The impact of obesity on the relationship between epicardial adipose tissue, left ventricular mass and coronary microvascular function

• Published in: European journal of nuclear medicine and molecular imaging Vol. 42; no. 10; pp. 1562 - 1573
• Main Authors: Bakkum, M. J., Danad, I., Romijn, M. A. J., Stuijfzand, W. J. A., Leonora, R. M., Tulevski, I. I., Somsen, G. A., Lammertsma, A. A., van Kuijk, C., van Rossum, A. C., Raijmakers, P. G., Knaapen, P.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2015; Springer Nature B.V
• Subjects: Adipose Tissue - physiopathology; Adiposity; Body fat; Cardiology; Cardiovascular disease; Coronary Circulation; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Female; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Imaging; Male; Medical imaging; Medicine; Medicine & Public Health; Microcirculation; Microvessels - physiopathology; Middle Aged; Nuclear Medicine; Obesity; Oncology; Organ Size; Original; Original Article; Orthopedics; Pericardium - physiopathology; Radiography; Radiology; Radionuclide Imaging; Reproducibility of Results; Sensitivity and Specificity; Tomography; O Positron emission tomography; Obesity; Coronary microvascular function; Left ventricular mass; [; O]H; Epicardial adipose tissue
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-015-3087-5

Purpose Epicardial adipose tissue (EAT) has been linked to coronary artery disease (CAD) and coronary microvascular dysfunction. However, its injurious effect may also impact the underlying myocardium. This study aimed to determine the impact of obesity on the quantitative relationship between left ventricular mass (LVM), EAT and coronary microvascular function. Methods A total of 208 (94 men, 45 %) patients evaluated for CAD but free of coronary obstructions underwent quantitative [ 15 O]H 2 O hybrid positron emission tomography (PET)/CT imaging. Coronary microvascular resistance (CMVR) was calculated as the ratio of mean arterial pressure to hyperaemic myocardial blood flow. Results Obese patients [body mass index (BMI) > 25, n  = 133, 64 % of total] had more EAT (125.3 ± 47.6 vs 93.5 ± 42.1 cc, p  < 0.001), a higher LVM (130.1 ± 30.4 vs 114.2 ± 29.3 g, p  < 0.001) and an increased CMVR (26.6 ± 9.1 vs 22.3 ± 8.6 mmHg×ml −1 ×min −1 ×g −1 , p  < 0.01) as compared to nonobese patients. Male gender (β = 40.7, p  < 0.001), BMI (β = 1.61, p  < 0.001), smoking (β = 6.29, p  = 0.03) and EAT volume (β = 0.10, p  < 0.01) were identified as independent predictors of LVM. When grouped according to BMI status, EAT was only independently associated with LVM in nonobese patients. LVM, hypercholesterolaemia and coronary artery calcium score were independent predictors of CMVR. Conclusion EAT volume is associated with LVM independently of BMI and might therefore be a better predictor of cardiovascular risk than BMI. However, EAT volume was not related to coronary microvascular function after adjustments for LVM and traditional risk factors.