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Published in: Journal of Cardiovascular Magnetic Resonance 1/2013

Open Access 01-12-2013 | Research

Intra-thoracic fat volume is associated with myocardial infarction in patients with metabolic syndrome

Authors: Umjeet S Jolly, Abraam Soliman, Charles McKenzie, Terry Peters, John Stirrat, Immaculate Nevis, Matthew Brymer, Tisha Joy, Maria Drangova, James A White

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2013

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Abstract

Background

Visceral adiposity is increased in those with Metabolic Syndrome (MetS) and atherosclerotic disease burden. In this study we evaluate for associations between intra-thoracic fat volume (ITFV) and myocardial infarction (MI) in patients with MetS.

Methods

Ninety-four patients with MetS, MI or both were identified from a cardiovascular CMR clinical registry. MetS was defined in accordance to published guidelines; where-as MI was defined as the presence of subendocardial-based injury on late gadolinium enhancement imaging in a coronary vascular distribution. A healthy control group was also obtained from the same registry. Patients were selected into the following groups: MetS+/MI- (N = 32), MetS-/MI + (N = 30), MetS+/MI + (N = 32), MetS-/MI- (N = 16). ITFV quantification was performed using signal threshold analysis of sequential sagittal CMR datasets (HASTE) and indexed to body mass index.

Results

The mean age of the population was 59.8 ± 12.5 years. MetS+ patients (N=64) demonstrated a significantly higher indexed ITFV compared to MetS- patients (p = 0.05). Patients in respective MetS-/MI-, MetS+/MI-, MetS-/MI+, and MetS+/MI + study groups demonstrated a progressive elevation in the indexed ITFV (22.3 ± 10.6, 28.6 ± 12.6, 30.6 ± 12.3, and 35.2 ± 11.4 ml/kg/m2, (p = 0.002)). Among MetS+ patients those with MI showed a significantly higher indexed ITFV compared to those without MI (p = 0.02).

