Association of pericardial adipose tissue with left ventricular structure and function: a region‐specific effect?

Abstract

Background The independent role of pericardial adipose tissue (PAT) as an ectopic fat associated with cardiovascular disease (CVD) remains controversial. This study aimed to determine whether PAT is associated with left ventricular (LV) structure and function independent of other markers of general obesity. Methods We studied 2471 participants (50.9 % women) without known CVD from the Korean Genome Epidemiology Study, who underwent 2D-echocardiography with tissue Doppler imaging (TDI) and computed tomography measurement for PAT. Results Study participants with more PAT were more likely to be men and had higher cardiometabolic indices, including blood pressure, glucose, and cholesterol levels (all P < 0.001). Greater pericardial fat levels across quartiles of PAT were associated with increased LV mass index and left atrial volume index (all P < 0.001) and decreased systolic (P = 0.015) and early diastolic (P < 0.001) TDI velocities, except for LV ejection fraction. These associations remained after a multivariable-adjusted model for traditional CV risk factors and persisted even after additional adjustment for general adiposity measures, such as waist circumference and body mass index. PAT was also the only obesity index independently associated with systolic TDI velocity (P < 0.001). Conclusions PAT was associated with subclinical LV structural and functional deterioration, and these associations were independent of and stronger than with general and abdominal obesity measures.

Physiological Changes and Pathological Pain Associated with Sedentary Lifestyle-Induced Body Systems Fat Accumulation and Their Modulation by Physical Exercise

“…Moreover, in these mini pigs, the PAT contributes to cardiac fibrosis development [165]. In humans, PAT also contributes to cardiac insulin resistance and left ventricular systolic dysfunction in obese individuals [166,167]. TGF-beta promotes cardiac fibrosis, the formation of cardiac fibroblasts into myofibroblasts.…”

Pericardial adiposity is independently linked to adverse cardiovascular phenotypes: a CMR study of 42 598 UK Biobank participants

“… 25 demonstrate consistent findings to our study, reporting positive association of CMR-measured epicardial adiposity and arterial stiffness measured by pulse wave velocity. In an echocardiography study by Kim et al 26 , higher PAT was associated with greater LV mass and poorer LV function by tissue doppler imaging (TDI) velocities. Similar to our study, these associations remained robust after adjustment for classic vascular risk factors, BMI, and waist circumference.…”

Adverse association of epicardial adipose tissue accumulation with cardiac function and atrioventricular coupling in postmenopausal women assessed by cardiac magnetic resonance imaging

“…Previous studies on EAT mainly focused on EAT thickness around the right ventricular free wall or pericardial adipose tissue (epicardial adipose tissue plus paracardial adipose tissue) measured by echocardiogram or CT. Kim et al found that pericardial adipose tissue (PAT) was more strongly associated with the subclinical LV dysfunction than BMI and waist circumference (15). However, EAT is embryologically different from paracardial adipose tissue.…”