Abstract
Epicardial adipose tissue may affect hemodynamics and cardiorespiratory fitness as it is a metabolically active visceral adipose tissue and a source of inflammatory bioactive substances that can substantially modulate cardiovascular morphology and function. However, the associations between epicardial adipose tissue and hemodynamics and cardiorespiratory fitness remain unclear. This cross-sectional study aimed to examine the association between epicardial adipose tissue volume and hemodynamics, and cardiorespiratory fitness among Japanese individuals of various ages and of both sexes. Epicardial adipose tissue volume was measured in 120 participants (age, 21–85 years) by cardiac magnetic resonance imaging. To evaluate cardiorespiratory fitness, peak oxygen uptake was measured by cardiopulmonary exercise testing. Peak cardiac output and arteriovenous oxygen difference were calculated by impedance cardiography. The epicardial adipose tissue volume was significantly increased in middle-aged and older women. The epicardial adipose tissue volume was significantly and negatively correlated to peak cardiac output and peak oxygen uptake, regardless of age and sex; furthermore, epicardial adipose tissue showed a strong negative correlation with peak heart rate. Epicardial adipose tissue and peak cardiac output were significantly associated (β = -0.359, 95% confidence interval, -0.119 to -0.049, p < 0.001), even after multivariate adjustment (R2 = 0.778). However, in the multiple regression analysis with peak oxygen uptake as a dependent variable, the epicardial adipose tissue volume was not an independent predictor. These data suggest that increased epicardial adipose tissue volume may be correlated with decreased peak oxygen uptake, which might have mediated the abnormal hemodynamics among Japanese people of various ages and of both sexes. Interventions targeting epicardial adipose tissue could potentially improve hemodynamics and cardiorespiratory fitness.
Highlights
Cardiorespiratory fitness (CRF) can improve the quality of life and survival of both healthy individuals and patients with cardiovascular disease [1,2]
The Epicardial adipose tissue (EAT) volume was significantly greater in the participants with metabolic syndrome components, LV hypertrophy (LVH), physical inactivity, abnormal value for the heart rate recovery (HRR), and exercise intolerance than in those without such factors, there was no significant difference in the EAT volume between current smokers and non-smokers (S2 Table)
These results suggest that increased EAT volume may be correlated with decreased peakVO2, which might have mediated the abnormal hemodynamics among Japanese people of various ages and of both sexes
Summary
Cardiorespiratory fitness (CRF) can improve the quality of life and survival of both healthy individuals and patients with cardiovascular disease [1,2]. As a cardiometabolic risk marker, several studies have suggested that EAT may affect peakVO2 [16,17] and cardiac function [17,18]. These studies did not examine physical activity [19] or the hemodynamic response as a possible mediator of the association between EAT and peakVO2. To the best of our knowledge, no study has examined the association between the volume of EAT and the hemodynamic response, including the CO and arteriovenous oxygen difference (a-vO2 diff) in various ages and of both sexes
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