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Published on: April 18, 2013
Simultaneous fat and bone assessment in hospitalized heart failure patients using non-contrast-enhanced computed
Masaaki Konishi1, Eiichi Akiyama1, Hiroyuki Suzuki1
1Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Insights
Heart failure patients with increased pericardial fat volume (PFV) showed reduced bone density and increased bone resorption. Advanced age, atrial fibrillation, and hypertension are linked to higher PFV, impacting bone health in heart failure.
Area of Science:
- Cardiology
- Radiology
- Metabolic Research
Background:
- Heart failure (HF) is linked to metabolic dysfunction, fat loss, and diminished bone and muscle mass.
- The specific role of pericardial fat (PF) in HF pathophysiology remains unclear.
- Pericardial fat may influence myocardial function and systemic metabolic processes.
Purpose of the Study:
- To characterize pericardial fat volume (PFV) in HF patients.
- To investigate the association between PFV and bone tissue parameters.
- To explore the relationship between PFV and clinical factors using cardiac CT.
Main Methods:
- 61 hospitalized HF patients (left ventricular ejection fraction ≤50%) underwent ECG-gated non-contrast CT.
- Simultaneously assessed: pericardial fat volume (PFV), thoracic vertebral CT density, and aortic valve calcification.
- Bone resorption marker (N-telopeptide) levels were also analyzed.
Main Results:
- Higher PFV index (PFV/body surface area) was observed in older patients (>65 years), and those with atrial fibrillation (AF) and hypertension.
- Increased PFV correlated with lower thoracic vertebral CT density, suggesting reduced bone density.
- Patients with higher PFV were more likely to have aortic valve calcification and altered bone turnover markers.
Conclusions:
- Cardiac CT effectively assessed pericardial fat and bone tissue simultaneously in HF patients.
- Advanced age, AF, and hypertension are associated with increased PFV.
- PFV is correlated with bone tissue characteristics and alterations in bone turnover, highlighting a potential link between fat deposition and bone health in HF.
Background:
Heart failure (HF) is associated with adverse metabolic influences and provokes fat loss as well as bone and muscle loss at the terminal stages. Pericardial fat is an ectopic fat depot that can potentially affect the myocardium, but the role of pericardial fat in HF is unclear. We sought to characterize pericardial fat in HF, particularly in association with bone tissue using cardiac computed tomography (CT).
Methods:
In 61 consecutive hospitalized HF patients with left ventricular ejection fraction ≤50%, pericardial fat volume (PFV), CT density in the thoracic vertebrae, and ectopic calcification in the aortic valve were assessed simultaneously using electrocardiogram-gated non-contrast-enhanced CT.
Results:
The mean PFV was 93.5±50.6cm(3), which might reflect the total body fat measured with dual energy X-ray absorptiometry (Pearson's r=0.48, p=0.01). The PFV index, defined as the PFV/body surface area, was significantly higher among older patients (>65 years; 63.5±30.6cm(3)/m(2) vs. 42.7±17.1cm(3)/m(2), p<0.01) and among patients with atrial fibrillation (AF; 70.9±36.4cm(3)/m(2) vs. 48.8±21.2cm(3)/m(2), p<0.01) and hypertension (60.7±29.3cm(3)/m(2) vs. 41.5±18.2cm(3)/m(2), p<0.01) compared to patients without these conditions. The PFV indices were comparable between the patients with and without ischemic etiology, diabetes, and renal dysfunction. Patients with increased PFV indices (above the median) exhibited lower CT density in the thoracic vertebrae (134±41 Hounsfield units vs. 161±57 Hounsfield units, p=0.04), and were more likely to have aortic valve calcification (48% vs. 18%, p=0.02) and N-telopeptide (bone resorption marker; 20.7±5.2nmolBCE/mmolCr vs. 25.5±5.9nmolBCE/mmolCr, p=0.03) levels than those without increased PFV indices.
Conclusions:
We simultaneously assessed the pericardial fat and bone tissue of HF patients with CT and successfully characterized AF, hypertension, and advanced age as factors that are associated with increased PFV. PFV was correlated with bone tissues and alterations in bone turnover.
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