Skip to main content
SpringerLink
Log in

Relationship between epicardial adipose tissue thickness and early impairment of left ventricular systolic function in patients with preserved ejection fraction

  • Short Communication
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

Epicardial adipose tissue (EAT) is metabolically bioactive fat. The present study aimed to clarify the relationship between EAT amount and early impairment of left ventricular (LV) systolic function in patients with preserved ejection fraction (EF), all evaluated echocardiographically. Participants comprised 62 elderly women (mean age ± standard deviation, 68 ± 11 years) with lifestyle-related diseases and EF ≥ 60 %. EAT amount was evaluated as thickness. Parameters suggesting early impairment of systolic function such as decreases in systolic mitral annular velocity (S′) and tissue mitral annular displacement percentage (TMAD %) were evaluated along with EF. Correlations between EAT thickness and these LV systolic functions were assessed. Influences of various factors on the resultant significant relationships were also assessed. EAT thickness correlated inversely with S′ and TMAD % (r = −0.402, p = 0.001 and r = −0.585, p < 0.001, respectively), but did not correlate with EF (r = 0.054, not significant). These significant relationships were maintained after considering factors such as body mass index, age, presence of lifestyle-related diseases and blood test results. A significant relationship existed between EAT amount and early impairment of LV systolic function in patients with preserved EF. Accumulation of EAT might contribute to the initial development of LV systolic dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Mazurek T, Zhang L, Zalewski A, Mannion JD, Diehl JT, Arafat H, Sarov-Blat L, O’Brien S, Keiper EA, Johnson AG, Martin J, Goldstein BJ, Shi Y (2003) Human epicardial adipose tissue is a source of inflammatory mediators. Circulation 108:2460–2466

    Article  PubMed  Google Scholar 

  2. Rabkin SW (2007) Epicardial fat: properties, function and relationship to obesity. Obes Rev 8:253–261

    Article  CAS  PubMed  Google Scholar 

  3. Iacobellis G, Willens HJ (2009) Echocardiographic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr 22:1311–1319

    Article  PubMed  Google Scholar 

  4. Iacobellis G, Bianco AC (2011) Epicardial adipose tissue: emerging physiological, pathophysiological and clinical features. Trends Endocrinol Metab 22:450–457

    Article  CAS  PubMed  Google Scholar 

  5. Cavalcante JL, Tamarappoo BK, Hachamovitch R, Kwon DH, Alraies MC, Halliburton S, Schoenhagen P, Dey D, Berman DS, Marwick TH (2012) Association of epicardial fat, hypertension, subclinical coronary artery disease, and metabolic syndrome with left ventricular diastolic dysfunction. Am J Cardiol 110:1793–1798

    Article  PubMed  PubMed Central  Google Scholar 

  6. Lin HH, Lee JK, Yang CY, Lien YC, Huang JW, Wu CK (2013) Accumulation of epicardial fat rather than visceral fat is an independent risk factor for left ventricular diastolic dysfunction in patients undergoing peritoneal dialysis. Cardiovasc Diabetol 12:127

    Article  PubMed  PubMed Central  Google Scholar 

  7. Yu CM, Lin H, Yang H, Kong SL, Zhang Q, Lee SW (2002) Progression of systolic abnormalities in patients with “isolated” diastolic heart failure and diastolic dysfunction. Circulation 105:1195–1201

    Article  PubMed  Google Scholar 

  8. Bruch C, Gradaus R, Gunia S, Breithardt G, Wichter T (2003) Doppler tissue analysis of mitral annular velocities: evidence for systolic abnormalities in patients with diastolic heart failure. J Am Soc Echocardiogr 16:1031–1036

    Article  PubMed  Google Scholar 

  9. Vinereanu D, Nicolaides E, Tweddel AC, Fraser AG (2005) “Pure” diastolic dysfunction is associated with long-axis systolic dysfunction. Implications for the diagnosis and classification of heart failure. Eur J Heart Fail 7:820–828

