Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Vienna, Austria.
Wilhelminenspital, Department of Internal Medicine I, Division of Oncology, Hematology and Palliative Care, Vienna, Austria.
PLoS One. 2016 Mar 11;11(3):e0151301. doi: 10.1371/journal.pone.0151301. eCollection 2016.
Obesity is a major risk factor to develop heart failure, in part due to possible lipotoxic effects of increased intramyocardial (MYCL) and/or local or paracrine effects of pericardial (PERI) lipid accumulation. Recent evidence suggests that MYCL is highly dynamic and might rather be a surrogate marker for disturbed energy metabolism than the underlying cause of cardiac dysfunction. On the other hand, PERI might contribute directly by mechanic and paracrine effects. Therefore, we hypothesized that PERI rather than MYCL is associated with myocardial function.
To avoid potential confounding of metabolic disease 31 metabolically healthy subjects (age: 29±10yrs; BMI: 23±3kg/m2) were investigated using 1H-magnetic resonance spectroscopy and imaging. MYCL and PERI, as well as systolic and diastolic left ventricular heart function were assessed. Additionally, anthropometric data and parameters of glucose and lipid metabolism were analyzed. Correlation analysis was performed using Pearson's correlation coefficient. Linear regression model was used to show individual effects of PERI and MYCL on myocardial functional parameters.
Correlation analysis with parameters of systolic heart function revealed significant associations for PERI (Stroke Volume (SV): R = -0.513 p = 0.001; CardiacIndex (CI): R = -0.442 p = 0.014), but not for MYCL (SV: R = -0.233; p = 0.207; CI: R = -0.130; p = 0.484). No significant correlations were found for E/A ratio as a parameter of diastolic heart function. In multiple regression analysis CI was negatively predicted by PERI, whereas no impact of MYCL was observed in direct comparison.
Cardiac fat depots impact left ventricular heart function in a metabolically healthy population. Direct comparison of different lipid stores revealed that PERI is a more important predictor than MYCL for altered myocardial function.
肥胖是心力衰竭的一个主要危险因素，部分原因是心肌内（MYCL）和/或心包（PERI）脂质积累的局部或旁分泌的可能脂毒性作用。最近的证据表明，MYCL 是高度动态的，与其说是心脏功能障碍的根本原因，不如说是能量代谢紊乱的替代标志物。另一方面，PERI 可能通过机械和旁分泌作用直接发挥作用。因此，我们假设 PERI 而不是 MYCL 与心肌功能有关。
为避免代谢性疾病的潜在混杂，我们对 31 名代谢健康的受试者（年龄：29±10 岁；BMI：23±3kg/m2）进行了 1H 磁共振光谱和成像研究。评估了 MYCL 和 PERI 以及左心室收缩和舒张功能。此外，还分析了人体测量数据以及葡萄糖和脂质代谢参数。采用 Pearson 相关系数进行相关性分析。采用线性回归模型显示 PERI 和 MYCL 对心肌功能参数的个体影响。
与收缩功能参数的相关性分析显示，PERI 与 PERI 呈显著相关（SV：R = -0.513，p = 0.001；CI：R = -0.442，p = 0.014），但与 MYCL 无相关性（SV：R = -0.233，p = 0.207；CI：R = -0.130，p = 0.484）。E/A 比值作为舒张功能参数与两者均无显著相关性。多元回归分析显示，CI 与 PERI 呈负相关，而 MYCL 无直接影响。
在代谢健康人群中，心脏脂肪沉积会影响左心室功能。对不同脂质储存的直接比较表明，PERI 比 MYCL 更能预测心肌功能的改变。
