title: Relationship between Regional Fat Distribution and Hypertrophic Cardiomyopathy Phenotype.
abstract: BACKGROUND
  Hypertrophic cardiomyopathy (HCM), the most common genetic heart disease, is characterized by heterogeneous phenotypic expression. Body mass index has been associated with LV mass and heart failure symptoms in HCM. The aim of our study was to investigate whether regional (trunk, appendicular, epicardial) fat distribution and extent could be related to hypertrophy severity and pattern in HCM.
  
  
  METHODS
  Cardiovascular magnetic resonance was performed in 32 subjects with echocardiography-based diagnosis of HCM (22M/10F, 57.2±12.6 years) characterized by predominant hypertrophy at the interventricular septum (IVS). Regional fat distribution was assessed by dual-energy X-ray absorptiometry.
  
  
  RESULTS
  Gender differences were detected in maximum IVS thickness (M: 18.3±3.8 mm vs. F: 14.3±4 mm, p = 0.012), right ventricle (RV) systolic function (M: 61.3±6.7%; F: 67.5±6.3%, p = 0.048), indexed RV end-diastolic (M: 64.8±16.3 ml/m2; F: 50.7±15.5 ml/m2, p = 0.04) and end-systolic volumes (M: 24.3±8.3 ml/m2; F: 16.7±7.4 ml/m2, p = 0.04). After adjusting for age and gender, maximum IVS thickness was associated with truncal fat (Tr-FAT) (β = 0.43, p = 0.02), but not with either appendicular or epicardial fat. Epicardial fat resulted independently associated with NT-proBNP levels (β = 0.63, p = 0.04). Late Gadolinium Enhancement-positive subjects displayed greater maximum IVS thickness (p = 0.02), LV mass index (p = 0.015) and NT-proBNP levels (p = 0.04), but no associations with fat amount or distribution were observed.
  
  
  CONCLUSIONS
  Truncal, but not appendicular or epicardial fat amount, seems to be related with maximum IVS thickness, the hallmark feature in our cohort of HCM patients. Further prospective researches are needed to assess a potential causative effect of central adiposity on HCM phenotype.
authors.affiliation: Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Guglielmi
authors.affiliation: Diagnostic Imaging Department, Policlinico Casilino, Rome, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Maresca
authors.affiliation: Cardiology Department, Policlinico Casilino, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Lanzillo
authors.affiliation: Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Giorgia Michela
authors.initials: GM
authors.lastname: Marinoni
authors.affiliation: Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: D'Adamo
authors.affiliation: Diagnostic Imaging Department, Policlinico Casilino, Rome, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Di Roma
authors.affiliation: Diagnostic Imaging Department, Policlinico Casilino, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Preziosi
authors.affiliation: Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Bellia
authors.affiliation: Cardiology Department, Policlinico Casilino, Rome, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Calò
authors.affiliation: Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Sbraccia
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D050218:Body Fat Distribution; D015992:Body Mass Index; D002312:Cardiomyopathy, Hypertrophic / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D010641:Phenotype