Pericardial Fat, Intrathoracic Fat, and Measures of Left Ventricular Structure and Function The Framingham Heart Study

被引:202
作者
Fox, Caroline S. [1 ,2 ,3 ]
Gona, Philimon [1 ,4 ]
Hoffmann, Udo [5 ]
Porter, Stacy A. [3 ]
Salton, Carol J. [7 ]
Massaro, Joseph M. [1 ,4 ]
Levy, Daniel
Larson, Martin G. [1 ,4 ]
D'Agostino, Ralph B., Sr. [1 ,4 ]
O'Donnell, Christopher J. [1 ,6 ]
Manning, Warren J. [7 ,8 ]
机构
[1] NHLBI, Framingham Heart Study, Framingham, MA USA
[2] Brigham & Womens Hosp, Dept Med, Div Endocrinol Diabet & Metab, Boston, MA 02115 USA
[3] Harvard Univ, Sch Med, Boston, MA USA
[4] Boston Univ, Dept Math, Boston, MA 02215 USA
[5] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Radiol, Boston, MA USA
[6] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Med, Boston, MA USA
[7] Beth Israel Deaconess Med Ctr, Div Cardiol, Boston, MA 02215 USA
[8] Beth Israel Deaconess Med Ctr, Dept Radiol, Boston, MA 02215 USA
关键词
epidemiology; magnetic resonance imaging; obesity; pericardium; risk factors; EPICARDIAL ADIPOSE-TISSUE; RISK-FACTORS; CARDIOVASCULAR-DISEASE; COMPUTED-TOMOGRAPHY; OBESE SUBJECTS; WEIGHT-LOSS; MASS; ECHOCARDIOGRAPHY; MORPHOLOGY; THICKNESS;
D O I
10.1161/CIRCULATIONAHA.108.828970
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-Pericardial fat has been implicated in the pathogenesis of obesity-related cardiovascular disease. Whether the associations of pericardial fat and measures of cardiac structure and function are independent of the systemic effects of obesity and visceral adiposity has not been fully explored. Methods and Results-Participants from the Framingham Heart Study (n = 997; 54.4% women) underwent chest and abdominal computed tomography and cardiovascular magnetic resonance imaging between 2002 and 2005. Pericardial fat, intrathoracic fat, and visceral adipose tissue quantified from multidetector computed tomography, along with body mass index and waist circumference, were examined in relation to cardiovascular magnetic resonance measures of left ventricular (LV) mass, LV end-diastolic volume, and left atrial dimension. In women, pericardial fat (r = 0.20 to 0.35, P < 0.001), intrathoracic fat (r = 0.25 to 0.37, P < 0.001), visceral adipose tissue (r = 0.24 to 0.45, P < 0.001), body mass index (r = 0.36 to 0.53, P < 0.001), and waist circumference (r = 0.30 to 0.48, P < 0.001) were directly correlated with LV mass, LV end-diastolic volume, and left atrial dimension. In men, pericardial fat (r = 0.19 to 0.37, P < 0.001), intrathoracic fat (r = 0.17 to 0.31, P < 0.001), visceral adipose tissue (r = 0.19 to 0.36, P < 0.001), body mass index (r = 0.32 to 0.44, P < 0.001), and waist circumference (r = 0.34 to 0.44, P < 0.001) were directly correlated with LV mass and left atrial dimension, but LV end-diastolic volume was not consistently associated with adiposity measures. Associations persisted after multivariable adjustment but not after additional adjustment for body weight and visceral adipose tissue, except for pericardial fat and left atrial dimension in men. Conclusions-Pericardial fat is correlated with cardiovascular magnetic resonance measures, but the association is not independent of or stronger than other ectopic fat stores or proxy measures of visceral adiposity. An important exception is left atrial dimension in men. These results suggest that the systemic effects of obesity on cardiac structure and function may outweigh the local pathogenic effects of pericardial fat. (Circulation. 2009; 119: 1586-1591.)
引用
收藏
页码:1586 / 1591
页数:6
相关论文
共 27 条
[1]  
[Anonymous], 2000, SAS/STAT User's Guide
[2]   Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease [J].
Baker, Adam R. ;
da Silva, Nancy F. ;
Quinn, David W. ;
Harte, Alison L. ;
Pagano, Domenico ;
Bonser, Robert S. ;
Kumar, Sudhesh ;
McTernan, Philip G. .
CARDIOVASCULAR DIABETOLOGY, 2006, 5 (1)
[3]   The ventricular epicardial fat is related to the myocardial mass in normal, ischemic and hypertrophic hearts [J].
Corradi, D ;
Maestri, R ;
Callegari, S ;
Pastori, P ;
Goldoni, M ;
Luong, TV ;
Bordi, C .
CARDIOVASCULAR PATHOLOGY, 2004, 13 (06) :313-316
[4]   AN APPROACH TO LONGITUDINAL STUDIES IN A COMMUNITY - FRAMINGHAM STUDY [J].
DAWBER, TR ;
KANNEL, WB ;
LYELL, LP .
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 1963, 107 (02) :539-&
[5]  
FINN JP, 1996, CLIN MAGNETIC RESONA, P168
[6]   Volumetric assessment of epicardial adipose tissue with cardiovascular magnetic resonance imaging [J].
Fluechter, Stephan ;
Haghi, Dariush ;
Dinter, Dietmar ;
Heberlein, Wolf ;
Kuehl, Harald P. ;
Neff, Wolfgang ;
Sueselbeck, Tim ;
Borggrefe, Martin ;
Papavassiliu, Theano .
OBESITY, 2007, 15 (04) :870-878
[7]   Abdominal visceral and subcutaneous adipose tissue compartments - Association with metabolic risk factors in the Framingham Heart Study [J].
Fox, Caroline S. ;
Massaro, Joseph M. ;
Hoffmann, Udo ;
Pou, Karla M. ;
Maurovich-Horvat, Pal ;
Liu, Chun-Yu ;
Vasan, Ramachandran S. ;
Murabito, Joanne M. ;
Meigs, James B. ;
Cupples, L. Adrienne ;
D'Agostino, Ralph B., Sr. ;
O'Donnell, Christopher J. .
CIRCULATION, 2007, 116 (01) :39-48
[8]   OBESITY AS AN INDEPENDENT RISK FACTOR FOR CARDIOVASCULAR-DISEASE - A 26-YEAR FOLLOW-UP OF PARTICIPANTS IN THE FRAMINGHAM HEART-STUDY [J].
HUBERT, HB ;
FEINLEIB, M ;
MCNAMARA, PM ;
CASTELLI, WP .
CIRCULATION, 1983, 67 (05) :968-977
[9]   Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart [J].
Iacobellis, G ;
Corradi, D ;
Sharma, AM .
NATURE CLINICAL PRACTICE CARDIOVASCULAR MEDICINE, 2005, 2 (10) :536-543
[10]   Relation between epicardial adipose tissue and left ventricular mass [J].
Iacobellis, G ;
Ribaudo, MC ;
Zappaterreno, A ;
Iannucci, CV ;
Leonetti, F .
AMERICAN JOURNAL OF CARDIOLOGY, 2004, 94 (08) :1084-1087