title: Accumulation of pericardial fat correlates with left ventricular diastolic dysfunction in patients with normal ejection fraction.
abstract: BACKGROUND
  Left ventricular diastolic dysfunction (LVDD) plays an important role in heart failure with normal left ventricular ejection fraction (LVEF). Obesity is one of the major comorbid conditions of LVDD. Pericardial fat (PF) is an ectopic fat depot with possible paracrine or mechanical effects on the coronary circulation and myocardial function.
  
  
  METHODS
  We measured PF volume on 64 slice computed tomography and analyzed echocardiographic parameters to confirm LVDD in 229 consecutive patients suspected of coronary artery disease with LVEF of more than 50% and no symptomatic heart failure (59% men, 67±12 years). LVDD was defined as the ratio of transmitral Doppler early filling velocity to tissue Doppler early diastolic mitral annular velocity (E/e') >10.
  
  
  RESULTS
  PF volume correlated significantly with E/e' (r=0.21, p<0.01), left ventricular mass index (r=0.23, p<0.001), and left atrial diameter (r=0.32, p<0.001). The mean PF volume was significantly greater in patients with LVDD (184±61cm(3), n=141) than in those without LVDD (154±58, n=88, p<0.001). Multivariate logistic regression analysis indicated that PF volume correlated significantly with the presence of LVDD (odds ratio: 2.00 per 100cm(3) increase in PF volume, p=0.02) independent of age, gender, abdominal obesity, hypertension, and diabetes.
  
  
  CONCLUSIONS
  PF volumes are significantly associated with LVDD, independent of other factors such as hypertension or diabetes. PF may be implicated in the pathogenesis of LVDD in patients with normal LVEF.
authors.affiliation: Department of Cardiovascular Medicine, Kumamoto University, Kumamoto, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Konishi
authors.forename: Seigo
authors.initials: S
authors.lastname: Sugiyama
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugamura
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Nozaki
authors.forename: Junichi
authors.initials: J
authors.lastname: Matsubara
authors.forename: Eiichi
authors.initials: E
authors.lastname: Akiyama
authors.forename: Daisuke
authors.initials: D
authors.lastname: Utsunomiya
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsuzawa
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000378:metabolism*; D000368:Aged; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006333:Heart Failure; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging / Q000378:metabolism*; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology*; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism* / Q000503:physiopathology