title: Pericardial fat and myocardial perfusion in asymptomatic adults from the Multi-Ethnic Study of Atherosclerosis.
abstract: BACKGROUND
  Pericardial fat has adverse effects on the surrounding vasculature. Previous studies suggest that pericardial fat may contribute to myocardial ischemia in symptomatic individuals. However, it is unknown if pericardial fat has similar effects in asymptomatic individuals.
  
  
  METHODS
  We determined the association between pericardial fat and myocardial blood flow (MBF) in 214 adults with no prior history of cardiovascular disease from the Minnesota field center of the Multi-Ethnic Study of Atherosclerosis (43% female, 56% Caucasian, 44% Hispanic). Pericardial fat volume was measured by computed tomography. MBF was measured by MRI at rest and during adenosine-induced hyperemia. Myocardial perfusion reserve (PR) was calculated as the ratio of hyperemic to resting MBF.
  
  
  RESULTS
  Gender-stratified analyses revealed significant differences between men and women including less pericardial fat (71.9±31.3 vs. 105.2±57.5 cm(3), p<0.0001) and higher resting MBF (1.12±0.23 vs. 0.93±0.19 ml/min/g, p<0.0001), hyperemic MBF (3.49±0.76 vs. 2.65±0.72 ml/min/g, p<0.0001), and PR (3.19±0.78 vs. 2.93±0.89, p = 0.03) in women. Correlations between pericardial fat and clinical and hemodynamic variables were stronger in women. In women only (p = 0.01 for gender interaction) higher pericardial fat was associated with higher resting MBF (p = 0.008). However, this association was attenuated after accounting for body mass index or rate-pressure product. There were no significant associations between pericardial fat and hyperemic MBF or PR after multivariate adjustment in either gender. In logistic regression analyses there was also no association between impaired coronary vasoreactivity, defined as having a PR <2.5, and pericardial fat in men (OR, 1.18; 95% CI, 0.82-1.70) or women (OR, 1.11; 95% CI, 0.68-1.82).
  
  
  CONCLUSIONS
  Our data fail to support an independent association between pericardial fat and myocardial perfusion in adults without symptomatic cardiovascular disease. Nevertheless, these findings highlight potentially important differences between asymptomatic and symptomatic individuals with respect to the underlying subclinical disease burden.
authors.affiliation: Department of Internal Medicine, Wake Forest School of Medicine; Winston-Salem, North Carolina, United States of America. tbrinkle@wakehealth.edu
authors.forename: Tina E
authors.initials: TE
authors.lastname: Brinkley
authors.forename: Michael
authors.initials: M
authors.lastname: Jerosch-Herold
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Folsom
authors.forename: J Jeffrey
authors.initials: JJ
authors.lastname: Carr
authors.forename: W Gregory
authors.initials: WG
authors.lastname: Hundley
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Allison
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Burke
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.forename: Jingzhong
authors.initials: J
authors.lastname: Ding
mesh_terms: D000273:Adipose Tissue / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000208:ethnology* / Q000503:physiopathology*; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000473:pathology*; D010477:Perfusion; D010496:Pericardium / Q000503:physiopathology*