title: Pericardial- Rather than Intramyocardial Fat Is Independently Associated with Left Ventricular Systolic Heart Function in Metabolically Healthy Humans.
abstract: BACKGROUND
  Obesity is a major risk factor to develop heart failure, in part due to possible lipotoxic effects of increased intramyocardial (MYCL) and/or local or paracrine effects of pericardial (PERI) lipid accumulation. Recent evidence suggests that MYCL is highly dynamic and might rather be a surrogate marker for disturbed energy metabolism than the underlying cause of cardiac dysfunction. On the other hand, PERI might contribute directly by mechanic and paracrine effects. Therefore, we hypothesized that PERI rather than MYCL is associated with myocardial function.
  
  
  METHODS
  To avoid potential confounding of metabolic disease 31 metabolically healthy subjects (age: 29±10yrs; BMI: 23±3kg/m2) were investigated using 1H-magnetic resonance spectroscopy and imaging. MYCL and PERI, as well as systolic and diastolic left ventricular heart function were assessed. Additionally, anthropometric data and parameters of glucose and lipid metabolism were analyzed. Correlation analysis was performed using Pearson's correlation coefficient. Linear regression model was used to show individual effects of PERI and MYCL on myocardial functional parameters.
  
  
  RESULTS
  Correlation analysis with parameters of systolic heart function revealed significant associations for PERI (Stroke Volume (SV): R = -0.513 p = 0.001; CardiacIndex (CI): R = -0.442 p = 0.014), but not for MYCL (SV: R = -0.233; p = 0.207; CI: R = -0.130; p = 0.484). No significant correlations were found for E/A ratio as a parameter of diastolic heart function. In multiple regression analysis CI was negatively predicted by PERI, whereas no impact of MYCL was observed in direct comparison.
  
  
  CONCLUSIONS
  Cardiac fat depots impact left ventricular heart function in a metabolically healthy population. Direct comparison of different lipid stores revealed that PERI is a more important predictor than MYCL for altered myocardial function.
authors.affiliation: Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Wolf
authors.affiliation: Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Winhofer
authors.affiliation: Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria.
authors.forename: Sabina
authors.initials: S
authors.lastname: Smajis
authors.affiliation: Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria.|Wilhelminenspital, Department of Internal Medicine I, Division of Oncology, Hematology and Palliative Care, Vienna, Austria.
authors.forename: Draženka
authors.initials: D
authors.lastname: Jankovic
authors.affiliation: Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria.|Metabolic Unit, Institute of Biomedical Engineering, National Research Council, Padova, Italy.|Medical Direction, Specialized Hospital Complex Agathenhof, A-9322 Micheldorf, Carinthia, Austria.
authors.forename: Christian-Heinz
authors.initials: CH
authors.lastname: Anderwald
authors.affiliation: Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Centre of Excellence-High Field MR, Vienna, Austria.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Trattnig
authors.affiliation: Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria.
authors.forename: Anton
authors.initials: A
authors.lastname: Luger
authors.affiliation: Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Krebs
authors.affiliation: Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria.|Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Centre of Excellence-High Field MR, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Krššák
mesh_terms: D050154:Adiposity; D000328:Adult; D015992:Body Mass Index; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006339:Heart Rate; D006801:Humans; D016014:Linear Models; D050356:Lipid Metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D009206:Myocardium / Q000378:metabolism*; D010496:Pericardium / Q000378:metabolism*; D013318:Stroke Volume; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult