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. 2013 Nov 14;15(1):103.
doi: 10.1186/1532-429X-15-103.

Cardiac steatosis and left ventricular function in men with metabolic syndrome

Kristofer Nyman, Marit Granér, Markku O Pentikäinen, Jesper Lundbom, Antti Hakkarainen, Reijo Sirén, Markku S Nieminen, Marja-Riitta Taskinen, Nina Lundbom, Kirsi Lauerma  1
Affiliations

Cardiac steatosis and left ventricular function in men with metabolic syndrome

Kristofer Nyman et al. J Cardiovasc Magn Reson. .

Abstract

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.

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Figures

Figure 1
Figure 1
Details of study design. Blue boxes indicate the number of study subjects at each stage and boxes outlined in red indicate drop-out rates at each stage.
Figure 2
Figure 2
Evaluation of diastolic function in left ventricular (LV) volume versus time curve. A) LV filling pattern in a normal subject. Early peak filling rate (PFR) is derived from the steepest gradient in the volume curve in the early filling phase. The horizontal white line demonstrates the diastolic diastasis phase (plateau) separating the early and late diastole. B) LV filling pattern in a metabolic syndrome patient with LV diastolic dysfunction demonstrating a depression of diastolic plateau and early PFR (arrow).
Figure 3
Figure 3
Determination of epicardial and pericardial fat. Contours of the epicardial (shown in blue) and pericardial (shown in red) fat were outlined in a 4-chamber oriented end-diastolic image.
Figure 4
Figure 4
Correlations of left ventricular mass-to-volume ratio (LV mass/EDV) and left ventricular early peak filling rate (PFR) with different cardiac fat compartments. A-C) Relationship of LV mass/EDV and all cardiac fat compartments showing positive associations. D) Notice non-significant correlation of PFR and myocardial TG content, and E-F) significant inverse correlation between PFR and epicardial and pericardial fat. Open circles indicate subjects with MetS and closed circles subjects without MetS.
See this image and copyright information in PMC

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