Association of pericardial fat, intrathoracic fat, and visceral abdominal fat with cardiovascular disease burden: the Framingham Heart Study (original) (raw)
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and visceral abdominal fat with cardiovascular disease burden: the Framingham Heart Study
2015
The aim of this study was to assess whether pericardial fat, intrathoracic fat, and visceral abdominal adipose tissue (VAT) are associated with the prevalence of cardiovascular disease (CVD). Methods and results Participants from the Framingham Heart Study Offspring cohort underwent abdominal and chest multidetector computed tomography to quantify volumes of pericardial fat, intrathoracic fat, and VAT. Relations between each fat depot and CVD were assessed using logistic regression. The analysis of 1267 participants (mean age 60 years, 53.8% women, 9.7% with prevalent CVD) demonstrated that pericardial fat [odds ratio (OR) 1.32, 95% confidence interval (CI) 1.11-1.57; P ¼ 0.002] and VAT (OR 1.35, 95% CI 1.11-1.57; P ¼ 0.003), but not intrathoracic fat (OR 1.14, 95% CI 0.93-1.39; P ¼ 0.22), were significantly associated with prevalent CVD in age-sex-adjusted models and after adjustment for body mass index and waist circumference. After multivariable adjustment, associations were attenuated (P. 0.14). Only pericardial fat was associated with prevalent myocardial infarction after adjusting for conventional measures of adiposity (OR 1.37, 95% CI 1.03-1.82; P ¼ 0.03). Conclusion Pericardial fat and VAT, but not intrathoracic fat, are associated with CVD independent of traditional measures of obesity but not after further adjustment for traditional risk factor. Taken together with our prior work, these findings may support the hypothesis that pericardial fat contributes to coronary atherosclerosis.
American Journal of Clinical Nutrition, 2009
Background: Pericardial fat (ie, fat around the heart) may have a direct role in the atherosclerotic process in coronary arteries through local release of inflammation-related cytokines. Crosssectional studies suggest that pericardial fat is positively associated with coronary artery disease independent of total body fat. Objective: We investigated whether pericardial fat predicts future coronary heart disease events. Design: We conducted a case-cohort study in 998 individuals, who were randomly selected from 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants and 147 MESA participants (26 from those 998 individuals) who developed incident coronary heart disease from 2000 to 2005. The volume of pericardial fat was determined from cardiac computed tomography at baseline. Results: The age range of the subjects was 45-84 y (42% men, 45% white, 10% Asian American, 22% African American, and 23% Hispanic). Pericardial fat was positively correlated with both body mass index (correlation coefficient = 0.45, P , 0.0001) and waist circumference (correlation coefficient = 0.57, P , 0.0001). In unadjusted analyses, pericardial fat (relative hazard per 1-SD increment: 1.33; 95% CI: 1.15, 1.54), but not body mass index (1.00; 0.84, 1.18), was associated with the risk of coronary heart disease. Waist circumference (1.14; 0.97, 1.34; P = 0.1) was marginally associated with the risk of coronary heart disease. The relation between pericardial fat and coronary heart disease remained significant after further adjustment for body mass index and other cardiovascular disease risk factors (1.26; 1.01, 1.59). The relation did not differ by sex. Conclusion: Pericardial fat predicts incident coronary heart disease independent of conventional risk factors, including body mass index.