Conclusions

ITFV is elevated in patients with MetS and incrementally elevated among those with evidence of prior ischemic myocardial injury. Accordingly, the quantification of ITFV may be a valuable marker of myocardial infarction risk among patients with MetS and warrants further investigation.
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Literature
1.
go back to reference Mahabadi AA, Massaro JM, Rosito GA, Levy D, Murabito JM, Wolf PA, et al: Association of pericardial fat, intrathoracic fat, and visceral abdominal fat with cardiovascular disease burden: the Framingham Heart Study. Eur Heart J. 2009, 30: 850-856.PubMedCentralCrossRefPubMed Mahabadi AA, Massaro JM, Rosito GA, Levy D, Murabito JM, Wolf PA, et al: Association of pericardial fat, intrathoracic fat, and visceral abdominal fat with cardiovascular disease burden: the Framingham Heart Study. Eur Heart J. 2009, 30: 850-856.PubMedCentralCrossRefPubMed
2.
go back to reference Iwasaki K, Matsumoto T, Aono H, Furukawa H, Samukawa M: Relationship between epicardial Fat measured by 64-multidetector computed tomography and coronary artery disease. Clin Cardiol. 2011, 34 (3): 166-171. 10.1002/clc.20840.CrossRefPubMed Iwasaki K, Matsumoto T, Aono H, Furukawa H, Samukawa M: Relationship between epicardial Fat measured by 64-multidetector computed tomography and coronary artery disease. Clin Cardiol. 2011, 34 (3): 166-171. 10.1002/clc.20840.CrossRefPubMed
3.
go back to reference Rosito GA, Massaro JM, Hoffmann U, Ruberg FL, Mahabadi AA, Vasan RS, et al: Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcification in a community-based sample: the Framingham Heart Study. Circulation. 2008, 117: 605-613. 10.1161/CIRCULATIONAHA.107.743062.CrossRefPubMed Rosito GA, Massaro JM, Hoffmann U, Ruberg FL, Mahabadi AA, Vasan RS, et al: Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcification in a community-based sample: the Framingham Heart Study. Circulation. 2008, 117: 605-613. 10.1161/CIRCULATIONAHA.107.743062.CrossRefPubMed
4.
go back to reference Momesso DP, Bussade I, Epifanio MA, Schettino CD, Russo LA, Kupfer R: Increased epicardial adipose tissue in type 1 diabetes is associated with central obesity and metabolic syndrome. Diabetes Res Clin Pract. 2011, 91: 47-53. 10.1016/j.diabres.2010.09.037.CrossRefPubMed Momesso DP, Bussade I, Epifanio MA, Schettino CD, Russo LA, Kupfer R: Increased epicardial adipose tissue in type 1 diabetes is associated with central obesity and metabolic syndrome. Diabetes Res Clin Pract. 2011, 91: 47-53. 10.1016/j.diabres.2010.09.037.CrossRefPubMed
5.
go back to reference Iacobellis G, Leonetti F: Epicardial adipose tissue and insulin resistance in obese subjects. J Clin Endocrinol Metab. 2005, 90: 6300-6302. 10.1210/jc.2005-1087.CrossRefPubMed Iacobellis G, Leonetti F: Epicardial adipose tissue and insulin resistance in obese subjects. J Clin Endocrinol Metab. 2005, 90: 6300-6302. 10.1210/jc.2005-1087.CrossRefPubMed
6.
go back to reference Yun CH, Lin TY, Wu YJ, Liu CC, Kuo JY, Yeh HI, et al: Pericardial and thoracic peri-aortic adipose tissues contribute to systemic inflammation and calcified coronary atherosclerosis independent of body fat composition, anthropometric measures and traditional cardiovascular risks. Eur J Radiol. 2011, 81 (4): 749-756.CrossRefPubMed Yun CH, Lin TY, Wu YJ, Liu CC, Kuo JY, Yeh HI, et al: Pericardial and thoracic peri-aortic adipose tissues contribute to systemic inflammation and calcified coronary atherosclerosis independent of body fat composition, anthropometric measures and traditional cardiovascular risks. Eur J Radiol. 2011, 81 (4): 749-756.CrossRefPubMed
7.
go back to reference Dey D, Wong ND, Tamarappoo B, Nakazato R, Gransar H, Cheng VY, et al: Computer-aided non-contrast CT-based quantification of pericardial and thoracic fat and their associations with coronary calcium and Metabolic Syndrome. Atherosclerosis. 2010, 209: 136-141. 10.1016/j.atherosclerosis.2009.08.032.PubMedCentralCrossRefPubMed Dey D, Wong ND, Tamarappoo B, Nakazato R, Gransar H, Cheng VY, et al: Computer-aided non-contrast CT-based quantification of pericardial and thoracic fat and their associations with coronary calcium and Metabolic Syndrome. Atherosclerosis. 2010, 209: 136-141. 10.1016/j.atherosclerosis.2009.08.032.PubMedCentralCrossRefPubMed
