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Assessment of Human Adipose Tissue Microvascular Function Using Videomicroscopy
Published on: September 29, 2017
Associations between epicardial, visceral, and subcutaneous adipose tissue with diastolic function in men with and
Rachel L Goldberg1, Tess E Peterson1, Sabina A Haberlen2
1Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
Insights
Increased epicardial fat and decreased subcutaneous fat are linked to diastolic dysfunction in men, irrespective of HIV status. This finding may explain heart failure risks in people with HIV.
Area of Science:
- Cardiology
- Infectious Diseases
- Metabolic Health
Background:
- People with HIV (PWH) face higher risks of diastolic dysfunction.
- Increased visceral adipose tissue, common in PWH, is linked to diastolic dysfunction.
- This study examines fat depots and subclinical diastolic dysfunction in men with and without HIV.
Purpose of the Study:
- To investigate the association between visceral, subcutaneous, and epicardial adipose tissue and subclinical diastolic dysfunction.
- To compare these associations in men with HIV (MWH) and men without HIV (MWOH).
Main Methods:
- Cross-sectional analysis of data from the Multicenter AIDS Cohort Study (MACS).
- Echocardiography assessed diastolic dysfunction; CT scans measured epicardial, visceral, subcutaneous, and liver adiposity.
- Multivariable logistic regression analyzed odds of diastolic dysfunction based on adiposity measures.
Main Results:
- Greater epicardial adipose tissue was associated with increased odds of diastolic dysfunction (OR: 1.54 per SD).
- This association was independent of HIV serostatus and viral suppression.
- Less subcutaneous adipose tissue was also linked to higher odds of diastolic dysfunction.
Conclusions:
- Increased epicardial adipose tissue and decreased subcutaneous adipose tissue are associated with diastolic dysfunction.
- These fat distribution patterns may contribute to heart failure with preserved ejection fraction risk in PWH.
Background:
People with HIV (PWH) are at greater risk for diastolic dysfunction compared with persons without HIV (PWOH). An increase in visceral adipose tissue is common among PWH and greater visceral adipose tissue is associated with diastolic dysfunction among PWOH. We investigated associations of visceral adipose tissue, subcutaneous adipose tissue, and other fat depots with subclinical diastolic dysfunction among men with and without HIV (MWH and MWOH).
Design:
Cross-sectional analysis of MWH and MWOH in the Multicenter AIDS Cohort Study (MACS).
Methods:
Participants underwent echocardiography for diastolic dysfunction assessment and CT scanning including subcutaneous, visceral, epicardial, and liver adiposity measurements. Diastolic dysfunction was defined by characterizing heart function on antiretroviral therapy0 criteria. Odds for diastolic dysfunction with each measure of adiposity were estimated using multivariable logistic regression.
Results:
Among 403 participants (median age 57, 55% white, median BMI 26 kg/m 2 ), 25% met criteria for diastolic dysfunction and 59% MWH (82% undetectable plasma HIV RNA). Greater epicardial adipose tissue area was associated with higher odds of diastolic dysfunction [odds ratio:1.54 per SD; 95%confidence interval (CI) 1.15-2.05] when adjusted for demographics, HIV serostatus, and cardiovascular risk factors. This association did not differ by HIV serostatus and persisted when excluding MWH who were not virally suppressed. Less subcutaneous adipose tissue was associated with higher odds of diastolic dysfunction. Other adipose depots were not associated with diastolic dysfunction.
Conclusion:
Greater epicardial adipose tissue and less subcutaneous adipose tissue were associated with diastolic dysfunction, regardless of HIV serostatus and viral suppression. Greater epicardial adipose tissue and less subcutaneous adipose tissue observed among PWH may contribute to risk for heart failure with preserved ejection fraction in this population.
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