Decrease of the Pericardial Fat around the Heart has a Positive Correlation with Improvement of Left Ventricular Performance

Abstract

Objective: The objective of the study was to evaluate the effect of an eight week period of very low calorie diet (VLCD) on left ventricular performance and on the amount of pericardial adipose tissue around the heart in obese people without heart disease. This is an extension of the study “Cardiac systolic and diastolic function can be improved over a short period of time in obese patients without heart disease by the very low calorie diet” with the same authors and study group, being currently under evaluation for publication in this Journal. Methods: Fifty-seven obese patients (41 women, 16 men, mean age 48.0±12.0 years, mean BMI 46.1±7.2g/m2) were assigned to a VLCD enriched with vegetables for eight weeks. Transthoracic echocardiography was performed before and after the diet period. Left ventricular size, ejection fraction, myocardial performance index and thickness of pericardial adipose tissue were measured. Results: During the diet period the BMI decreased from 46.1±7.2 kg/m2 to 41.7±6.4 kg/m2 (p<0.0001). The left ventricular performance index decreased from 0.41±0.07 to 0.37±0.07 (p<0.0001) showing significant systolic and diastolic improvement in the performance of left ventricle. The thickness of pericardial fat decreased from 2.2±1.6 mm to 1.4±1.3 mm (p<0.0001). The improvement of the left ventricular myocardial performance index correlated positively with the decrease of pericardial fat (r=0.46, p<0.001). Conclusion: Changing the diet for only eight weeks time caused significant reduction in BMI as well as in the amount of pericardial fat and significant improvement in the systolic and diastolic performance of the left ventricle in obese persons. There was a positive correlation between the improvement on left ventricular performance and the decrease of pericardial fat.