8.
go back to reference Forouzandeh F, Chang SM, Muhyieddeen K, Zaid RR, Trevino AR, Xu J, et al: Does quantifying epicardial and intrathoracic fat with noncontrast computed tomography improve risk stratification beyond calcium scoring alone?. Circ Cardiovasc Imaging. 2013, 6: 58-66. 10.1161/CIRCIMAGING.112.976316.CrossRefPubMed Forouzandeh F, Chang SM, Muhyieddeen K, Zaid RR, Trevino AR, Xu J, et al: Does quantifying epicardial and intrathoracic fat with noncontrast computed tomography improve risk stratification beyond calcium scoring alone?. Circ Cardiovasc Imaging. 2013, 6: 58-66. 10.1161/CIRCIMAGING.112.976316.CrossRefPubMed
9.
go back to reference Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al: Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009, 120: 1640-1645. 10.1161/CIRCULATIONAHA.109.192644.CrossRefPubMed Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al: Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009, 120: 1640-1645. 10.1161/CIRCULATIONAHA.109.192644.CrossRefPubMed
11.
go back to reference Kim RJ, Shah DJ, Judd RM: How we perform delayed enhancement imaging. J Cardiovasc Magn Reson. 2003, 5: 505-514. 10.1081/JCMR-120022267.CrossRefPubMed Kim RJ, Shah DJ, Judd RM: How we perform delayed enhancement imaging. J Cardiovasc Magn Reson. 2003, 5: 505-514. 10.1081/JCMR-120022267.CrossRefPubMed
12.
go back to reference Mahrholdt H, Wagner A, Holly TA, Elliott MD, Bonow RO, Kim RJ, et al: Reproducibility of chronic infarct size measurement by contrast-enhanced magnetic resonance imaging. Circulation. 2002, 106: 2322-2327. 10.1161/01.CIR.0000036368.63317.1C.CrossRefPubMed Mahrholdt H, Wagner A, Holly TA, Elliott MD, Bonow RO, Kim RJ, et al: Reproducibility of chronic infarct size measurement by contrast-enhanced magnetic resonance imaging. Circulation. 2002, 106: 2322-2327. 10.1161/01.CIR.0000036368.63317.1C.CrossRefPubMed
13.
go back to reference Dey D, Suzuki Y, Suzuki S, Ohba M, Slomka PJ, Polk D, et al: Automated quantitation of pericardiac fat from noncontrast CT. Invest Radiol. 2008, 43: 145-153. 10.1097/RLI.0b013e31815a054a.CrossRefPubMed Dey D, Suzuki Y, Suzuki S, Ohba M, Slomka PJ, Polk D, et al: Automated quantitation of pericardiac fat from noncontrast CT. Invest Radiol. 2008, 43: 145-153. 10.1097/RLI.0b013e31815a054a.CrossRefPubMed
14.
go back to reference Wang TD, Lee WJ, Shih FY, Huang CH, Chang YC, Chen WJ, et al: Relations of epicardial adipose tissue measured by multidetector computed tomography to components of the metabolic syndrome are region-specific and independent of anthropometric indexes and intraabdominal visceral fat. J Clin Endocrinol Metab. 2009, 94: 662-669. 10.1210/jc.2008-0834.CrossRefPubMed Wang TD, Lee WJ, Shih FY, Huang CH, Chang YC, Chen WJ, et al: Relations of epicardial adipose tissue measured by multidetector computed tomography to components of the metabolic syndrome are region-specific and independent of anthropometric indexes and intraabdominal visceral fat. J Clin Endocrinol Metab. 2009, 94: 662-669. 10.1210/jc.2008-0834.CrossRefPubMed
15.
go back to reference Kissebah AH, Vydelingum N, Murray R, Evans DJ, Hartz AJ, Kalkhoff RK, et al: Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab. 1982, 54: 254-260. 10.1210/jcem-54-2-254.CrossRefPubMed Kissebah AH, Vydelingum N, Murray R, Evans DJ, Hartz AJ, Kalkhoff RK, et al: Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab. 1982, 54: 254-260. 10.1210/jcem-54-2-254.CrossRefPubMed
16.
go back to reference Sharma AM: Mediastinal fat, insulin resistance, and hypertension. Hypertension. 2004, 44: 117-118. 10.1161/01.HYP.0000137993.70745.82.CrossRefPubMed Sharma AM: Mediastinal fat, insulin resistance, and hypertension. Hypertension. 2004, 44: 117-118. 10.1161/01.HYP.0000137993.70745.82.CrossRefPubMed
17.
go back to reference Baker AR, Silva NF, Quinn DW, Harte AL, Pagano D, Bonser RS, et al: Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovasc Diabetol. 2006, 5: 1-10.1186/1475-2840-5-1.PubMedCentralCrossRefPubMed Baker AR, Silva NF, Quinn DW, Harte AL, Pagano D, Bonser RS, et al: Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovasc Diabetol. 2006, 5: 1-10.1186/1475-2840-5-1.PubMedCentralCrossRefPubMed
18.
