Abstract 2429: Pericardial Fat and Left Ventricular End Diastolic Volume, A Subclinical Marker of Heart Failure with Normal Ejection Fraction: The Multi-Ethnic Study of Atherosclerosis
Heart failure with a normal ejection fraction (HFnlEF) is highly prevalent and has similar adverse effects on quality of life and mortality as classic systolic heart failure or heart failure with reduced ejection (HFrEF). Despite its high prevalence, the etiology of HFnlEF is unknown. Pericardial fat is a type of visceral adipose tissue and is therefore an inflammatory tissue, which secretes adipocytokines. We hypothesized that pericardial fat plays an incremental role in reducing left ventricular (LV) end-diastolic volume and increasing LV hypertrophy; therefore, predisposing individuals to developing HFnlEF. Using standardized protocols, cardiac CT and MRI scans were examined for pericardial fat and multiple markers of left ventricular (LV) structure and function in 1,056 Multi-Ethnic Study of Atherosclerosis participants without known cardiovascular disease (42.4% male; 44.8% Caucasian, 10.6% Asian American, 21.3% African American, 23.3% Hispanic; age 45 to 84 years). In this cross-sectional analysis, after adjustment for age, gender, ethnicity, body mass index, and LV end diastolic mass, each standard deviation greater volume of pericardial fat was associated with a 5.2 ml smaller LV end diastolic volume (p < 0.0001), 3.2 ml smaller stroke volume (p < 0.0001), 2.1 ml smaller LV systolic volume (p = 0.002), and a 0.05 g/ml greater LV mass-volume ratio (p < 0.0001). Results did not change significantly when adjusting for diabetes, hypertension, smoking history, physical activity, and coronary calcium score. Greater in pericardial fat volume is associated adversely with multiple known markers of HFnlEF and therefore may play a role in the development of HFnlEF.