Pericardial Fat and Right Ventricular Morphology: The Multi-Ethnic Study of Atherosclerosis- Right Ventricle Study (MESA-RV)

Abstract

BackgroundPericardial fat has been implicated in the pathogenesis of obesity-related cardiovascular disease. Proposed mechanisms may be relevant in right heart failure, but relationships between pericardial fat and right ventricular (RV) morphology have not been explored.MethodsThe Multi-Ethnic Study of Atherosclerosis is a prospective cohort that enrolled participants without clinical cardiovascular disease. Pericardial fat was measured using computed tomography and RV parameters using cardiac MRI. Linear regression estimated associations of pericardial fat with RV mass, RV end diastolic volume (RV-EDV), RV end systolic volume (RV-ESV), RV stroke volume (RV-SV), and RV ejection fraction (RV-EF). Limited models adjusted for age, gender, race, height, and study site with and without weight. Fully adjusted models also accounted for socioeconomic parameters and health behaviors. Adjustment for left ventricular morphology, metabolic syndrome, and systemic inflammation was also performed.ResultsThe study sample included 3988 participants with complete assessment of RV morphology, pericardial fat and all covariates. Greater pericardial fat volume was associated with reduced RV mass (-0.3g per 40 cm3 increase in pericardial fat, p<0.001), smaller RV-EDV (-3.7ml per 40 cm3 increase in pericardial fat, p<0.001), smaller RV-ESV (-1.0ml per 40cm3 increase in pericardial fat, p<0.001), and smaller RV-SV (-2.7mL per 40 cm3 increase in pericardial fat, p<0.001) in participants after adjustment for weight. Associations were unchanged when accounting for health behaviors, markers of systemic inflammation, and the metabolic syndrome.ConclusionsGreater pericardial fat was associated with reduced RV mass, smaller RV-EDV, smaller RV-ESV, and smaller RV-SV in participants after adjustment for weight. Relationships between pericardial fat and RV morphology could be relevant to diseases of right heart failure.

Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?

“…Numerous clinical studies have unveiled the association between EAT volume and early defects in cardiac structure, volume and function (50,57,78,87,123,128,131,143,177,328,333). Increased amount of EAT has been associated with increased left ventricular (LV) mass and abnormal right ventricle geometry or subclinical dysfunction (97,330). This is in accordance with initial necropsic and echographic studies showing an increase in LV mass to be strongly related to EAT, irrespective of CAD or hypertrophy (50,128,131).…”

Three‐Dimensional Micro Computed Tomography Analysis of the Lung Vasculature and Differential Adipose Proteomics in the Sugen/Hypoxia Rat Model of Pulmonary Arterial Hypertension

“…Heart adipose dysfunction may not only locally affect the vascular remodeling of coronary arteries or have a paracrine effect on the lung vasculature but may also diminish ventricular function. 53 Additional experiments evaluating the small visceral adipose depots in various vascular beds, including adipose surrounding the pulmonary artery, will aid in determining a localized versus a systemic inflammatory contribution to vascular remodeling and the progression of PAH. Within the actual lung tissue, we found lipid-laden cells surrounding the lung vasculature in both the SU/hyp and control lungs colocalized with positive labeling for complement proteins C3 and C4.…”

Pericardial adipose tissue is an independent risk factor of coronary artery disease and is associated with risk factors of coronary artery disease

“…Additionally, PATV is also associated with mass and dysfunction of the right ventricle. 28 The present study also investigated the correlation between pulse pressure and PATV. To the best of our knowledge, this is the first study to show that left and right ventricular fat volumes were positively correlated with PATV.…”