Epicardial adipose tissue is tightly associated with exercise intolerance in patients with type 2 diabetes mellitus with asymptomatic left ventricular structural and functional abnormalities

• Published in: Journal of diabetes and its complications Vol. 34; no. 5; p. 107552
• Main Authors: Sugita, Yousuke, Ito, Katsuhiko, Sakurai, Shigeki, Sakai, Satoshi, Kuno, Shinya
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2020; Elsevier Limited
• Subjects: Age; Asymptomatic left ventricular structural and functional abnormality; Blood pressure; Body fat; Body mass index; Cholesterol; Cytokines; Diabetes; Ejection fraction; Epicardial adipose tissue; Exercise; Exercise capacity; Fasting; Flow velocity; Heart failure; Homeostasis; Insulin resistance; Lipoproteins; Obesity; Type 2 diabetes mellitus; United Kingdom > UK; Japan; Heart failure; Asymptomatic left ventricular structural and functional abnormality; Type 2 diabetes mellitus; Exercise capacity; Epicardial adipose tissue
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2020.107552

This study aimed to elucidate whether the volume of epicardial adipose tissue (EAT) is associated with left ventricular (LV) structural and functional abnormalities and exercise capacity in patients with type 2 diabetes mellitus (T2DM). EAT thickness and LV structural and functional abnormality components (e.g., global longitudinal strain, E/e', LV mass index, relative wall thickness) were measured using echocardiography in 176 patients with asymptomatic stage A and B heart failure (SAHF and SBHF, respectively) and 62 healthy controls (HC). Peak oxygen uptake (peakVO2) was measured by using cardiopulmonary exercise testing. Even when matching study participants for age, sex, and body mass index, the EAT was thicker (HCs 5.5 ± 1.2 versus SAHF 6.4 ± 1.0 and SBHF 9.3 ± 1.7 mm) and peakVO2 was lower (HC 24.1 ± 3.3 versus SAHF 19.1 ± 2.0 and SBHF 16.9 ± 3.1 ml/kg/min) in the heart failure (HF) group than in the HC group (p < 0.001). EAT thickness (β = −0.189, p < 0.001) and peakVO2 were significantly associated, even after adjusting for multivariates (R2 = 0.457). In T2DM patients with asymptomatic HF, EAT may be associated with LV structural and functional abnormalities and exercise intolerance. •EAT may be independently associated with exercise capacity indicators.•HR response may affect the relationship between EAT and exercise capacity.•Myocardial contractility also affects this relationship.