Abstract 13180: Impact of Epicardial Adipose Tissue in Modulating Cardiac Mechanics, Contractile Function and Twist Behavior - Possible Mechanisms in the Transition from Hypertension to Heart Failure Development
Background: Excessive visceral adipose tissue, a central marker of abnormal metabolic process, has recently been shown to exert an independent effect on cardiac struture and to confer increased cardiovascular risks. However, data regarding its influence on cardiac mechanics and contractile function in subjects with heart failure and preserved ejection fraction (HFpEF) remained elusive.
Methods: We studied 40 (mean age: 57.2±13 years) heart failure patients with preserved left ventricular (LV) ejection fraction (HFpEF) from outpatient clinics. Age-controlled hypertensives (N=46) and normal control (N=40) group were recruited from health evaluation center at the same time of patients enrollment. Transthoracic echocardiography (GE-Vingmed, Horten, Norway) was performed with myocardial deformation imaging including global LV longitudinal, radial, circumferential strain, left atrial (LA) strain and cardiac twist analyzed in addition to conventional measures. Both epicardial (EAT) and thoracic peri-aortic (TAT) adipose tissue were quantified by multi-detector Computed Tomography (MDCT) (Sensation 16, Siemens Medical Solutions, Forchheim, Germany) with off-line analysis (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA).
Results: Compared to hypertensive and normal group, patients with HFpEF tended to have higher LV volume, LV mass index and LA diameter (all p<0.05) though similar LVEF. In addition, both EAT and TAT were higher in HFpEF group which were accompanied by significantly reduced LV strain value from all three directions and lower LA strain (all p<0.05) with relatively preserved LV twist (p=0.06). In a multivariate model (adjusted for age, gender, body mass index, blood pressure, renal function and LV mass), each increased standard deviation of EAT and TAT were independently associated with a decline in both longitudinal and LA strain (ß coef: 0.26 & -0.24 for EAT; ß coef: 0.31 & -0.24 for TAT, all p<0.05, respectively).
Conclusions: Visceral fat amount may influence cardiac structures and contractile function in terms of myocardial deformation. Our data also suggested that excessive burden of visceral adipose tissue may partly play a role in the transition from hypertension to early stage heart failure development.
- © 2011 by American Heart Association, Inc.