Abstract
BackgroundThe independent role of pericardial adipose tissue (PAT) as an ectopic fat associated with cardiovascular disease (CVD) remains controversial. This study aimed to determine whether PAT is associated with left ventricular (LV) structure and function independent of other markers of general obesity.MethodsWe studied 2471 participants (50.9 % women) without known CVD from the Korean Genome Epidemiology Study, who underwent 2D-echocardiography with tissue Doppler imaging (TDI) and computed tomography measurement for PAT.ResultsStudy participants with more PAT were more likely to be men and had higher cardiometabolic indices, including blood pressure, glucose, and cholesterol levels (all P < 0.001). Greater pericardial fat levels across quartiles of PAT were associated with increased LV mass index and left atrial volume index (all P < 0.001) and decreased systolic (P = 0.015) and early diastolic (P < 0.001) TDI velocities, except for LV ejection fraction. These associations remained after a multivariable-adjusted model for traditional CV risk factors and persisted even after additional adjustment for general adiposity measures, such as waist circumference and body mass index. PAT was also the only obesity index independently associated with systolic TDI velocity (P < 0.001).ConclusionsPAT was associated with subclinical LV structural and functional deterioration, and these associations were independent of and stronger than with general and abdominal obesity measures.
Highlights
The independent role of pericardial adipose tissue (PAT) as an ectopic fat associated with cardiovascu‐ lar disease (CVD) remains controversial
Pericardial adipose tissue (PAT), which refers to the combination of epicardial adipose tissue (EAT, fat enclosed by the pericardial sac) and paracardial fat
Other studies have shown independent associations between Epicardial adipose tissue (EAT) and left ventricular (LV) mass, Left atrium (LA) size, as well as LV systolic or diastolic function [11,12,13,14]. These recent studies, were limited by their small sample size and lack of adjustment for general adiposity measures. Because they have focused on only EAT, disregarding the potential contribution of paracardial fat on LV structure and function, little is known whether the PAT, including paracardial fat, is associated with the changes of LV structure and function, independent of general adiposity measures, despite its correlation with CVD
Summary
The independent role of pericardial adipose tissue (PAT) as an ectopic fat associated with cardiovascu‐ lar disease (CVD) remains controversial. Given that epicardial or paracardial fat accumulation is just among a variety of ectopic fat depots (e.g., in liver, pancreas, and muscle) associated with general obesity, there is some controversy regarding its independent role in heart diseases beyond those associated with the standard indices of excess adiposity, such as body mass index (BMI) and waist circumference (WC). Other studies have shown independent associations between EAT and LV mass, LA size, as well as LV systolic or diastolic function [11,12,13,14] These recent studies, were limited by their small sample size and lack of adjustment for general adiposity measures. Because they have focused on only EAT, disregarding the potential contribution of paracardial fat on LV structure and function, little is known whether the PAT, including paracardial fat, is associated with the changes of LV structure and function, independent of general adiposity measures, despite its correlation with CVD
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