Pericardial fat, intrathoracic fat, and measures of left ventricular structure and function: the Framingham Heart Study.
Pericardial fat, intrathoracic fat, and measures of left ventricular structure and function: the Framingham Heart Study.
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DOI：
10.1161/circulationaha.108.828970
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发表时间：
2009-03-31
期刊：
影响因子：
37.8
通讯作者：
Manning WJ
中科院分区：
文献类型：
--
作者：
Fox CS;Gona P;Hoffmann U;Porter SA;Salton CJ;Massaro JM;Levy D;Larson MG;D'Agostino RB Sr;O'Donnell CJ;Manning WJ
心包脂肪与肥胖相关的心血管疾病的发病机制有关。心包脂肪和心脏结构和功能的测量是否独立于肥胖和内脏肥胖症的全身性影响尚未得到充分的探讨。来自弗雷明翰心脏研究的参与者(n=997，54.4%为女性)在2002至2005年间接受了胸部和腹部CT和心血管磁共振(CMR)检查。通过多层计算机断层扫描对心包脂肪、胸腔内脂肪和内脏脂肪组织(VAT)、体重指数(BMI)和腰围进行量化，并与CMR测量的左心室(LV)质量、LV舒张末容量(LVEDV)和左房内径相关。女性心包脂肪(r=0.2~0.35，p<；0.001)、胸腔内脂肪(r=0.25~0.37，p<；0.001)、VAT(r=0.24~0.45，p<；0.001)、体重指数(r=0.36~0.53，p<；0.001)、腰围(r=0.3~0.48，p<；0.001)与左心室重量、左心室射血分数、左心房内径呈正相关。在男性中，心包脂肪(r=0.19~0.37，p&t；0.001)、胸腔内脂肪(r=0.17~0.31，p&t；0.001)、增值税(r=0.19~0.36，p<；0.001)、体重指数(r=0.32~0.44，p&t；0.001)、腰围(r=0.34~0.44，p&t；0.001)与左心室重量和左房内径直接相关，但左心室射血分数与肥胖程度并不一致。在多变量调整后，相关性持续存在，但在对体重和增值税进行额外调整后，相关性不存在，男性心包脂肪和左房内径除外。心包脂肪与CMR测量相关，但这种关联并不独立于或强于其他异位脂肪储存或内脏肥胖的替代测量。一个重要的例外是男性的左房内径。这些结果表明，肥胖对心脏结构和功能的全身性影响可能超过心包脂肪的局部致病作用。
Pericardial fat has been implicated in the pathogenesis of obesity-related cardiovascular disease. Whether the associations of pericardial fat and measures of cardiac structure and function are independent of the systemic effects of obesity and visceral adiposity has not been fully explored. Participants from the Framingham Heart Study (n=997, 54.4% women) underwent chest and abdominal CT and cardiovascular MRI (CMR) between 2002 and 2005. Pericardial fat, intrathoracic fat, and visceral adipose tissue (VAT) quantified from multidetector computed tomography, along with BMI and waist circumference, were examined in relation to CMR measures of left ventricular (LV) mass, LV end diastolic volume (LVEDV), and left atrial dimension. In women, pericardial fat (r=0.20 to 0.35, p<0.001), intrathoracic fat (r=0.25 to 0.37, p<0.001), VAT (r=0.24 to 0.45, p<0.001), BMI (r=0.36 to 0.53, p<0.001), and waist circumference (r=0.30 to 0.48, p<0.001) were directly correlated with LV mass, LVEDV, and left atrial dimension. In men, pericardial fat (r=0.19 to 0.37, p<0.001), intrathoracic fat (r=0.17 to 0.31, p<0.001), VAT (r=0.19 to 0.36, p<0.001), BMI (r=0.32 to 0.44, p<0.001), and waist circumference (r=0.34 to 0.44, p<0.001) were directly correlated with LV mass and left atrial dimension, but LVEDV was not consistently associated with adiposity measures. Associations persisted after multivariable adjustment, but not after additional adjustment for body weight and VAT, with the exception of pericardial fat and left atrial dimension in men. Pericardial fat is correlated with CMR measures, but the association is not independent of or stronger than other ectopic fat stores or proxy measures of visceral adiposity. An important exception is left atrial dimension in men. These results suggest that the systemic effects of obesity on cardiac structure and function may outweigh the local pathogenic effects of pericardial fat.