International Journal of Cardiology, 2018
Background: To explore the relationship between coronary and extra-coronary atherosclerotic plaque burden with total and regional fat depots among patients undergoing ECG-gated aortic computed tomography angiography (CTA). Methods: The subjects of this study comprised a cohort of consecutive patients who underwent ECG-gated thoracoabdominal CTA. We assessed the number of coronary segments with plaques (segment-involvement score, SIS); and the extra-coronary atherosclerotic plaque burden, comprising the aorta and supra-aortic trunks, iliofemoral arteries, and visceral arteries (extra-coronary SS). Total and regional fat volume (FV) were calculated. Results: A total of 2700 vascular segments were evaluated in 90 patients. Obese patients (n = 31, 34%) showed similar coronary SIS (p = 0.41) and extra-coronary SS (p = 0.22) than non-obese patients. General body fat measurements were not related to atherosclerotic plaque burden scores, without associations between coronary or extra-coronary plaque burden and BMI (p = 0.68, and p = 0.91), abdominal circumference (p = 0.13, p = 0.89), total body FV (p = 0.50, p = 0.98), or abdominal FV (p = 0.51, p = 0.99). Pericardial FV was related to coronary SIS (p b 0.0001) and extra-coronary SS (p = 0.008), and visceral FV was related to the coronary SIS (p = 0.006) and extra-coronary SS (p = 0.056). Abdominal subcutaneous fat was inversely related to coronary SIS (p = 0.038) and extra-coronary SS (p = 0.010). Pericardial FV was identified as the only independent predictor of extensive coronary [OR 1.020 (95% CI 1.001-1.039), p = 0.036] and extra-coronary [OR 1.018 (95% CI 1.001-1.036), p = 0.035] plaque burden. Conclusions: In the present study, pericardial and visceral fat were associated with an increased atherosclerotic burden, whereas we identified an inverse relationship between subcutaneous abdominal fat and plaque burden.
European Journal of Echocardiography, 2014
To investigate the association of pericardial, mediastinal, and intrathoracic fat volumes with the presence and severity of coronary artery disease (CAD), metabolic syndrome (MS), and cardiac risk factors (CRFs). Methods and results Two hundred and sixteen consecutive patients who underwent cardiac magnetic resonance (CMR) imaging and had a coronary angiogram within 12 months of the CMR were studied. Fat volume was measured by drawing region of interest curves, from short-axis cine views from base to apex and from a four-chamber cine view. Pericardial fat, mediastinal fat, intrathoracic fat (addition of pericardial and mediastinal fat volumes), and fat ratio (pericardial fat/mediastinal fat) were analysed for their association with the presence and severity of CAD (determined based on the Duke CAD Jeopardy Score), MS, CRFs, and death or myocardial infarction on follow-up. Pericardial fat volume was significantly greater in patients with CAD when compared with those without CAD [38.3 + 25.1 vs. 31.9 + 21.4 cm 3 (P ¼ 0.04)]. A correlation between the severity of CAD and fat volume was found for pericardial fat (b ¼ 1, P , 0.01), mediastinal fat (b ¼ 1, P ¼ 0.03), intrathoracic fat (b ¼ 2, P ¼ 0.01), and fat ratio (b ¼ 0.005, P ¼ 0.01). These correlations persisted for all four thoracic fat measurements even after performing a stepwise linear regression analysis for relevant risk factors. Patients with MS had significantly greater mediastinal and intrathoracic fat volumes when compared with those without MS [126 + 33.5 vs. 106 + 30.1 cm 3 (P , 0.01) and 165 + 54.9 vs. 140 + 52 cm 3 (P , 0.01), respectively]. However, there was no significant difference in pericardial fat, mediastinal fat, intrathoracic fat, or fat ratio between patients with or without myocardial infarction during the follow-up [33.6 + 22.1 vs. 35.7 + 23.8 cm 3 (P ¼ 0.67); 115 + 26.2 vs. 114 + 33.8 cm 3 (P ¼ 0.84); 149 + 44.7 vs. 150 + 55.7 cm 3 (P ¼ 0.95); and 0.27 + 0.15 vs. 0.28 + 0.14 (P ¼ 0.70), respectively]. There was no significant difference in pericardial fat, mediastinal fat, intrathoracic fat, or fat ratio between patients who were alive compared with those who died during follow-up [36.6 + 26.6 vs. 35.3 + 23.2 cm 3 (P ¼ 0.76); 114 + 40.2 vs. 114 + 31.4 cm 3 (P ¼ 0.95); 150 + 64.7 vs. 149 + 52.5 cm 3 (P ¼ 0.92); and 0.29 + 0.15 vs. 0.28 + 0.14 (P ¼ 0.85), respectively]. Conclusion Our study confirms an association between pericardial fat volume with the presence and severity of CAD. Furthermore, an association between mediastinal and intrathoracic fat volumes with MS was found.
