Effects of Bariatric Surgery on Cardiac Ectopic Fat Lesser Decrease in Epicardial Fat Compared to Visceral Fat Loss and No Change in Myocardial Triglyceride Content
Effects of Bariatric Surgery on Cardiac Ectopic Fat Lesser Decrease in Epicardial Fat Compared to Visceral Fat Loss and No Change in Myocardial Triglyceride Content
复制标题
DOI：
10.1016/j.jacc.2012.06.016
复制
发表时间：
2012-10-09
影响因子：
24
通讯作者：
Dutour, Anne
中科院分区：
文献类型：
--
作者：
Gaborit, Benedicte;Jacquier, Alexis;Dutour, Anne
目的应用3T磁共振成像技术，探讨肥胖手术（BS）诱导的减重对病态肥胖患者心脏异位脂肪的影响。背景：心脏病是肥胖患者死亡和发病的主要原因之一。心脏异位脂肪的沉积与心脏病风险增加有关。持续减肥是否能调节心外膜脂肪或心肌脂肪尚不清楚。方法23例病态肥胖患者在基线和BS后6个月采用h -1磁共振波谱测定心肌甘油三酯含量（MTGC）、磁共振成像评估心外膜脂肪体积（EFV）、心功能和计算机断层扫描测量脏腹脂肪（VAF）。结果BS使体重指数从43.1 +/- 4.5 kg/m2降至32.3 +/- 4.0 kg/m2，皮下脂肪从649 +/- 162 cm(2)降至442 +/- 127 cm2， VAF从190 +/- 83 cm2降至107 +/- 44 cm2， EFV从137 +/- 37 ml降至98 +/- 25 ml（均p < 0.0001）。MTGC无显著变化：1.03 +/- 0.2% vs 1.1 +/- 0.2% （p = 0.85）。观察到左心室质量（118 +/- 24 g vs 101 +/- 18 g）和心输出量（7.1 +/- 1.6 l/min vs 5.4 +/- 1.0 l/min）显著降低，并与体重减轻有统计学意义（p < 0.05）。与VAF减少（-40 +/- 19%）相比，EFV的损失有限（-27 +/- 11%）。EFV变化与体重指数百分比或VAF损失无关（p = 0.007）。睡眠呼吸暂停综合征患者EFV与VAF损失的比值降低（1.34 +/- 0.3比0.52 +/- 0.08,p < 0.05）。结论6个月BS治疗对心脏异位脂肪沉积有不同的调节作用，心外膜脂肪明显减少，心肌脂肪无变化。睡眠呼吸暂停患者心外膜脂肪体积损失有限。减肥手术对心外膜脂肪组织及心肌功能的影响[J] . journal of Cardiology; 2012;60:1381-9) (C) 2012 by American College of Cardiology Foundation
Objectives This study investigated the effect of bariatric surgery (BS)-induced weight loss on cardiac ectopic fat using 3T magnetic resonance imaging in morbid obesity.Background Heart disease is one of the leading causes of mortality and morbidity in obese patients. Deposition of cardiac ectopic fat has been related to increased heart risk. Whether sustained weight loss can modulate epicardial fat or myocardial fat is unknown.Methods Twenty-three morbidly obese patients underwent H-1-magnetic resonance spectroscopy to determine myocardial triglyceride content (MTGC), magnetic resonance imaging to assess epicardial fat volume (EFV), cardiac function, and computed tomography visceral abdominal fat (VAF) measurements at baseline and 6 months after BS.Results The BS reduced body mass index significantly, from 43.1 +/- 4.5 kg/m(2) to 32.3 +/- 4.0 kg/m2, subcutaneous fat from 649 +/- 162 cm(2) to 442 +/- 127 cm2, VAF from 190 +/- 83 cm2 to 107 +/- 44 cm2, and EFV from 137 +/- 37 ml to 98 +/- 25 ml (all p < 0.0001). There was no significant change in MTGC: 1.03 +/- 0.2% versus 1.1 +/- 0.2% (p = 0.85). A significant reduction in left ventricular mass (118 +/- 24 g vs. 101 +/- 18 g) and cardiac output (7.1 +/- 1.6 l/min vs. 5.4 +/- 1.0 l/min) was observed and was statistically associated with weight loss (p < 0.05). The loss in EFV was limited (-27 +/- 11%) compared to VAF diminution (-40 +/- 19%). The EFV variation was not correlated with percentage of body mass index or VAF loss (p = 0.007). The ratio of %EFV to %VAF loss decreased with sleep apnea syndrome (1.34 +/- 0.3 vs. 0.52 +/- 0.08, p < 0.05).Conclusions Six-month BS modulates differently cardiac ectopic fat deposition, with a significant decrease in epicardial fat and no change in myocardial fat. Epicardial fat volume loss was limited in patients with sleep apnea. (Impact of Bariatric Surgery on Epicardial Adipose Tissue and on Myocardial Function; NCT01284816) (J Am Coll Cardiol 2012;60:1381-9) (C) 2012 by the American College of Cardiology Foundation