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Associations of region‐specific visceral adiposity with subclinical atrial dysfunction and outcomes of heart failure
AIMS: Excessive visceral adiposity (VAT) plays an essential role in metabolic derangements with those close to heart further mediates myocardial homeostasis. The disparate biological links between region‐specific VAT and cardiometabolic profiles as mediators influencing atrial kinetics remain unexpl...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7754950/ https://www.ncbi.nlm.nih.gov/pubmed/33113275 http://dx.doi.org/10.1002/ehf2.12761 |
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author | Huang, Bo‐Han Chang, Shun‐Chuan Yun, Chun‐Ho Sung, Kuo‐Tzu Lai, Yau‐Huei Lo, Chi‐In Huang, Wen‐Hung Chien, Shih‐Chieh Liu, Lawrence Yu‐Min Hung, Ta‐Chuan Kuo, Jen‐Yuan Lin, Jiun‐Lu Bulwer, Bernard Hou, Charles Jia‐Yin Chen, Ying‐Ju Su, Cheng‐Huang Yeh, Hung‐I Hung, Chung‐Lieh |
author_facet | Huang, Bo‐Han Chang, Shun‐Chuan Yun, Chun‐Ho Sung, Kuo‐Tzu Lai, Yau‐Huei Lo, Chi‐In Huang, Wen‐Hung Chien, Shih‐Chieh Liu, Lawrence Yu‐Min Hung, Ta‐Chuan Kuo, Jen‐Yuan Lin, Jiun‐Lu Bulwer, Bernard Hou, Charles Jia‐Yin Chen, Ying‐Ju Su, Cheng‐Huang Yeh, Hung‐I Hung, Chung‐Lieh |
author_sort | Huang, Bo‐Han |
collection | PubMed |
description | AIMS: Excessive visceral adiposity (VAT) plays an essential role in metabolic derangements with those close to heart further mediates myocardial homeostasis. The disparate biological links between region‐specific VAT and cardiometabolic profiles as mediators influencing atrial kinetics remain unexplored. METHODS AND RESULTS: Among 1326 asymptomatic individuals, region‐specific VAT including peri‐aortic root fat (PARF) and total pericardial fat (PCF) of cardiac region, together with thoracic peri‐aortic adipose tissue (TAT), was assessed using multiple‐detector computed tomography. VAT measures were related to functional left atrial (LA) metrics assessed by speckle‐tracking algorithm and clinical outcomes of atrial fibrillation (AF) and heart failure (HF). Multivariate linear regression models incorporating body fat, metabolic syndrome, and E/TDI‐e' consistently demonstrated independent associations of larger PARF/PCF with peak atrial longitudinal systolic strain (PALS) reduction, higher LA stiffness, and worsened strain rate components; instead, TAT was independently associated with cardiometabolic profiles. PARF rather than PCF or TAT conferred independent prognostic values for incident AF/HF by multivariate Cox regression (adjusted hazard ratio: 1.56, 95% confidence interval: 1.17–2.08, P = 0.002) during a median of 1790 days (interquartile range: 25th to 75th: 1440–1927 days) of follow‐up, with subjects categorized into worst PALS and largest VAT tertiles demonstrating highest events (all log‐rank P < 0.001). Mediation analysis showed that higher triglyceride and lower high‐density lipoproteins may serve as intermediary factors for effects between VAT and LA functional metrics, with lesser role by glucose level. CONCLUSIONS: Visceral adiposity surrounding atrial region was tightly associated with subclinical atrial dysfunction and incident AF or HF beyond metabolic factors. Instead, peri‐aortic adiposity may mediate their toxic effects mainly through circulating cardiometabolic profiles. |
format | Online Article Text |
