Association between epicardial adipose tissue and cardiac dysfunction in subjects with severe obesity

Author:

Chin Jie Fen12,Aga Yaar S.12,Abou Kamar S.12,Kroon D.2,Snelder Sanne M.12,van de Poll Sweder W.E.2,Kardys Isabella1,Brugts Jasper J.1,de Boer Rudolf A.1,van Dalen Bas M.12

Affiliation:

1. Department of Cardiology, Thoraxcenter Erasmus University Medical Center Rotterdam The Netherlands

2. Department of Cardiology Franciscus Gasthuis & Vlietland Rotterdam The Netherlands

Abstract

AbstractAimEpicardial adipose tissue (EAT) plays a role in obesity‐related heart failure with preserved ejection fraction. However, the association of EAT thickness with the development of cardiac dysfunction in subjects with severe obesity without known cardiovascular disease is unclear. The aim of this study was to determine the association between EAT thickness and cardiac dysfunction and describe the potential value of EAT as an early marker of cardiac dysfunction.Methods and resultsSubjects with body mass index ≥35 kg/m2 aged 35 to 65 years, who were referred for bariatric surgery, without suspicion of or known cardiac disease, were enrolled. Conventional transthoracic echocardiography and strain analyses were performed. A total of 186 subjects were divided into tertiles based on EAT thickness, of whom 62 were in EAT‐1 (EAT <3.8 mm), 63 in EAT‐2 (EAT 3.8–5.4 mm), and 61 in EAT‐3 (EAT >5.4 mm). Parameters of systolic and diastolic function were comparable between tertiles. Patients in EAT‐3 had the lowest global longitudinal strain (GLS) and left atrial contractile strain (LASct). Linear regression showed that a one‐unit increase in EAT thickness (mm) was independently associated with a decrease in GLS (%) (β coefficient −0.404, p = 0.002), and a decrease in LASct (%) (β coefficient −0.544, p = 0.027). Furthermore, EAT‐3 independently predicted cardiac dysfunction as defined by a GLS <18% (odds ratio 2.8, p = 0.013) and LASct <14% (odds ratio 2.5, p = 0.045).ConclusionsIncreased EAT thickness in subjects with obesity without known cardiac disease was independently associated with subclinical cardiac dysfunction. Our findings suggest that EAT might play a role in the early stages of cardiac dysfunction in obesity before this may progress to overt clinical disease.

Publisher

Wiley

Subject

Cardiology and Cardiovascular Medicine

Reference35 articles.

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2. Health Effects of Overweight and Obesity in 195 Countries

3. Obesity Is an Independent Risk Factor for Heart Failure: Zona Franca Cohort Study

4. Evidence Supporting the Existence of a Distinct Obese Phenotype of Heart Failure With Preserved Ejection Fraction

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