European Journal of Radiology, 2012
Background: Coronary atherosclerosis has traditionally been proposed to be associated with several cardiovascular risk factors and anthropometric measures. However, clinical data regarding the independent value of visceral adipose tissue in addition to such traditional predictors remains obscure. Materials and methods: We subsequently studied 719 subjects (age: 48.1 ± 8.3 years, 25% females) who underwent multidetector computed tomography (MDCT) for coronary calcium score (CCS) quantification. Baseline demographic data and anthropometric measures were taken with simultaneous body fat composition estimated. Visceral adipose tissue of pericardial and thoracic peri-aortic fat was quantified by MDCT using TeraRecon Aquarius workstation (San Mateo, CA). Traditional cardiovascular risk stratification was calculated by metabolic (NCEP ATP III) and Framingham (FRS) scores and high-sensitivity CRP (Hs-CRP) was taken to represent systemic inflammation. The independent value of visceral adipose tissue to systemic inflammation and CCS was assessed by utilizing multivariable regression analysis. Results: Of all subjects enrolled in this study, the mean values for pericardial and peri-aortic adipose tissue were 74.23 ± 27.51 and 7.23 ± 3.69 ml, respectively. Higher visceral fat quartile groups were associated with graded increase of risks for cardiovascular diseases. Both adipose burdens strongly correlated with anthropometric measures including waist circumference, body weight and body mass index (all p < 0.001). In addition, both visceral amount correlates well with ATP and FRS scores, all lipid profiles and systemic inflammation marker in terms of Hs-CRP (all p < 0.001). After adjustment for baseline variables, both visceral fat were independently related to Hs-CRP levels (all p < 0.05), but only pericardial fat exerted independent role in coronary calcium deposit. Conclusion: Both visceral adipose tissues strongly correlated with systemic inflammation beyond traditional cardiovascular risks and anthropometric measures, though only pericardial fat exerted independent role in coronary calcium deposit. Our data suggested that visceral adipose tissue may thus contribute to systemic inflammation and play an independent role in the pathogenesis of atherosclerosis.
European Journal of …, 2011
Background: Coronary atherosclerosis has traditionally been proposed to be associated with several cardiovascular risk factors and anthropometric measures. However, clinical data regarding the independent value of visceral adipose tissue in addition to such traditional predictors remains obscure. Materials and methods: We subsequently studied 719 subjects (age: 48.1 ± 8.3 years, 25% females) who underwent multidetector computed tomography (MDCT) for coronary calcium score (CCS) quantification. Baseline demographic data and anthropometric measures were taken with simultaneous body fat composition estimated. Visceral adipose tissue of pericardial and thoracic peri-aortic fat was quantified by MDCT using TeraRecon Aquarius workstation (San Mateo, CA). Traditional cardiovascular risk stratification was calculated by metabolic (NCEP ATP III) and Framingham (FRS) scores and high-sensitivity CRP (Hs-CRP) was taken to represent systemic inflammation. The independent value of visceral adipose tissue to systemic inflammation and CCS was assessed by utilizing multivariable regression analysis. Results: Of all subjects enrolled in this study, the mean values for pericardial and peri-aortic adipose tissue were 74.23 ± 27.51 and 7.23 ± 3.69 ml, respectively. Higher visceral fat quartile groups were associated with graded increase of risks for cardiovascular diseases. Both adipose burdens strongly correlated with anthropometric measures including waist circumference, body weight and body mass index (all p < 0.001). In addition, both visceral amount correlates well with ATP and FRS scores, all lipid profiles and systemic inflammation marker in terms of Hs-CRP (all p < 0.001). After adjustment for baseline variables, both visceral fat were independently related to Hs-CRP levels (all p < 0.05), but only pericardial fat exerted independent role in coronary calcium deposit. Conclusion: Both visceral adipose tissues strongly correlated with systemic inflammation beyond traditional cardiovascular risks and anthropometric measures, though only pericardial fat exerted independent role in coronary calcium deposit. Our data suggested that visceral adipose tissue may thus contribute to systemic inflammation and play an independent role in the pathogenesis of atherosclerosis.