Abstract
BackgroundVisceral adiposity is increased in those with Metabolic Syndrome (MetS) and atherosclerotic disease burden. In this study we evaluate for associations between intra-thoracic fat volume (ITFV) and myocardial infarction (MI) in patients with MetS.MethodsNinety-four patients with MetS, MI or both were identified from a cardiovascular CMR clinical registry. MetS was defined in accordance to published guidelines; where-as MI was defined as the presence of subendocardial-based injury on late gadolinium enhancement imaging in a coronary vascular distribution. A healthy control group was also obtained from the same registry. Patients were selected into the following groups: MetS+/MI- (N = 32), MetS-/MI + (N = 30), MetS+/MI + (N = 32), MetS-/MI- (N = 16). ITFV quantification was performed using signal threshold analysis of sequential sagittal CMR datasets (HASTE) and indexed to body mass index.ResultsThe mean age of the population was 59.8 ± 12.5 years. MetS+ patients (N=64) demonstrated a significantly higher indexed ITFV compared to MetS- patients (p = 0.05). Patients in respective MetS-/MI-, MetS+/MI-, MetS-/MI+, and MetS+/MI + study groups demonstrated a progressive elevation in the indexed ITFV (22.3 ± 10.6, 28.6 ± 12.6, 30.6 ± 12.3, and 35.2 ± 11.4 ml/kg/m2, (p = 0.002)). Among MetS+ patients those with MI showed a significantly higher indexed ITFV compared to those without MI (p = 0.02).ConclusionsITFV is elevated in patients with MetS and incrementally elevated among those with evidence of prior ischemic myocardial injury. Accordingly, the quantification of ITFV may be a valuable marker of myocardial infarction risk among patients with MetS and warrants further investigation.
Highlights
Visceral adiposity is increased in those with Metabolic Syndrome (MetS) and atherosclerotic disease burden
Of the 62 patients demonstrating Late Gadolinium Enhancement (LGE)-cardiovascular magnetic resonance (CMR) evidence of prior myocardial infarction (MI) 10 (16%) were clinically silent with no history of a clinical event
Among a sampled cohort of patients undergoing CMR imaging, intra-thoracic fat volume (ITFV) is both associated with MetS and is incrementally elevated among those with objective evidence of myocardial infarction
Summary
Visceral adiposity is increased in those with Metabolic Syndrome (MetS) and atherosclerotic disease burden. In this study we evaluate for associations between intra-thoracic fat volume (ITFV) and myocardial infarction (MI) in patients with MetS. Visceral adiposity is a recognized phenotypic feature of Metabolic Syndrome (MetS) and may be a quantifiable imaging marker of atherosclerotic disease risk [1,2,3]. The intra-thoracic fat volume (ITFV) is one such marker shown to be reproducible by thoracic computed tomography (CT) imaging, and appears to correlate with other validated cardiovascular risk prediction models [4,5] as well as serologic markers of vascular inflammation [6]. ITFV measures were compared to control populations of patients without MetS both with and without prior myocardial infarction. A novel, rapid cardiovascular magnetic resonance (CMR) based approach to the quantification of ITFV was employed and validated
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