Abstract 14696: An Increase in Epicardial Fat Volume is Associated With Left Ventricular Diastolic and Intrinsic Systolic Dysfunction
Background: Epicardial adipose tissue (EAT), a metabolically active visceral fat depot surrounding the heart, is associated with cardiovascular event risk. Recent experimental studies have demonstrated that secreted factors from EAT is implicated in the development of cardiomyocyte dysfunction. However, the relation of EAT to cardiac function in human is still unclear.
Methods: One hundred and seventy-three subjects with left ventricular (LV) ejection fraction (EF) > or = 50% and without significant cardiovascular disease were studied. All underwent cardiac multidetector computed tomography (MDCT), echocardiography, and measurement of homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides, high- and low-density lipoproteins, and BNP. Epicardial fat volume (EFV) was measured from MDCT images by dedicated software. We measured conventional echocardiographic indices (left atrial volume index [LAVi] and mitral annular systolic [s’] and early diastolic [e’] velocities), and intrinsic myocardial contractility index (global longitudinal peak systolic strain [GLS]) using 2-dimensional speckle-tracking echocardiography. The subjects were divided in three groups by tertiles of EFV.
Results: HOMA-IR, triglycerides, and low-density lipoprotein increased from the first to third tertile of EFV, whereas high-density lipoprotein showed a stepwise decrease. LAVi and E/e’ significantly increased across EFV tertiles (LAVi: 32 ± 7 vs. 34 ± 7 vs. 37 ± 6 ml/m2, p < 0.05; E/e’: 8.3 ± 3.3 vs. 10.0 ± 4.2 vs. 11.0 ± 3.1, p < 0.05) and e’ showed a stepwise decrease with increasing tertile of EFV (9.0 ± 3.3 vs. 6.9 ± 2.2 vs. 6.1 ± 1.4 cm/s, p < 0.05). There were no significant differences in LVEF and s’ among the EFV tertiles, whereas GLS was significantly increased with increasing tertile of EFV (-20.1 ± 2.6 vs. -18.6 ± 3.9 vs. -16.7 ± 2.4 %, p < 0.01). In multivariate regression models, the highest tertile group of EFV had higher odds ratios for increased GLS compared with that of the lowest tertile group (OR [95% confidence interval], 3.54 [1.84-7.01], p < 0.01).
Conclusions: An increase in EFV is associated with not only LV diastolic dysfunction but also occult systolic dysfunction, suggesting a crucial role of adipose tissue in cardiac function.
- © 2013 by American Heart Association, Inc.