id | pubmed-7754950 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77549502020-12-23 Associations of region‐specific visceral adiposity with subclinical atrial dysfunction and outcomes of heart failure Huang, Bo‐Han Chang, Shun‐Chuan Yun, Chun‐Ho Sung, Kuo‐Tzu Lai, Yau‐Huei Lo, Chi‐In Huang, Wen‐Hung Chien, Shih‐Chieh Liu, Lawrence Yu‐Min Hung, Ta‐Chuan Kuo, Jen‐Yuan Lin, Jiun‐Lu Bulwer, Bernard Hou, Charles Jia‐Yin Chen, Ying‐Ju Su, Cheng‐Huang Yeh, Hung‐I Hung, Chung‐Lieh ESC Heart Fail Original Research Articles AIMS: Excessive visceral adiposity (VAT) plays an essential role in metabolic derangements with those close to heart further mediates myocardial homeostasis. The disparate biological links between region‐specific VAT and cardiometabolic profiles as mediators influencing atrial kinetics remain unexplored. METHODS AND RESULTS: Among 1326 asymptomatic individuals, region‐specific VAT including peri‐aortic root fat (PARF) and total pericardial fat (PCF) of cardiac region, together with thoracic peri‐aortic adipose tissue (TAT), was assessed using multiple‐detector computed tomography. VAT measures were related to functional left atrial (LA) metrics assessed by speckle‐tracking algorithm and clinical outcomes of atrial fibrillation (AF) and heart failure (HF). Multivariate linear regression models incorporating body fat, metabolic syndrome, and E/TDI‐e' consistently demonstrated independent associations of larger PARF/PCF with peak atrial longitudinal systolic strain (PALS) reduction, higher LA stiffness, and worsened strain rate components; instead, TAT was independently associated with cardiometabolic profiles. PARF rather than PCF or TAT conferred independent prognostic values for incident AF/HF by multivariate Cox regression (adjusted hazard ratio: 1.56, 95% confidence interval: 1.17–2.08, P = 0.002) during a median of 1790 days (interquartile range: 25th to 75th: 1440–1927 days) of follow‐up, with subjects categorized into worst PALS and largest VAT tertiles demonstrating highest events (all log‐rank P < 0.001). Mediation analysis showed that higher triglyceride and lower high‐density lipoproteins may serve as intermediary factors for effects between VAT and LA functional metrics, with lesser role by glucose level. CONCLUSIONS: Visceral adiposity surrounding atrial region was tightly associated with subclinical atrial dysfunction and incident AF or HF beyond metabolic factors. Instead, peri‐aortic adiposity may mediate their toxic effects mainly through circulating cardiometabolic profiles. John Wiley and Sons Inc. 2020-10-28 /pmc/articles/PMC7754950/ /pubmed/33113275 http://dx.doi.org/10.1002/ehf2.12761 Text en © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Articles Huang, Bo‐Han Chang, Shun‐Chuan Yun, Chun‐Ho Sung, Kuo‐Tzu Lai, Yau‐Huei Lo, Chi‐In Huang, Wen‐Hung Chien, Shih‐Chieh Liu, Lawrence Yu‐Min Hung, Ta‐Chuan Kuo, Jen‐Yuan Lin, Jiun‐Lu Bulwer, Bernard Hou, Charles Jia‐Yin Chen, Ying‐Ju Su, Cheng‐Huang Yeh, Hung‐I Hung, Chung‐Lieh Associations of region‐specific visceral adiposity with subclinical atrial dysfunction and outcomes of heart failure |
title | Associations of region‐specific visceral adiposity with subclinical atrial dysfunction and outcomes of heart failure |
title_full | Associations of region‐specific visceral adiposity with subclinical atrial dysfunction and outcomes of heart failure |
title_fullStr | Associations of region‐specific visceral adiposity with subclinical atrial dysfunction and outcomes of heart failure |
title_full_unstemmed | Associations of region‐specific visceral adiposity with subclinical atrial dysfunction and outcomes of heart failure |
title_short | Associations of region‐specific visceral adiposity with subclinical atrial dysfunction and outcomes of heart failure |
title_sort | associations of region‐specific visceral adiposity with subclinical atrial dysfunction and outcomes of heart failure |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7754950/ https://www.ncbi.nlm.nih.gov/pubmed/33113275 http://dx.doi.org/10.1002/ehf2.12761 |
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