Abstract 19045: Epicardial Fat is Related to Left Ventricular Diastolic Dysfunction in Healthy Obese and Metabolic Syndrome Obese
Introduction: Epicardial fat is a metabolically active visceral fat depot with anatomical and functional contiguity to the myocardium and is associated with metabolic syndrome (MetS) and diabetes in the obese.
Hypothesis: The objective of this study was to evaluate the association of epicardial fat thickness (EFT) with diastolic function and to understand the role of EFT in relation to potential risk factors (i.e. hypertension and MetS) of diastolic dysfunction (DD) in obese with variable degrees of the MetS and preserved systolic function.
Methods: We studied 320 subjects (mean BMI 37±10 kg/m2, age 44±12 years) participating in a standardized weight reduction program. EFT was measured by transthoracic echocardiography. Diastolic function was assessed according to ESC and ASE recommendations by means of pw- and tissue Doppler echocardiography. The MetS was defined according to NCEP ATPIII criteria.
Results: The study population consisted of 133 obese with MetS, 37 hypertensive obese without MetS, 78 healthy obese, and 71 non-obese subjects. DD was detected in MetS, hypertensive obese, and healthy obese in 26%, 24%, and 23%, respectively. E’ lat. , E/E’ lat., E’/A’, left atrial size, as well as the myocardial performance index TEI were strongly associated with increasing numbers of MetS components and with increasing EFT (each p<0.001). In each group of patients, EFT was significantly higher with than without DD, but this difference was more pronounced in healthy obese (7.5±0.8 vs. 5.5±0.3 mm, p=0.008), than in hypertensive obese (8.1±0.8 vs. 6.4±0.5 mm, p=0.031) or MetS obese (8.6±0.6 vs. 7.2±0.3 mm, p=0.028). Using multivariate regression tree statistics as well as conditional variable importance statistics EFT was the most important predictor for DD and for an increased filling index E/E’ lat. (adjusted standardized weights EFT: 0.33, age: 0.22, hypertension: 0.12, LV mass: 0.11, MetS: 0.05).
Conclusions: Epicardial fat contributes to an impaired left ventricular diastolic function in obese patients even after accounting for associated co-morbididties such as hypertension and the metabolic syndrome. Diastolic dysfunction is also present in “healthy obese” and might be related to an increased epicardial fat thickness in these patients.
Author Disclosures: M. Manka: None. S. Fenk: None. C. Strack: None. S. Kempinger: None. G. Riegger: None. G. Schmitz: None. T. Loew: None. A. Baessler: None. M. Fischer: None.
- © 2014 by American Heart Association, Inc.