    Article  PubMed  Google Scholar 

  10. Roberson DA, Cui W (2009) Tissue Doppler imaging measurement of left ventricular systolic function in children: mitral annular displacement index is superior to peak velocity. J Am Soc Echocardiogr 22:376–382

    Article  PubMed  Google Scholar 

  11. Khawaja T, Greer C, Chokshi A, Chavarria N, Thadani S, Jones M, Schaefle K, Bhatia K, Collado JE, Shimbo D, Einstein AJ, Schulze PC (2011) Epicardial fat volume in patients with left ventricular systolic dysfunction. Am J Cardiol 108:397–401

    Article  PubMed  Google Scholar 

  12. Ahn SG, Lim HS, Joe DY, Kang SJ, Choi BJ, Choi SY, Yoon MH, Hwang GS, Tahk SJ, Shin JH (2008) Relationship of epicardial adipose tissue by echocardiography to coronary artery disease. Heart 94:e7

    Article  PubMed  Google Scholar 

  13. Pierdomenico SD, Mancini M, Cuccurullo C, Guglielmi MD, Pierdomenico AM, Di Nicola M, Di Carlo S, Lapenna D, Cuccurullo F (2013) Prediction of carotid plaques in hypertensive patients by risk factors, left ventricular hypertrophy, and epicardial adipose tissue thickness. Heart Vessels 28:277–283

    Article  PubMed  Google Scholar 

  14. Zencirci E, Zencirci AE, Değirmencioğlu A, Karakuş G, Uğurlucan M, Özden K, Erdem A, Güllü AU, Ekmekçi A, Velibey Y, Erer HB, Çelik S, Akyol A (2014) The relationship between epicardial adipose tissue and ST-segment resolution in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Heart Vessels. doi:10.1007/s00380-013-0459-2

    PubMed  Google Scholar 

  15. DeCara JM, Toledo E, Salgo IS, Lammertin G, Weinert L, Lang RM (2005) Evaluation of left ventricular systolic function using automated angle-independent motion tracking of mitral annular displacement. J Am Soc Echocardiogr 18:1266–1269

    Article  PubMed  Google Scholar 

  16. Buss SJ, Mereles D, Emami M, Korosoglou G, Riffel JH, Bertel D, Schonland SO, Hegenbart U, Katus HA, Hardt SE (2012) Rapid assessment of longitudinal systolic left ventricular function using speckle tracking of the mitral annulus. Clin Res Cardiol 101:273–280

    Article  PubMed  Google Scholar 

  17. Iacobellis G, Pond CM, Sharma AM (2006) Different “weight” of cardiac and general adiposity in predicting left ventricle morphology. Obesity (Silver Spring) 14:1679–1684

    Article  Google Scholar 

  18. Bambace C, Sepe A, Zoico E, Telesca M, Olioso D, Venturi S, Rossi A, Corzato F, Faccioli S, Cominacini L, Santini F, Zamboni M (2014) Inflammatory profile in subcutaneous and epicardial adipose tissue in men with and without diabetes. Heart Vessels 29:42–48

    Article  PubMed  Google Scholar 

  19. Kim HM, Kim KJ, Lee HJ, Yu HT, Moon JH, Kang ES, Cha BS, Lee HC, Lee BW, Kim YJ (2012) Epicardial adipose tissue thickness is an indicator for coronary artery stenosis in asymptomatic type 2 diabetic patients: its assessment by cardiac magnetic resonance. Cardiovasc Diabetol 11:83

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Dagvasumberel M, Shimabukuro M, Nishiuchi T, Ueno J, Takao S, Fukuda D, Hirata Y, Kurobe H, Soeki T, Iwase T, Kusunose K, Niki T, Yamaguchi K, Taketani Y, Yagi S, Tomita N, Yamada H, Wakatsuki T, Harada M, Kitagawa T, Sata M (2012) Gender disparities in the association between epicardial adipose tissue volume and coronary atherosclerosis: a 3-dimensional cardiac computed tomography imaging study in Japanese subjects. Cardiovasc Diabetol 11:106

