Pericardial, But Not Hepatic, Fat by CT Is Associated With CV Outcomes and Structure: The Multi-Ethnic Study of Atherosclerosis.
Pericardial, But Not Hepatic, Fat by CT Is Associated With CV Outcomes and Structure: The Multi-Ethnic Study of Atherosclerosis.
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DOI：
10.1016/j.jcmg.2016.10.024
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发表时间：
2017-09
期刊：
影响因子：
--
通讯作者：
Murthy VL
中科院分区：
文献类型：
--
作者：
Shah RV;Anderson A;Ding J;Budoff M;Rider O;Petersen SE;Jensen MK;Koch M;Allison M;Kawel-Boehm N;Wisocky J;Jerosch-Herold M;Mukamal K;Lima JAC;Murthy VL
确定局部（心包）脂肪与心血管疾病（CVD）事件和心脏重塑之间的相关性，与总体肥胖标志物无关。心包脂肪（包裹心脏的局部脂肪储存库）对心肌功能和长期心血管（CV）预后的影响独立于肥胖或肝脏脂肪的全身后果，这是一个积极争论的领域。我们研究了4，234名参与多种族动脉粥样硬化研究的参与者，同时进行心脏磁共振（CMR）成像和计算机断层扫描（CT）测量心包脂肪体积和肝脏衰减（肝脏脂肪的测量）。Poisson和考克斯回归用于估计硬动脉粥样硬化性CVD（ASCVD）、全因死亡、心力衰竭、全因CVD、硬CHD和卒中的年风险，作为心包和肝脏脂肪的函数。广义加性模型用于评估左心室（LV）结构和功能的CMR指数与心包脂肪之间的关联。根据相关临床、人口统计学和心脏代谢协变量调整模型。具有较高心包和肝脏脂肪的梅萨参与者更可能是老年人，更常见的是男性，并且具有较高的心脏代谢危险因素（包括血脂异常，血脂异常，高血压）以及肥胖相关炎症的患病率。中位随访12.2年（IQR 11.6-12.8岁），心包脂肪与较高的硬ASCVD发生率相关。（标准化危险比[SHR] 1.22，95%可信区间[CI] 1.10-1.35，P=0.0001; CT显示肝脂肪与硬ASCVD无显著相关性（SHR 0.96，95%CI 0.86-1.08，P=0.52）。较高的心包脂肪与较大的左心室质量指数（37.8 vs. 33.9 g/m2.7，最高vs.最低四分位数，P<0.01）、左心室质量体积比（1.2 vs. 1.1，最高vs.最低四分位数，P<0.01）相关。在校正模型中，较高的心包脂肪体积与较大的LV质量（P<0.0001）和同心度（P<0.0001）相关。心包脂肪与CVD预后差和LV重塑相关，独立于胰岛素抵抗、炎症和肝脏脂肪的CT测量。
To determine the associations between local (pericardial) fat and incident CV disease (CVD) events and cardiac remodeling independent of markers of overall adiposity. The impact of pericardial fat—a local fat depot encasing the heart—on myocardial function and long-term cardiovascular (CV) prognosis independent of systemic consequences of adiposity or hepatic fat is an area of active debate. We studied 4,234 participants enrolled in the Multi-Ethnic Study of Atherosclerosis with concomitant cardiac magnetic resonance (CMR) imaging and computed tomographic (CT) measurements for pericardial fat volume and hepatic attenuation (a measure of liver fat). Poisson and Cox regression were used to estimate the annualized risk of incident hard atherosclerotic CVD (ASCVD), all-cause death, heart failure, all-cause CVD, hard CHD and stroke as a function of pericardial and hepatic fat. Generalized additive models were used to assess the association between CMR indices of left ventricular (LV) structure and function and pericardial fat. Models were adjusted for relevant clinical, demographic, and cardiometabolic covariates. MESA participants with higher pericardial and hepatic fat were more likely to be older, more frequently male, and had a higher prevalence of cardiometabolic risk factors (including dysglycemia, dyslipdemia, hypertension), as well as adiposity-associated inflammation. Over a median 12.2-year follow-up (IQR 11.6–12.8 years), pericardial fat was associated with a higher rate of incident hard ASCVD (standardized hazard ratio [SHR] 1.22, 95% confidence interval [CI] 1.10–1.35, P=0.0001; hepatic fat by CT was not significantly associated with hard ASCVD (SHR 0.96, 95% CI 0.86–1.08, P=0.52). Higher pericardial fat was associated with greater indexed LV mass (37.8 vs. 33.9 g/m2.7, highest vs. lowest quartile, P<0.01), LV mass-to-volume ratio (1.2 vs. 1.1, highest vs. lowest quartile, P<0.01). In adjusted models, a higher pericardial fat volume was associated with greater LV mass (P<0.0001) and concentricity (P<0.0001). Pericardial fat is associated with poorer CVD prognosis and LV remodeling, independent of insulin resistance, inflammation and CT measures of hepatic fat.
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影响因子：
37.8
作者：
Go AS;Mozaffarian D;Roger VL;Benjamin EJ;Berry JD;Blaha MJ;Dai S;Ford ES;Fox CS;Franco S;Fullerton HJ;Gillespie C;Hailpern SM;Heit JA;Howard VJ;Huffman MD;Judd SE;Kissela BM;Kittner SJ;Lackland DT;Lichtman JH;Lisabeth LD;Mackey RH;Magid DJ;Marcus GM;Marelli A;Matchar DB;McGuire DK;Mohler ER 3rd;Moy CS;Mussolino ME;Neumar RW;Nichol G;Pandey DK;Paynter NP;Reeves MJ;Sorlie PD;Stein J;Towfighi A;Turan TN;Virani SS;Wong ND;Woo D;Turner MB;American Heart Association Statistics Committee and Stroke Statistics Subcommittee
通讯作者：
American Heart Association Statistics Committee and Stroke Statistics Subcommittee
DOI：
10.1161/circimaging.113.000532
发表时间：
2013-09
期刊：
Circulation. Cardiovascular imaging
影响因子：
--
作者：
Neeland IJ;Gupta S;Ayers CR;Turer AT;Rame JE;Das SR;Berry JD;Khera A;McGuire DK;Vega GL;Grundy SM;de Lemos JA;Drazner MH
通讯作者：
Drazner MH
影响因子：
37.8
作者：
Bild, DE;Detrano, R;Saad, MF
通讯作者：
Saad, MF
影响因子：
37.8
作者：
Mazurek, T;Zhang, LF;Shi, Y
通讯作者：
Shi, Y
影响因子：
7.1
作者：
Ding, Jingzhong;Hsu, Fang-Chi;Carr, J. Jeffrey
通讯作者：
Carr, J. Jeffrey