Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Stenbäckinkatu 11, BOX 281, Helsinki FI-00029 HUS, Finland.
J Cardiovasc Magn Reson. 2013 Nov 14;15(1):103. doi: 10.1186/1532-429X-15-103.
Ectopic accumulation of fat accompanies visceral obesity with detrimental effects. Lipid oversupply to cardiomyocytes leads to cardiac steatosis, and in animal studies lipotoxicity has been associated with impaired left ventricular (LV) function. In humans, studies have yielded inconclusive results. The aim of the study was to evaluate the role of epicardial, pericardial and myocardial fat depots on LV structure and function in male subjects with metabolic syndrome (MetS).
A study population of 37 men with MetS and 38 men without MetS underwent cardiovascular magnetic resonance and proton magnetic spectroscopy at 1.5 T to assess LV function, epicardial and pericardial fat area and myocardial triglyceride (TG) content.
All three fat deposits were greater in the MetS than in the control group (p <0.001). LV diastolic dysfunction was associated with MetS as measured by absolute (471 mL/s vs. 667 mL/s, p = 0.002) and normalized (3.37 s⁻¹ vs. 3.75 s⁻¹, p = 0.02) LV early diastolic peak filling rate and the ratio of early diastole (68% vs. 78%, p = 0.001). The amount of epicardial and pericardial fat correlated inversely with LV diastolic function. However, myocardial TG content was not independently associated with LV diastolic dysfunction.
In MetS, accumulation of epicardial and pericardial fat is linked to the severity of structural and functional alterations of the heart. The role of increased intramyocardial TG in MetS is more complex and merits further study.
脂肪异位堆积伴随着内脏肥胖，具有有害影响。脂肪供应给心肌细胞会导致心脏脂肪变性，在动物研究中，脂毒性与左心室（LV）功能受损有关。在人类中，研究结果尚无定论。本研究旨在评估男性代谢综合征（MetS）患者心外膜、心包和心肌脂肪沉积对 LV 结构和功能的作用。
一项研究人群包括 37 名 MetS 男性和 38 名非 MetS 男性，在 1.5T 磁共振上进行心血管磁共振和质子磁共振波谱检查，以评估 LV 功能、心外膜和心包脂肪面积以及心肌三酰甘油（TG）含量。
MetS 组的三种脂肪沉积均大于对照组（p<0.001）。LV 舒张功能障碍与 MetS 相关，通过绝对（471 mL/s 比 667 mL/s，p=0.002）和标准化（3.37 s⁻¹ 比 3.75 s⁻¹，p=0.02）LV 早期舒张峰值充盈率以及早期舒张期（68%比 78%，p=0.001）比值来衡量。心外膜和心包脂肪量与 LV 舒张功能呈负相关。然而，心肌 TG 含量与 LV 舒张功能障碍无独立相关性。
在 MetS 中，心外膜和心包脂肪的堆积与心脏结构和功能改变的严重程度有关。心肌 TG 增加在 MetS 中的作用更为复杂，值得进一步研究。
