Association of volumetric epicardial adipose tissue quantification and cardiac structure and function

Nitesh Nerlekar, Rahul G. Muthalaly, Nathan Wong, Udit Thakur, Dennis T.L. Wong, Adam J. Brown, Thomas H. Marwick

Research output: Contribution to journalReview ArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Background-—Epicardial adipose tissue (EAT) is in immediate apposition to the underlying myocardium and, therefore, has the potential to influence myocardial systolic and diastolic function or myocardial geometry, through paracrine or compressive mechanical effects. We aimed to review the association between volumetric EAT and markers of myocardial function and geometry. Methods and Results-—PubMed, Medline, and Embase were searched from inception to May 2018. Studies were included only if complete EAT volume or mass was reported and related to a measure of myocardial function and/or geometry. Meta-analysis and meta-regression were used to evaluate the weighted mean difference of EAT in patients with and without diastolic dysfunction. Heterogeneity of data reporting precluded meta-analysis for systolic and geometric associations. In the 22 studies included in the analysis, there was a significant correlation with increasing EAT and presence of diastolic dysfunction and mean e 0 (average mitral annular tissue Doppler velocity) and E/e 0 (early inflow/ annular velocity ratio) but not E/A (ratio of peak early (E) and late (A) transmitral inflow velocities), independent of adiposity measures. There was a greater EAT in patients with diastolic dysfunction (weighted mean difference, 24.43 mL; 95% confidence interval, 18.5–30.4 mL; P<0.001), and meta-regression confirmed the association of increasing EAT with diastolic dysfunction (P=0.001). Reported associations of increasing EAT with increasing left ventricular mass and the inverse correlation of EAT with left ventricular ejection fraction were inconsistent, and not independent from other adiposity measures. Conclusions-—EAT is associated with diastolic function, independent of other influential variables. EAT is an effect modifier for chamber size but not systolic function.

Original languageEnglish
Article numbere009975
Number of pages20
JournalAmerican Heart Association. Journal. Cardiovascular and Cerebrovascular Disease
Volume7
Issue number23
DOIs
Publication statusPublished - 1 Dec 2018

Keywords

  • Diastolic function
  • Epicardial fat
  • Systolic dysfunction

Cite this

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title = "Association of volumetric epicardial adipose tissue quantification and cardiac structure and function",
abstract = "Background-—Epicardial adipose tissue (EAT) is in immediate apposition to the underlying myocardium and, therefore, has the potential to influence myocardial systolic and diastolic function or myocardial geometry, through paracrine or compressive mechanical effects. We aimed to review the association between volumetric EAT and markers of myocardial function and geometry. Methods and Results-—PubMed, Medline, and Embase were searched from inception to May 2018. Studies were included only if complete EAT volume or mass was reported and related to a measure of myocardial function and/or geometry. Meta-analysis and meta-regression were used to evaluate the weighted mean difference of EAT in patients with and without diastolic dysfunction. Heterogeneity of data reporting precluded meta-analysis for systolic and geometric associations. In the 22 studies included in the analysis, there was a significant correlation with increasing EAT and presence of diastolic dysfunction and mean e 0 (average mitral annular tissue Doppler velocity) and E/e 0 (early inflow/ annular velocity ratio) but not E/A (ratio of peak early (E) and late (A) transmitral inflow velocities), independent of adiposity measures. There was a greater EAT in patients with diastolic dysfunction (weighted mean difference, 24.43 mL; 95{\%} confidence interval, 18.5–30.4 mL; P<0.001), and meta-regression confirmed the association of increasing EAT with diastolic dysfunction (P=0.001). Reported associations of increasing EAT with increasing left ventricular mass and the inverse correlation of EAT with left ventricular ejection fraction were inconsistent, and not independent from other adiposity measures. Conclusions-—EAT is associated with diastolic function, independent of other influential variables. EAT is an effect modifier for chamber size but not systolic function.",
keywords = "Diastolic function, Epicardial fat, Systolic dysfunction",
author = "Nitesh Nerlekar and Muthalaly, {Rahul G.} and Nathan Wong and Udit Thakur and Wong, {Dennis T.L.} and Brown, {Adam J.} and Marwick, {Thomas H.}",
year = "2018",
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language = "English",
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journal = "American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease",
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Association of volumetric epicardial adipose tissue quantification and cardiac structure and function. / Nerlekar, Nitesh; Muthalaly, Rahul G.; Wong, Nathan; Thakur, Udit; Wong, Dennis T.L.; Brown, Adam J.; Marwick, Thomas H.

