Christopher Maroules MD, Presenter: Nothing to Disclose

Nicolle Fernandez BS, Abstract Co-Author: Nothing to Disclose

Susan Lakoski MD, Abstract Co-Author: Nothing to Disclose

Susan Matulevicius MD, Abstract Co-Author: Nothing to Disclose

Suhny Abbara MD, Abstract Co-Author: Research Consultant, Radiology Consulting Group

Alice Y. Chang MD, MSc, Abstract Co-Author: Nothing to Disclose

Prior studies have demonstrated that epicardial adipose tissue (EAT) is significantly reduced in patients with heart failure and that lower EAT correlates with lower left ventricular ejection fraction. Other studies have demonstrated a positive correlation between EAT and insulin resistance. We sought to determine the association between EAT and cardiovascular performance during exercise among asymptomatic women with the metabolic syndrome. 

We recruited 27 asymptomatic premenopausal women with the metabolic syndrome who underwent cardiac magnetic resonance imaging (CMR) at 3 Tesla. EAT thickness was measured along the left ventricular anterior wall from a two chamber, ECG-gated cine image at end-diastole. Insulin sensitivity was calculated from a frequently sampled intravenous glucose tolerance test. Measurements of cardiovascular performance were obtained during an exercise treadmill test, including oxygen uptake (VO2). Body fat composition was determined by hydrostatic underwater weighting. Univariate analyses were performed using Spearman correlation. Adjustment for insulin sensitivity was performed using linear regression. 

The median age of study participants was 39 (interquartile range, IQR: 34-45) years and the median body mass index (BMI) was 35 (IQR: 29-38) kg/m2. EAT positively correlated with BMI (p=0.04), waist circumference (p=0.03), and hip circumference (p=0.02), but did not correlate with percent body fat (p=0.13). EAT positively correlated with VO2 indexed to weight during steady state exercise (r=0.59, p=0.03), but not at rest or maximum effort. In linear regression models after adjusting for insulin sensitivity, EAT remained significantly associated with steady state exercise VO2 indexed to weight (p=0.01).  

Among asymptomatic women with the metabolic syndrome, epicardial adipose tissue by CMR is associated with VO2 during exercise independent of insulin sensitivity. 

Depletion of epicardial adipose tissue may be a useful marker of subclinical cardiovascular disease. Future studies should explore the role of epicardial adipose tissue as a predictor of cardiovascular risk and response to therapeutic interventions. 

Maroules, C, Fernandez, N, Lakoski, S, Matulevicius, S, Abbara, S, Chang, A, Epicardial Adipose Tissue is Associated with Cardiovascular Performance during Exercise in Asymptomatic Women with the Metabolic Syndrome.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006688.html