures of left ventricular structure and function: the Framingham Heart
Caroline S Fox1, Philimon Gona, Udo Hoffmann
1National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA 01702, USA. foxca@nhlbi.nih.gov
Insights
Pericardial fat correlates with cardiac structure, but its effects are not independent of overall obesity or visceral fat. The systemic impact of obesity on the heart appears more significant than localized pericardial fat.
Area of Science:
- Cardiology
- Obesity Research
- Medical Imaging
Background:
- Pericardial fat is linked to obesity-related cardiovascular disease.
- The independence of pericardial fat's cardiac associations from systemic obesity effects requires further investigation.
Purpose of the Study:
- To explore the association between pericardial fat and cardiac structure/function.
- To determine if these associations are independent of visceral adiposity and overall obesity.
Main Methods:
- Utilized data from 997 Framingham Heart Study participants (2002-2005).
- Employed computed tomography (CT) for quantifying pericardial fat, intrathoracic fat, and visceral adipose tissue (VAT).
- Used cardiovascular magnetic resonance imaging (CMR) to assess left ventricular (LV) mass, LV end-diastolic volume, and left atrial dimension.
Main Results:
- Pericardial fat, intrathoracic fat, VAT, BMI, and waist circumference were correlated with LV mass and left atrial dimension in women.
- In men, similar correlations were observed for LV mass and left atrial dimension, but not consistently for LV end-diastolic volume.
- Associations generally persisted after multivariable adjustment but not after adjustment for body weight and VAT, except for pericardial fat and left atrial dimension in men.
Conclusions:
- Pericardial fat is associated with cardiac measures, but not independently of other fat stores or obesity proxies.
- Systemic obesity effects on cardiac structure and function may be more influential than local pericardial fat.
- Left atrial dimension in men represents a notable exception where pericardial fat association may be more distinct.
Background:
Pericardial fat has been implicated in the pathogenesis of obesity-related cardiovascular disease. Whether the associations of pericardial fat and measures of cardiac structure and function are independent of the systemic effects of obesity and visceral adiposity has not been fully explored.
Methods And Results:
Participants from the Framingham Heart Study (n=997; 54.4% women) underwent chest and abdominal computed tomography and cardiovascular magnetic resonance imaging between 2002 and 2005. Pericardial fat, intrathoracic fat, and visceral adipose tissue quantified from multidetector computed tomography, along with body mass index and waist circumference, were examined in relation to cardiovascular magnetic resonance measures of left ventricular (LV) mass, LV end-diastolic volume, and left atrial dimension. In women, pericardial fat (r=0.20 to 0.35, P<0.001), intrathoracic fat (r=0.25 to 0.37, P<0.001), visceral adipose tissue (r=0.24 to 0.45, P<0.001), body mass index (r=0.36 to 0.53, P<0.001), and waist circumference (r=0.30 to 0.48, P<0.001) were directly correlated with LV mass, LV end-diastolic volume, and left atrial dimension. In men, pericardial fat (r=0.19 to 0.37, P<0.001), intrathoracic fat (r=0.17 to 0.31, P<0.001), visceral adipose tissue (r=0.19 to 0.36, P<0.001), body mass index (r=0.32 to 0.44, P<0.001), and waist circumference (r=0.34 to 0.44, P<0.001) were directly correlated with LV mass and left atrial dimension, but LV end-diastolic volume was not consistently associated with adiposity measures. Associations persisted after multivariable adjustment but not after additional adjustment for body weight and visceral adipose tissue, except for pericardial fat and left atrial dimension in men.
Conclusions:
Pericardial fat is correlated with cardiovascular magnetic resonance measures, but the association is not independent of or stronger than other ectopic fat stores or proxy measures of visceral adiposity. An important exception is left atrial dimension in men. These results suggest that the systemic effects of obesity on cardiac structure and function may outweigh the local pathogenic effects of pericardial fat.
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