Myocardial adipose deposition and the development of heart failure with preserved ejection fraction
Open accessAbstract
AIMS: It has been proposed that an increase of myocardial adiposity is related to left ventricular (LV) diastolic dysfunction. The specific roles of myocardial steatosis including epicardial fat and intramyocardial fat for diastolic function are unknown in those patients suffering heart failure (HF) with reduced (HFrEF) or preserved ejection fraction (HFpEF). This study aims to determine the complex relationship between myocardial adiposity in patients with HFrEF or HFpEF. METHODS AND RESULTS: Using cardiac magnetic resonance imaging (CMRI), myocardial steatosis was measured in 305 subjects (34 patients with HFrEF, 163 with HFpEF, and 108 non-HF controls). We also evaluated cardiac structure and diastolic and systolic function by echocardiography and CMRI. Patients with HFpEF had significantly more intramyocardial fat than HFrEF patients or non-HF controls [intramyocardial fat content (%), 1.56 (1.26, 1.89) vs. 0.75 (0.50, 0.87) and 1.0 (0.79, 1.15), P < 0.05]. Intramyocardial fat amount (%) was higher in HFpEF women than in men [1.91% (1.17%, 2.32%) vs. 1.22 (0.87%, 2.02%), P = 0.01]. When estimated by CMRI (left ventricular peak filling rate), echocardiographic E/e' level, or left atrial volume index, intramyocardial fat correlated with LV diastolic dysfunction parameters in HFpEF patients, and this was independent of age, co-morbidities, body mass index, gender, and myocardial fibrosis (standardized coefficient: β = -0.34, P = 0.03; β = 0.29, P = 0.025; and β = 0.25, P = 0.02, respectively). CONCLUSIONS: Patients with HFpEF had significantly more intramyocardial fat than HFrEF patients or non-HF controls. Independent of risk factors or gender, intramyocardial fat correlated with LV diastolic dysfunction parameters in HFpEF patients.
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In non-obese patients, with or without diabetes, fat deposition in myocardium is significantly more represented in subjects with HFpEF than HFrEF or non-HF controls.
“Moreover, in a population of non-obese patients, with or without diabetes, fat deposition in myocardium was significantly more represented in subjects with HFpEF than HFrEF or non-HF controls [89].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [89]
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- Authors
- Wu, C.-K., Lee, J.-K., Hsu, J.-C., Su, M.-Y. M., Wu, Y.-F., Lin, T.-T., Lan, C.-W., Hwang, J.-J., & Lin, L.-Y.
- Affiliations
- National Taiwan University (TW)
- Chia-Yi Christian Hospital (TW)
- National Taiwan University Hospital (TW)
- Department of Family Medicine, Taipei City Hospital, Renai Branch , Taipei ,
- National Yang Ming Chiao Tung University (TW)
- Corresponding author
- Lin, Ting-Tse
- Lin, Lian-Yu
- Venue
- European Journal of Heart Failure
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-09-11
- Volume
- 22
- Issue
- 3
- Pages
- 445-454
- ISSN
- 1388-9842 (ISSN-L)
- 1879-0844
- OpenAlex
- W2985962366
- Cited by
- 162
- References
- 44
- Citations by year
- 2026: 16 · 2025: 42 · 2024: 29 · 2023: 22 · 2022: 21 · 2021: 17 · 2020: 14 · 2019: 1
- FWCI
- 9.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- European Journal of Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Science Council
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Keywords
- myocardial steatosis, heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, epicardial adipose tissue, left ventricular diastolic dysfunction, sex differences, left atrial volume index, E/e' ratio, cardiac magnetic resonance imaging
- MeSH terms
- Diastole, Female, Heart Failure, Humans, Male, Myocardium, Stroke Volume, Adipocytes, Ventricular Dysfunction, Left
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