Heart Fat Infiltration In Subjects With and Without Coronary Artery Disease

• Published in: The journal of clinical endocrinology and metabolism Vol. 100; no. 9; pp. 3364 - 3371
• Main Authors: Mazzali, Gloria, Fantin, Francesco, Zoico, Elena, Sepe, Anna, Bambace, Clara, Faccioli, Silvia, Pedrotti, Martina, Corzato, Francesca, Rizzatti, Vanni, Faggian, Giuseppe, Micciolo, Rocco, Cinti, Saverio, Santini, Francesco, Zamboni, Mauro
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.09.2015
• Subjects: Adipocytes; Adiponectin; Adiponectin - blood; Adipose tissue; Adipose Tissue - metabolism; Adipose Tissue - pathology; Aged; Apoptosis; Biopsy; Body Mass Index; Bypass; C-reactive protein; C-Reactive Protein - metabolism; Cardiomyocytes; Cardiovascular disease; Carrier Proteins - metabolism; Coronary artery disease; Coronary Artery Disease - metabolism; Coronary Artery Disease - pathology; Coronary vessels; Diabetes mellitus; Heart surgery; Homeostasis; Humans; Hypoxia; Immunohistochemistry; Insulin Resistance - physiology; Leptin; Leptin - blood; Localization; Male; Membrane Proteins - metabolism; Middle Aged; Myocardium; Myocardium - metabolism; Myocardium - pathology; Pericardium - metabolism; Pericardium - pathology; Perilipin-1; Perilipin-2; Phosphoproteins - metabolism; Rheumatic heart disease; Sensitivity analysis; Steatosis; Vein & artery diseases; Waist Circumference
• ISSN: 0021-972X; 1945-7197; 1945-7197
• DOI: 10.1210/jc.2015-1787

Context:Fat may accumulate around the heart in epicardial adipose tissue or inside the heart as lipid droplets (LDs).Objective:To compare myocardial steatosis between subjects with and without coronary artery disease (CAD and non-CAD) and to identify which cells contain LDs.Design:Body mass index, waist circumference, glucose, insulin, homeostasis model assessment index, leptin, adiponectin, and high-sensitivity C-reactive protein were evaluated in CAD and non-CAD subjects. Biopsies were collected from right atrial myocardium. Immunohistochemistry for perilipin (PLIN) 1 and 2 was used to characterize LDs and their localization in adipocytes or myocardial cells, respectively. Cardiomyocytes apoptosis and hypoxia inducible factor 1 alpha were obtained in a subgroup of subjects.Setting:The study took place in a hospital.Patients:Male subjects consecutively undergoing elective cardiac surgery either for coronary bypass grafting (CAD, n = 23) or for valve replacement (non-CAD, n = 18).Main Outcomes and Measures:The study was designed to compare myocardial steatosis between subjects with and without coronary artery disease.Results:PLIN1 and PLIN2 resulted significantly higher in CAD than in non-CAD subjects, as did apoptosis. PLIN1 was positively associated with circulating leptin, high-sensitivity C-reactive protein, and apoptosis, and negatively with adiponectin. PLIN2 was positively associated with body mass index, waist circumference, and leptin and negatively with adiponectin. After taking into account the absence/presence of hypertension, diabetes, and CAD/non-CAD, adiponectin was negatively associated with PLIN1 (r2 = 0.532); waist circumference and adiponectin were associated with PLIN2 (r2 = 0.399).Conclusions:Myocardial steatosis is greater in CAD than non-CAD subjects, depending on both metabolically active adipocytes interspersed among cardiomyocytes and higher fat deposition inside cardiomyocytes; serum adiponectin and waist circumference are independent predictors of myocardial steatosis.