In: American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease, Vol. 7, No. 23, e009975, 01.12.2018.

Research output: Contribution to journalReview ArticleResearchpeer-review

TY - JOUR

T1 - Association of volumetric epicardial adipose tissue quantification and cardiac structure and function

AU - Nerlekar, Nitesh

AU - Muthalaly, Rahul G.

AU - Wong, Nathan

AU - Thakur, Udit

AU - Wong, Dennis T.L.

AU - Brown, Adam J.

AU - Marwick, Thomas H.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background-—Epicardial adipose tissue (EAT) is in immediate apposition to the underlying myocardium and, therefore, has the potential to influence myocardial systolic and diastolic function or myocardial geometry, through paracrine or compressive mechanical effects. We aimed to review the association between volumetric EAT and markers of myocardial function and geometry. Methods and Results-—PubMed, Medline, and Embase were searched from inception to May 2018. Studies were included only if complete EAT volume or mass was reported and related to a measure of myocardial function and/or geometry. Meta-analysis and meta-regression were used to evaluate the weighted mean difference of EAT in patients with and without diastolic dysfunction. Heterogeneity of data reporting precluded meta-analysis for systolic and geometric associations. In the 22 studies included in the analysis, there was a significant correlation with increasing EAT and presence of diastolic dysfunction and mean e 0 (average mitral annular tissue Doppler velocity) and E/e 0 (early inflow/ annular velocity ratio) but not E/A (ratio of peak early (E) and late (A) transmitral inflow velocities), independent of adiposity measures. There was a greater EAT in patients with diastolic dysfunction (weighted mean difference, 24.43 mL; 95% confidence interval, 18.5–30.4 mL; P<0.001), and meta-regression confirmed the association of increasing EAT with diastolic dysfunction (P=0.001). Reported associations of increasing EAT with increasing left ventricular mass and the inverse correlation of EAT with left ventricular ejection fraction were inconsistent, and not independent from other adiposity measures. Conclusions-—EAT is associated with diastolic function, independent of other influential variables. EAT is an effect modifier for chamber size but not systolic function.

AB - Background-—Epicardial adipose tissue (EAT) is in immediate apposition to the underlying myocardium and, therefore, has the potential to influence myocardial systolic and diastolic function or myocardial geometry, through paracrine or compressive mechanical effects. We aimed to review the association between volumetric EAT and markers of myocardial function and geometry. Methods and Results-—PubMed, Medline, and Embase were searched from inception to May 2018. Studies were included only if complete EAT volume or mass was reported and related to a measure of myocardial function and/or geometry. Meta-analysis and meta-regression were used to evaluate the weighted mean difference of EAT in patients with and without diastolic dysfunction. Heterogeneity of data reporting precluded meta-analysis for systolic and geometric associations. In the 22 studies included in the analysis, there was a significant correlation with increasing EAT and presence of diastolic dysfunction and mean e 0 (average mitral annular tissue Doppler velocity) and E/e 0 (early inflow/ annular velocity ratio) but not E/A (ratio of peak early (E) and late (A) transmitral inflow velocities), independent of adiposity measures. There was a greater EAT in patients with diastolic dysfunction (weighted mean difference, 24.43 mL; 95% confidence interval, 18.5–30.4 mL; P<0.001), and meta-regression confirmed the association of increasing EAT with diastolic dysfunction (P=0.001). Reported associations of increasing EAT with increasing left ventricular mass and the inverse correlation of EAT with left ventricular ejection fraction were inconsistent, and not independent from other adiposity measures. Conclusions-—EAT is associated with diastolic function, independent of other influential variables. EAT is an effect modifier for chamber size but not systolic function.

KW - Diastolic function

KW - Epicardial fat

KW - Systolic dysfunction

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U2 - 10.1161/JAHA.118.009975

DO - 10.1161/JAHA.118.009975

M3 - Review Article

VL - 7

JO - American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease

JF - American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease

SN - 2047-9980

IS - 23

M1 - e009975

ER -