Abstract 12562: Accumulation of Pericardial Fat Correlates with Diastolic Dysfunction in Patients with Preserved Ejection Fraction
Background: Left ventricular diastolic dysfunction (LVDD) plays an important role in heart failure with preserved left ventricular ejection fraction (LVEF). There is no specific therapeutic strategy for LVDD partly because of lack of understanding its pathophysiological mechanism(s). Obesity, together with female gender, elderly, hypertension, diabetes, and coronary artery disease (CAD), is an important factor in LVDD. Pericardial fat (PF) is increased in obese patients and PF volume correlates with the presence of coronary atherosclerosis independent of other risk factors, indicating that PF may have paracrine or mechanical effects on the coronary circulation and myocardium.
Methods and Results: We measured PF volume on 64-slice computed tomography (CT) scans and analyzed echocardiographic parameters to confirm LVDD in consecutive patients suspected of CAD with LVEF ≥50% (n=234, 60% men, 67±11 years, CAD 40%). LVDD was examined by tissue Doppler oriented criterion using the ratio of transmitral Doppler early filling velocity to tissue Doppler early diastolic mitral annular velocity (E/e′). Presence of LVDD was diagnosed by E/e′ ≥15 and excluded by E/e′<8. When the E/e′ value was borderline (15>E/e′≥8), LVDD was further diagnosed by left atrial diameter ≥40 mm and excluded by <40 mm. PF volume significantly correlated with E/e′ (r=0.21, p<0.01) and left atrial diameter (r=0.32, p<0.01), but not with LVEF. The mean PF volume was significantly greater in patients with LVDD (193±60 cm3, n=87) than those without LVDD (161±59, n=147, p<0.01). Univariate logistic regression analysis showed significant relationships between presence of LVDD and abdominal obesity, hypertension, diabetes, and PF volumes. Multivariate logistic regression analysis indicated that PF volume significantly correlated with the presence of LVDD (per 100cm3 increase in PF volume, odds ratio; 1.81, 95% confidence interval; 1.00 to 3.25, p<0.05) independent of age, gender, abdominal obesity, hypertension, diabetes and CAD.
Conclusion: PF volumes are significantly associated with LVDD independent of other risk factors such as hypertension or diabetes. PF may be implicated in the pathogenesis of LVDD and PF deposition could be a potential therapeutic target to improve LVDD.
- © 2010 by American Heart Association, Inc.