title: Intra-thoracic fat volume is associated with myocardial infarction in patients with metabolic syndrome.
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 ± 1.4 ml/kg/m(2), (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.
authors.affiliation: Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada. jwhite@imaging.robarts.ca.
authors.forename: Umjeet S
authors.initials: US
authors.lastname: Jolly
authors.forename: Abraam
authors.initials: A
authors.lastname: Soliman
authors.forename: Charles
authors.initials: C
authors.lastname: McKenzie
authors.forename: Terry
authors.initials: T
authors.lastname: Peters
authors.forename: John
authors.initials: J
authors.lastname: Stirrat
authors.forename: Immaculate
authors.initials: I
authors.lastname: Nevis
authors.forename: Matthew
authors.initials: M
authors.lastname: Brymer
authors.forename: Tisha
authors.initials: T
authors.lastname: Joy
authors.forename: Maria
authors.initials: M
authors.lastname: Drangova
authors.forename: James A
authors.initials: JA
authors.lastname: White
mesh_terms: D050154:Adiposity; D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000473:pathology; D009942:Organometallic Compounds; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol
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