Epicardial, visceral and subcutaneous adipose tissue in heart failure with preserved ejection fraction

IF 3.7 2区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Michelle Lobeek, Lea P. A. Timmann, Dirk J. van Veldhuisen, Just Dronkers, Riemer H. J. A. Slart, Michiel Rienstra, Alain R. Viddeleer, Thomas M. Gorter
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引用次数: 0

Abstract

Aims

Obesity is common in patients with heart failure with preserved ejection fraction (HFpEF), and adipose tissue (AT) plays a key role in its pathophysiology. We examined the distribution and association of visceral AT (VAT), subcutaneous AT (SAT) and epicardial AT (EAT) in HFpEF using multimodality imaging.

Methods

Heart failure patients with left ventricular ejection fraction >40% were prospectively enrolled. All patients underwent cardiac magnetic resonance (CMR) imaging and total body computed tomography (CT). EAT was measured on CMR, and VAT, SAT and waist circumference (WC) were measured on CT. Linear regression analysis was used to assess associations between EAT and other AT depots.

Results

In total, 68 patients were included. Mean age was 73 ± 8 years; 34 (50%) were women. Twenty-six patients (38%) were obese, while 60 (91%) had increased WC and 58 (85%) had increased VAT. Body mass index (BMI) and WC were comparable between men and women, but men had more EAT (217 vs. 180 mL, P < 0.001) and VAT (306 vs. 196 cm2, P < 0.001), but less SAT (177 vs. 276 cm2, P < 0.001), as compared with women. After adjusting for age, gender and BMI, VAT was only associated with EAT, albeit modest (β = 0.40, P < 0.001, R2 = 0.40), but not with SAT.

Conclusions

The distribution of various AT depots is markedly different between men and women with HFpEF. Men have more VAT and EAT, but less SAT. The observed variation in AT depots may potentially contribute to gender-related differences in cardiovascular risk.

Abstract Image

心外膜、内脏和皮下脂肪组织与保留射血分数的心力衰竭。
目的:肥胖在保留射血分数(HFpEF)心力衰竭患者中很常见,脂肪组织(AT)在其病理生理中起关键作用。我们使用多模态成像检查了HFpEF中内脏AT (VAT)、皮下AT (SAT)和心外膜AT (EAT)的分布和相关性。方法:前瞻性纳入左心室射血分数为bbb40 %的心力衰竭患者。所有患者均接受了心脏磁共振(CMR)成像和全身计算机断层扫描(CT)。CMR测量EAT, CT测量VAT、SAT和腰围(WC)。使用线性回归分析评估EAT与其他AT仓库之间的相关性。结果:共纳入68例患者。平均年龄73±8岁;34例(50%)为女性。肥胖26例(38%),WC增加60例(91%),VAT增加58例(85%)。身体质量指数(BMI)和WC在男女之间具有可比性,但男性有更多的EAT (217 vs 180 mL, P 2, P 2 = 0.40),但与sat没有可比性。结论:HFpEF患者的各种AT库分布在男女之间有显著差异。男性的VAT和EAT更高,但SAT更低。观察到的AT库的差异可能会导致心血管风险的性别差异。
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来源期刊
ESC Heart Failure
ESC Heart Failure Medicine-Cardiology and Cardiovascular Medicine
CiteScore
7.00
自引率
7.90%
发文量
461
审稿时长
12 weeks
期刊介绍: ESC Heart Failure is the open access journal of the Heart Failure Association of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure. The journal aims to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as the clinical, social and population sciences all form part of the discipline that is heart failure. Accordingly, submission of manuscripts on basic, translational, clinical and population sciences is invited. Original contributions on nursing, care of the elderly, primary care, health economics and other specialist fields related to heart failure are also welcome, as are case reports that highlight interesting aspects of heart failure care and treatment.
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