title: The association among MDCT-derived three-dimensional visceral adiposities on cardiac diastology and dyssynchrony in asymptomatic population.
abstract: BACKGROUND
  Visceral adipose tissue, a biologically active fat depot, has been proposed as a reliable marker for visceral adiposity and metabolic abnormalities. Effects of such adiposity on LV diastolic function and dyssynchrony remained largely unknown.
  
  
  METHODS
  We assessed pericardial fat (PCF) and thoracic peri-aortic fat (TPAF) by three-dimensional (3D) volume-vender multi-detector computed tomography (MDCT) (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA). Echo-derived diastolic parameters and tissue Doppler imaging (TDI) defined mitral annular systolic (S'), early diastolic (E') velocities as well as LV filling (E/E') were all obtained. Intra-ventricular systolic (Sys-D) and diastolic (Dias-D) dyssynchrony were assessed by TDI method.
  
  
  RESULTS
  A total of 318 asymptomatic subjects (mean age: 53.5 years, 36.8 % female) were eligible in this study. Greater PCF and TPAF were both associated with unfavorable diastolic indices and higher diastolic dyssynchrony (all p < 0.05). These associations remained relatively unchanged in multi-variate models. PCF and TPAF set at 81.68 & 8.11 ml yielded the largest sensitivity and specificity (78.6 and 60 % for PCF, 75 and 66.6 % for TPAF, respectively) in predicting abnormally high LV diastolic dyssynchrony, which was defined as Dias-D≧55 ms.
  
  
  CONCLUSIONS
  Increasing visceral adiposity may be associated with adverse effects on myocardium, primarily featured by worse diastolic function and greater degree of dyssynchrony.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Road, Taipei, Taiwan.|Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Hsinchu, Taiwan.|Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.|Mackay Medical College, Taipei, Taiwan.
authors.forename: Yau-Huei
authors.initials: YH
authors.lastname: Lai
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Road, Taipei, Taiwan.|Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Hsinchu, Taiwan.|Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.|Mackay Medical College, Taipei, Taiwan.
authors.forename: Charles Jia-Yin
authors.initials: CJ
authors.lastname: Hou
authors.affiliation: Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan.|Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei, Taiwan.
authors.forename: Chun-Ho
authors.initials: CH
authors.lastname: Yun
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Road, Taipei, Taiwan.|Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Hsinchu, Taiwan.|Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.|Mackay Medical College, Taipei, Taiwan.
authors.forename: Kuo-Tzu
authors.initials: KT
authors.lastname: Sung
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Road, Taipei, Taiwan.|Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Hsinchu, Taiwan.|Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.|Mackay Medical College, Taipei, Taiwan.
authors.forename: Cheng-Huang
authors.initials: CH
authors.lastname: Su
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei, Taiwan.
authors.forename: Tung-Hsin
authors.initials: TH
authors.lastname: Wu
authors.affiliation: Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Fei-Shih
authors.initials: FS
authors.lastname: Yang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Road, Taipei, Taiwan.|Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Hsinchu, Taiwan.|Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.|Mackay Medical College, Taipei, Taiwan.|The Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Ta-Chuan
authors.initials: TC
authors.lastname: Hung
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Road, Taipei, Taiwan. jotaro3791@gmail.com.|Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Hsinchu, Taiwan. jotaro3791@gmail.com.|Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan. jotaro3791@gmail.com.|Mackay Medical College, Taipei, Taiwan. jotaro3791@gmail.com.|The Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan. jotaro3791@gmail.com.
authors.forename: Chung-Lieh
authors.initials: CL
authors.lastname: Hung
authors.affiliation: University Hospitals Harrington Heart & Vascular Institute, Division of Cardiology, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Hiram G
authors.initials: HG
authors.lastname: Bezerra
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Road, Taipei, Taiwan.|Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Hsinchu, Taiwan.|Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.|Mackay Medical College, Taipei, Taiwan.
authors.forename: Hung-I
authors.initials: HI
authors.lastname: Yeh
mesh_terms: D050154:Adiposity / Q000502:physiology; D058070:Asymptomatic Diseases; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D056128:Obesity, Abdominal / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*