Pericardial fat and its influence on cardiac diastolic function

• Published in: Cardiovascular diabetology Vol. 19; no. 1; pp. 129 - 11
• Main Authors: de Wit-Verheggen, Vera H. W., Altintas, Sibel, Spee, Romy J. M., Mihl, Casper, van Kuijk, Sander M. J., Wildberger, Joachim E., Schrauwen-Hinderling, Vera B., Kietselaer, Bas L. J. H., van de Weijer, Tineke
• Format: Journal Article
• Language: English
• Published: England BioMed Central 17.08.2020; BMC
• Subjects: Adipose Tissue - diagnostic imaging; Adipose Tissue - physiopathology; Adiposity; Adult; Aged; Angiography; Asymptomatic; Asymptomatic Diseases; Biomarkers; Cardiac diastolic function; Cardiac function; Cardiomyocytes; Cardiovascular disease; Computed tomography; Computed Tomography Angiography; Coronary Angiography; Creatinine; Cross-Sectional Studies; Diabetes; Diastole; Echocardiography; Epicardial fat; Fatty acids; Female; Heart; Heart failure; Humans; Male; Medical imaging; Metabolism; Middle Aged; Mortality; Obesity; Original Investigation; Overweight; Pericardial fat; Pericardium; Regression analysis; Retrospective Studies; Risk Assessment; Risk Factors; Software; Studies; Ventricle; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - etiology; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left; Pericardial fat; Cardiac diastolic function; Epicardial fat
• DOI: 10.1186/s12933-020-01097-2
• ISSN: 1475-2840

Pericardial fat (PF) has been suggested to directly act on cardiomyocytes, leading to diastolic dysfunction. The aim of this study was to investigate whether a higher PF volume is associated with a lower diastolic function in healthy subjects. 254 adults (40-70 years, BMI 18-35 kg/m , normal left ventricular ejection fraction), with (a)typical chest pain (otherwise healthy) from the cardiology outpatient clinic were retrospectively included in this study. All patients underwent a coronary computed tomographic angiography for the measurement of pericardial fat volume, as well as a transthoracic echocardiography for the assessment of diastolic function parameters. To assess the independent association of PF and diastolic function parameters, multivariable linear regression analysis was performed. To maximize differences in PF volume, the group was divided in low (lowest quartile of both sexes) and high (highest quartile of both sexes) PF volume. Multivariable binary logistic analysis was used to study the associations within the groups between PF and diastolic function, adjusted for age, BMI, and sex. Significant associations for all four diastolic parameters with the PF volume were found after adjusting for BMI, age, and sex. In addition, subjects with high pericardial fat had a reduced left atrial volume index (p = 0.02), lower E/e (p < 0.01) and E/A (p = 0.01), reduced e' lateral (p < 0.01), reduced e' septal p = 0.03), compared to subjects with low pericardial fat. These findings confirm that pericardial fat volume, even in healthy subjects with normal cardiac function, is associated with diastolic function. Our results suggest that the mechanical effects of PF may limit the distensibility of the heart and thereby directly contribute to diastolic dysfunction. Trial registration NCT01671930.