title: Adiposity Is Associated with Gender-Specific Reductions in Left Ventricular Myocardial Perfusion during Dobutamine Stress.
abstract: BACKGROUND
  Obesity and visceral adiposity are increasingly recognized risk factors for cardiovascular disease. Visceral fat may reduce myocardial perfusion by impairing vascular endothelial function. Women experience more anginal symptoms compared to men despite less severe coronary artery stenosis, as assessed by angiography. Women and men have different fat storage patterns which may account for the observed differences in cardiovascular disease. Therefore, our objective was to evaluate the relationship between visceral adipose tissue distributions and myocardial perfusion in men and women.
  
  
  METHODS
  Visceral and subcutaneous fat distributions and myocardial perfusion were measured in 69 men and women without coronary artery disease using magnetic resonance imaging techniques. Myocardial perfusion index was quantified after first-pass perfusion with gadolinium contrast at peak dose dobutamine stress.
  
  
  RESULTS
  We observed inverse relationships between female gender (r = -0.35, p = 0.003), pericardial fat (r = -0.36, p = 0.03), intraperitoneal fat (r = -0.37, p = 0.001), and retroperitoneal fat (r = -0.36, p = 0.002) and myocardial perfusion index. Visceral fat depots were not associated with reduced myocardial perfusion at peak dose dobutamine in men. However, in women, BMI (r = -0.33, p = 0.04), pericardial fat (r = -0.53, p = 0.02), subcutaneous fat (r = -0.39, p = 0.01) and intraperitoneal fat (r = -0.30, p = 0.05) were associated with reduced myocardial perfusion during dobutamine stress.
  
  
  CONCLUSIONS
  Higher visceral fat volumes are associated with reduced left ventricular myocardial perfusion at peak dose dobutamine stress in women but not in men. These findings suggest that visceral fat may contribute to abnormal microcirculatory coronary artery perfusion syndromes, explaining why some women exhibit more anginal symptoms despite typically lower grade epicardial coronary artery stenoses than men.
authors.affiliation: Department of Medicine, Division of Cardiology, University of Mississippi Medical Center, Jackson, Mississippi, United States of America.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Hall
authors.affiliation: Department of Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Tina E
authors.initials: TE
authors.lastname: Brinkley
authors.affiliation: Division of Cardiology, Beloit Memorial Hospital, Beloit, Wisconsin, United States of America.
authors.forename: Haroon
authors.initials: H
authors.lastname: Chughtai
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Morgan
authors.affiliation: Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Hamilton
authors.affiliation: Department of Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Jordan
authors.affiliation: Department of Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: R Brandon
authors.initials: RB
authors.lastname: Stacey
authors.affiliation: Department of Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Sandra
authors.initials: S
authors.lastname: Soots
authors.affiliation: Department of Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: W Gregory
authors.initials: WG
authors.lastname: Hundley
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000503:physiopathology; D004280:Dobutamine / Q000737:chemistry*; D025401:Echocardiography, Stress; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D050152:Intra-Abdominal Fat / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D009206:Myocardium / Q000473:pathology; D009765:Obesity; D012307:Risk Factors; D012737:Sex Factors; D013312:Stress, Physiological
chemical_list: D004280:Dobutamine