Cardiac steatosis and left ventricular function in men with metabolic syndrome.
BACKGROUND
Ectopic accumulation of fat accompanies visceral obesity with detrimental effects. Lipid oversupply to cardiomyocytes leads to cardiac steatosis, and in animal studies lipotoxicity has been associated with impaired left ventricular (LV) function. In humans, studies have yielded inconclusive results. The aim of the study was to evaluate the role of epicardial, pericardial and myocardial fat depots on LV structure and function in male subjects with metabolic syndrome (MetS).


METHODS
A study population of 37 men with MetS and 38 men without MetS underwent cardiovascular magnetic resonance and proton magnetic spectroscopy at 1.5 T to assess LV function, epicardial and pericardial fat area and myocardial triglyceride (TG) content.


RESULTS
All three fat deposits were greater in the MetS than in the control group (p <0.001). LV diastolic dysfunction was associated with MetS as measured by absolute (471 mL/s vs. 667 mL/s, p = 0.002) and normalized (3.37 s⁻¹ vs. 3.75 s⁻¹, p = 0.02) LV early diastolic peak filling rate and the ratio of early diastole (68% vs. 78%, p = 0.001). The amount of epicardial and pericardial fat correlated inversely with LV diastolic function. However, myocardial TG content was not independently associated with LV diastolic dysfunction.


CONCLUSIONS
In MetS, accumulation of epicardial and pericardial fat is linked to the severity of structural and functional alterations of the heart. The role of increased intramyocardial TG in MetS is more complex and merits further study.
Kristofer
K
Nyman
Marit
M
Granér
Markku O
MO
Pentikäinen
Jesper
J
Lundbom
Antti
A
Hakkarainen
Reijo
R
Sirén
Markku S
MS
Nieminen
Marja-Riitta
MR
Taskinen
Nina
N
Lundbom
Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Stenbäckinkatu 11, BOX 281, Helsinki FI-00029 HUS, Finland. kirsi.lauerma@hus.fi.
Kirsi
K
Lauerma
D000273:Adipose Tissue / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D050154:Adiposity; D000328:Adult; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D016022:Case-Control Studies; D003971:Diastole; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D012720:Severity of Illness Index; D012737:Sex Factors; D014280:Triglycerides / Q000378:metabolism; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D016277:Ventricular Function, Left
D014280:Triglycerides