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Heart Fat Infiltration In Subjects With and Without Coronary Artery Disease
Gloria Mazzali1, Francesco Fantin1, Elena Zoico1
1Department of Medicine (G.M., F.F., E.Z., A.S., C.B., S.F., M.P., F.C., V.R., M.Z.), Geriatric Section, University of Verona, Verona, Italy; Department of Cardiac Surgery (G.F.), University of Verona, Verona, Italy; Department of Psychology and Cognitive Sciences (R.M.), University of Trento, Trento, Italy; Institute of Human Morphology (S.C.), University of Ancona, Ancona, Italy; and Division of Cardiac Surgery (F.S.), University of Genova, Genova, Italy.
Insights
Myocardial steatosis, or fat in the heart muscle, is significantly higher in patients with coronary artery disease (CAD). Adiponectin and waist circumference are key predictors of this condition.
Area of Science:
- Cardiology
- Metabolic Research
- Cell Biology
Background:
- Fat accumulation in the heart occurs as epicardial adipose tissue or intracellular lipid droplets (LDs).
- Understanding myocardial steatosis is crucial for cardiovascular health.
Purpose of the Study:
- To compare myocardial steatosis between subjects with and without coronary artery disease (CAD).
- To identify the specific cells containing lipid droplets within the myocardium.
Main Methods:
- Evaluated metabolic markers (BMI, glucose, lipids, leptin, adiponectin, hs-CRP) in CAD and non-CAD male subjects.
- Utilized immunohistochemistry (perilipin 1 and 2) on right atrial myocardium biopsies to characterize LDs and their cellular localization.
- Assessed cardiomyocyte apoptosis and hypoxia-inducible factor 1 alpha in a subgroup.
Main Results:
- Coronary artery disease (CAD) subjects exhibited significantly higher levels of perilipin 1 (PLIN1), perilipin 2 (PLIN2), and cardiomyocyte apoptosis compared to non-CAD subjects.
- PLIN1 showed positive associations with leptin, high-sensitivity C-reactive protein (hs-CRP), and apoptosis, and a negative association with adiponectin.
- PLIN2 correlated positively with body mass index, waist circumference, and leptin, and negatively with adiponectin. Adiponectin and waist circumference emerged as independent predictors of myocardial steatosis.
Conclusions:
- Myocardial steatosis is more pronounced in individuals with CAD, involving both interstitial adipocytes and intracellular lipid deposition within cardiomyocytes.
- Serum adiponectin levels and increased waist circumference are independent predictors of myocardial steatosis, highlighting their clinical significance.
Context:
Fat may accumulate around the heart in epicardial adipose tissue or inside the heart as lipid droplets (LDs).
Objective:
To compare myocardial steatosis between subjects with and without coronary artery disease (CAD and non-CAD) and to identify which cells contain LDs.
Design:
Body mass index, waist circumference, glucose, insulin, homeostasis model assessment index, leptin, adiponectin, and high-sensitivity C-reactive protein were evaluated in CAD and non-CAD subjects. Biopsies were collected from right atrial myocardium. Immunohistochemistry for perilipin (PLIN) 1 and 2 was used to characterize LDs and their localization in adipocytes or myocardial cells, respectively. Cardiomyocytes apoptosis and hypoxia inducible factor 1 alpha were obtained in a subgroup of subjects.
Setting:
The study took place in a hospital.
Patients:
Male subjects consecutively undergoing elective cardiac surgery either for coronary bypass grafting (CAD, n = 23) or for valve replacement (non-CAD, n = 18).
Main Outcomes And Measures:
The study was designed to compare myocardial steatosis between subjects with and without coronary artery disease.
Results:
PLIN1 and PLIN2 resulted significantly higher in CAD than in non-CAD subjects, as did apoptosis. PLIN1 was positively associated with circulating leptin, high-sensitivity C-reactive protein, and apoptosis, and negatively with adiponectin. PLIN2 was positively associated with body mass index, waist circumference, and leptin and negatively with adiponectin. After taking into account the absence/presence of hypertension, diabetes, and CAD/non-CAD, adiponectin was negatively associated with PLIN1 (r(2) = 0.532); waist circumference and adiponectin were associated with PLIN2 (r(2) = 0.399).
Conclusions:
Myocardial steatosis is greater in CAD than non-CAD subjects, depending on both metabolically active adipocytes interspersed among cardiomyocytes and higher fat deposition inside cardiomyocytes; serum adiponectin and waist circumference are independent predictors of myocardial steatosis.
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An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...