Key result
Total epicardial adipose tissue is linked to impaired diastolic function, without localized effects on LV strain.
Why the study?
It was uncertain whether regional epicardial adipose tissue exerts localized effects on adjacent myocardial left ventricular function in high-risk obese adults.
Observational (n=71)
Effect estimate: r = -0.30
p-value: p=0.015
Regional epicardial adipose tissue does not exert localized effects on adjacent LV segment function, and its association with diastolic function is largely mediated by systemic visceral adiposity.
Regional EAT shows no localized LV effects in obesity; leaves open whether global associations reflect visceral adiposity rather than direct paracrine action.
OBJECTIVE: The aim of this retrospective study was to determine whether regional epicardial adipose tissue (EAT) exerts localized effects on adjacent myocardial left ventricular (LV) function. METHODS: Cardiac magnetic resonance imaging (MRI), echocardiography, dual-energy x-ray absorptiometry, and exercise testing were performed in 71 patients with obesity with elevated cardiac biomarkers and visceral fat. Total and regional (anterior, inferior, lateral, right ventricular) EAT was quantified by MRI. Diastolic function was quantified by echocardiography. MRI was used to quantify regional longitudinal LV strain. RESULTS: EAT was associated with visceral adiposity (r = 0.47, p < 0.0001) but not total fat mass. Total EAT was associated with markers of diastolic function (early tissue Doppler relaxation velocity [e'], mitral inflow velocity ratio [E/A], early mitral inflow/e' ratio [E/e']), but only E/A remained significant after adjustment for visceral adiposity (r = -0.30, p = 0.015). Right ventricular and LV EAT had similar associations with diastolic function. There was no evidence for localized effects of regional EAT deposition on adjacent regional longitudinal strain. CONCLUSIONS: There was no association between regional EAT deposition and corresponding regional LV segment function. Furthermore, the association between total EAT and diastolic function was attenuated after adjustment for visceral fat, indicating that systemic metabolic impairments contribute to diastolic dysfunction in high-risk middle-aged adults.
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Hearon et al. (2023) conducted an observational in Obesity with elevated cardiac biomarkers and visceral fat (n=71). Epicardial adipose tissue (EAT) was evaluated on Regional longitudinal LV strain and diastolic function (r = -0.30, p=0.015). Total epicardial adipose tissue was associated with the E/A ratio of diastolic function after adjustment for visceral adiposity (r = -0.30, p = 0.015), with no localized effects on regional LV strain.
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