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. 2022 Sep 21:9:939515.
doi: 10.3389/fcvm.2022.939515. eCollection 2022.

Both epicardial and peri-aortic adipose tissue blunt heart rate recovery beyond body fat mass

Sheng-Hsiung Chang  1   2   3 , Po-Hua Chu  1 , Cheng-Ting Tsai  1   2   3 , Jen-Yuan Kuo  1   2   3 , Jui-Peng Tsai  1   2   3 , Ta-Chuan Hung  1   2   3 , Charles Jia-Yin Hou  1   2   3 , Yau-Hui Lai  4 , Chia-Yuan Liu  5 , Wei-Ming Huang  3   5   6 , Chun-Ho Yun  3   6 , Hung-I Yeh  1   2   3 , Chung-Lieh Hung  1   2   3
Affiliations

Both epicardial and peri-aortic adipose tissue blunt heart rate recovery beyond body fat mass

Sheng-Hsiung Chang et al. Front Cardiovasc Med. .

Abstract

Background: Epicardial adipose tissue (EAT) as a marker of metabolic disorders has been shown to be closely associated with a variety of unfavorable cardiovascular events and cardiac arrhythmias. Data on regional-specific visceral adiposity outside the heart and its modulation on autonomic dysfunction, particularly heart rate recovery after exercise, remain obscure.

Methods: We studied 156 consecutive subjects (mean age: 49.3 ± 8.0 years) who underwent annual health surveys and completed treadmill tests. Multi-detector computed tomography-based visceral adiposity, including EAT and peri-aortic fat (PAF) tissue, was quantified using dedicated software (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA). We further correlated EAT and PAF with blood pressure and heart rate (HR) recovery information from an exercise treadmill test. Metabolic abnormalities were scored by anthropometrics in combination with biochemical data.

Results: Increased EAT and PAF were both associated with a smaller reduction in systolic blood pressure during the hyperventilation stage before exercise compared to supine status (β-coefficient (coef.): -0.19 and -0.23, respectively, both p < 0.05). Both visceral adipose tissue mediated an inverted relationship with heart rate recovery at 3 (EAT: β-coef.: -0.3; PAF: β-coef.: -0.36) and 6 min (EAT: β-coef.: -0.32; PAF: β-coef.: -0.34) after peak exercise, even after adjusting for baseline clinical variables and body fat composition (all p < 0.05).

Conclusion: Excessive visceral adiposity, whether proximal or distal to the heart, may modulate the autonomic response by lowering the rate of HR recovery from exercise after accounting for clinical metabolic index. Cardiac autonomic dysfunction may partly explain the increase in cardiovascular morbidity and mortality related to both visceral fats.

Keywords: epicardial adipose tissue; heart rate recovery; multidetector computed tomography; peri-aortic adipose tissue; visceral adiposity measures.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Multidetector computed tomography (MDCT) demonstrated regional-specific adiposity measures including (A,B) epicardial adipose tissue (EAT) and (C,D) peri-aortic fat (PAF) in (A,C) axial view and (B,D) three-dimensional (3D) reconstruction. (A) The EAT was defined as the fat inside the pericardial sac with pericardium labeled in yellow color. (C) The PAF was defined as the fat surrounding the thoracic descending aorta with the region of interest labeled in yellow. In the 3D reconstruction of the (B) EAT and (D) PAF, where orange regions indicate visceral fat tissue.
Figure 2
Figure 2
The association between resting status heart rate (HR) including sequential supine, standing postures, hyperventilation, and the tertile groups of epicardial adipose tissue (EAT) and peri-aortic fat (PAF) showed an increased trend though not reaching statistical significance.
Figure 3
Figure 3
Linear relationships among the epicardial adipose tissue (EAT), peri-aortic fat (PAF), and heart rate recovery at 3 and 6 min from maximal heart rate after maximal exercise.
See this image and copyright information in PMC

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