    Article  PubMed  PubMed Central  Google Scholar 

  21. Yamashita K, Yamamoto MH, Ebara S, Okabe T, Saito S, Hoshimoto K, Yakushiji T, Isomura N, Araki H, Obara C, Ochiai M (2014) Association between increased epicardial adipose tissue volume and coronary plaque composition. Heart Vessels 29:569–577

    Article  PubMed  PubMed Central  Google Scholar 

  22. Hirata Y, Tabata M, Kurobe H, Motoki T, Akaike M, Nishio C, Higashida M, Mikasa H, Nakaya Y, Takanashi S, Igarashi T, Kitagawa T, Sata M (2011) Coronary atherosclerosis is associated with macrophage polarization in epicardial adipose tissue. J Am Coll Cardiol 58:248–255

    Article  CAS  PubMed  Google Scholar 

  23. Hirata Y, Kurobe H, Akaike M, Chikugo F, Hori T, Bando Y, Nishio C, Higashida M, Nakaya Y, Kitagawa T, Sata M (2011) Enhanced inflammation in epicardial fat in patients with coronary artery disease. Int Heart J 52:139–142

    Article  CAS  PubMed  Google Scholar 

  24. Tamarappoo B, Dey D, Shmilovich H, Nakazato R, Gransar H, Cheng VY, Friedman JD, Hayes SW, Thomson LE, Slomka PJ, Rozanski A, Berman DS (2010) Increased pericardial fat volume measured from noncontrast CT predicts myocardial ischemia by SPECT. JACC Cardiovasc Imaging 3:1104–1112

    Article  PubMed  PubMed Central  Google Scholar 

  25. Sicari R, Sironi AM, Petz R, Frassi F, Chubuchny V, De Marchi D, Positano V, Lombardi M, Picano E, Gastaldelli A (2011) Pericardial rather than epicardial fat is a cardiometabolic risk marker: an MRI vs echo study. J Am Soc Echocardiogr 24:1156–1162

    Article  PubMed  Google Scholar 

  26. Atalar F, Gormez S, Caynak B, Akan G, Tanriverdi G, Bilgic-Gazioglu S, Gunay D, Duran C, Akpinar B, Ozbek U, Buyukdevrim AS, Yazici Z (2012) The role of mediastinal adipose tissue 11β-hydroxysteroid dehydrogenase type 1 and glucocorticoid expression in the development of coronary atherosclerosis in obese patients with ischemic heart disease. Cardiovasc Diabetol 11:115

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

This work was supported by Japan Society for the Promotion of Science (JSPS) KAKENHI.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan

    Keiko Watanabe, Tomonori Kishino, Junko Sano, Toshiyuki Ariga, Kouki Ohtsuka, Hiroaki Ohnishi & Takashi Watanabe

  2. Department of Laboratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan

    Tomonori Kishino, Satsuki Matsushima, Kouki Ohtsuka, Hiroaki Ohnishi & Takashi Watanabe

  3. Department of Clinical Engineering, Kyorin University Faculty of Health Sciences, Tokyo, Japan

    Tomonori Kishino

  4. The Third Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan

    Tomonori Kishino, Shuhei Okuyama & Hideaki Mori

Authors
  1. Keiko Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tomonori Kishino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Junko Sano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Toshiyuki Ariga
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shuhei Okuyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hideaki Mori
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Satsuki Matsushima
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kouki Ohtsuka
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hiroaki Ohnishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Takashi Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomonori Kishino.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Watanabe, K., Kishino, T., Sano, J. et al. Relationship between epicardial adipose tissue thickness and early impairment of left ventricular systolic function in patients with preserved ejection fraction. Heart Vessels 31, 1010–1015 (2016). https://doi.org/10.1007/s00380-015-0650-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-015-0650-8

Keywords

Search

Navigation