go back to reference Chaowalit N, Lopez-Jimenez F: Epicardial adipose tissue: friendly companion or hazardous neighbour for adjacent coronary arteries?. Eur Heart J. 2008, 29: 695-697. 10.1093/eurheartj/ehm643.CrossRefPubMed Chaowalit N, Lopez-Jimenez F: Epicardial adipose tissue: friendly companion or hazardous neighbour for adjacent coronary arteries?. Eur Heart J. 2008, 29: 695-697. 10.1093/eurheartj/ehm643.CrossRefPubMed
19.
go back to reference Ridker PM: C-reactive protein and the prediction of cardiovascular events among those at intermediate risk: moving an inflammatory hypothesis toward consensus. J Am Coll Cardiol. 2007, 49: 2129-2138. 10.1016/j.jacc.2007.02.052.CrossRefPubMed Ridker PM: C-reactive protein and the prediction of cardiovascular events among those at intermediate risk: moving an inflammatory hypothesis toward consensus. J Am Coll Cardiol. 2007, 49: 2129-2138. 10.1016/j.jacc.2007.02.052.CrossRefPubMed
20.
go back to reference Liu J, Fox CS, Hickson D, Sarpong D, Ekunwe L, May WD, et al: Pericardial adipose tissue, atherosclerosis, and cardiovascular disease risk factors: the Jackson heart study. Diabetes Care. 2010, 33: 1635-1639. 10.2337/dc10-0245.PubMedCentralCrossRefPubMed Liu J, Fox CS, Hickson D, Sarpong D, Ekunwe L, May WD, et al: Pericardial adipose tissue, atherosclerosis, and cardiovascular disease risk factors: the Jackson heart study. Diabetes Care. 2010, 33: 1635-1639. 10.2337/dc10-0245.PubMedCentralCrossRefPubMed
21.
go back to reference Brinkley TE, Jerosch-Herold M, Folsom AR, Carr JJ, Hundley WG, Allison MA, et al: Pericardial fat and myocardial perfusion in asymptomatic adults from the Multi-Ethnic Study of Atherosclerosis. PLoS One. 2011, 6: e28410-10.1371/journal.pone.0028410.PubMedCentralCrossRefPubMed Brinkley TE, Jerosch-Herold M, Folsom AR, Carr JJ, Hundley WG, Allison MA, et al: Pericardial fat and myocardial perfusion in asymptomatic adults from the Multi-Ethnic Study of Atherosclerosis. PLoS One. 2011, 6: e28410-10.1371/journal.pone.0028410.PubMedCentralCrossRefPubMed
22.
go back to reference Lehman SJ, Massaro JM, Schlett CL, O’Donnell CJ, Hoffmann U, Fox CS: Peri-aortic fat, cardiovascular disease risk factors, and aortic calcification: the Framingham Heart Study. Atherosclerosis. 2010, 210: 656-661. 10.1016/j.atherosclerosis.2010.01.007.PubMedCentralCrossRefPubMed Lehman SJ, Massaro JM, Schlett CL, O’Donnell CJ, Hoffmann U, Fox CS: Peri-aortic fat, cardiovascular disease risk factors, and aortic calcification: the Framingham Heart Study. Atherosclerosis. 2010, 210: 656-661. 10.1016/j.atherosclerosis.2010.01.007.PubMedCentralCrossRefPubMed
23.
go back to reference Wong CX, Abed HS, Molaee P, Nelson AJ, Brooks AG, Sharma G, Leong DP, Lau DH, Middeldorp ME, Roberts-Thomson KC, Wittert GA, Abhayaratna WP, Worthley SG, Sanders P: Pericardial fat is associated with atrial fibrillation severity and ablation outcome. J Am Coll Cardiol. 2011, 57 (17): 1745-1751. 10.1016/j.jacc.2010.11.045.CrossRefPubMed Wong CX, Abed HS, Molaee P, Nelson AJ, Brooks AG, Sharma G, Leong DP, Lau DH, Middeldorp ME, Roberts-Thomson KC, Wittert GA, Abhayaratna WP, Worthley SG, Sanders P: Pericardial fat is associated with atrial fibrillation severity and ablation outcome. J Am Coll Cardiol. 2011, 57 (17): 1745-1751. 10.1016/j.jacc.2010.11.045.CrossRefPubMed
24.
go back to reference Berglund J, Johansson L, Ahlström H, Kullberg J: Three-point dixon method enables whole-body water and fat imaging of obese subjects. Magn Reson Med. 2010, 63: 1659-1668. 10.1002/mrm.22385.CrossRefPubMed Berglund J, Johansson L, Ahlström H, Kullberg J: Three-point dixon method enables whole-body water and fat imaging of obese subjects. Magn Reson Med. 2010, 63: 1659-1668. 10.1002/mrm.22385.CrossRefPubMed
Metadata
Title
Intra-thoracic fat volume is associated with myocardial infarction in patients with metabolic syndrome
Authors
Umjeet S Jolly
Abraam Soliman
Charles McKenzie
Terry Peters
John Stirrat
Immaculate Nevis
Matthew Brymer
Tisha Joy
Maria Drangova
James A White
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Journal of Cardiovascular Magnetic Resonance / Issue 1/2013
Electronic ISSN: 1532-429X
DOI
https://doi.org/10.1186/1532-429X-15-77

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