Clinical Exercise Physiology, Human Performance Laboratory, Ball State University, Muncie, Indiana, United States.
DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, Tennessee, United States.
Am J Physiol Heart Circ Physiol. 2024 Oct 1;327(4):H927-H934. doi: 10.1152/ajpheart.00436.2024. Epub 2024 Aug 16.
Aortic perivascular adipose tissue (aPVAT) density is associated with age-related aortic stiffness in humans and therefore, may contribute to cardiovascular dysfunction. A lower subendocardial viability ratio (SEVR), an estimate of myocardial perfusion, indicates greater cardiovascular disease (CVD) risk and is associated with aortic stiffness in clinical populations. However, the influence of aortic stiffness on the relation between aPVAT density and SEVR/cardiovascular (CV) hemodynamics in apparently healthy adults is unknown. We hypothesize that greater aPVAT density will be associated with lower SEVR and higher CV hemodynamics independent of aortic stiffness. Fourteen (6 males/8 females; mean age, 55.4 ± 5.6 yr; body mass index, 25.5 ± 0.6 kg/m) adults completed resting measures of myocardial perfusion (SEVR), CV hemodynamics (pulse wave analysis), aortic stiffness [carotid-femoral pulse wave velocity (cfPWV)], and a computed tomography scan to acquire aPVAT and visceral adipose tissue (VAT) density. Greater aPVAT density (i.e., higher density) was associated with lower SEVR ( = -0.78, < 0.001) and a higher systolic pressure time integral ( = 0.49, = 0.03), forward pulse height ( = 0.49, = 0.03), reflected pulse height ( = 0.55, = 0.02), ejection duration ( = 0.56, = 0.02), and augmentation pressure ( = 0.69, = 0.003), but not with the diastolic pressure time integral ( = -0.22, = 0.22). VAT density was not associated with SEVR or any CV hemodynamic endpoints (all, > 0.05). Furthermore, the relation between aPVAT density and SEVR remained after adjusting for aortic stiffness ( = -0.66, = 0.01) but not age ( = -0.24, > 0.05). These data provide initial evidence for aPVAT as a novel yet understudied local fat depot contributing to lower myocardial perfusion in apparently healthy adults with aging. Aortic perivascular adipose tissue (aPVAT) density is associated with aging and aortic stiffness in humans and, therefore, may contribute to lower myocardial perfusion. We demonstrate that greater aPVAT, but not visceral adipose tissue density is associated with lower myocardial perfusion and augmentation pressure independent of aortic stiffness, but not independent of age. These data provide novel evidence for aPVAT as a potential therapeutic target to improve myocardial perfusion and cardiovascular function in humans with aging.
主动脉周围脂肪组织（aPVAT）密度与人类年龄相关的主动脉僵硬有关，因此可能导致心血管功能障碍。 心内膜下存活比（SEVR）较低，这是心肌灌注的估计值，表明心血管疾病（CVD）风险更高，并与临床人群中的主动脉僵硬有关。 然而，主动脉僵硬对显然健康成年人中 aPVAT 密度与 SEVR/心血管（CV）血液动力学之间关系的影响尚不清楚。 我们假设，无论主动脉僵硬如何，更大的 aPVAT 密度都将与较低的 SEVR 和更高的 CV 血液动力学相关。 14 名（6 名男性/8 名女性；平均年龄 55.4±5.6 岁；体重指数 25.5±0.6kg/m）成年人完成了心肌灌注（SEVR），CV 血液动力学（脉搏波分析），主动脉僵硬[颈股脉搏波速度（cfPWV）]的静息测量，以及计算机断层扫描以获取 aPVAT 和内脏脂肪组织（VAT）密度。 更大的 aPVAT 密度（即更高的密度）与较低的 SEVR（=-0.78，<0.001）和更高的收缩期压力时间积分（=0.49，=0.03），正向脉搏高度（=0.49，=0.03），反射脉搏高度（=0.55，=0.02），射血持续时间（=0.56，=0.02）和增强压力（=0.69，=0.003）相关，但与舒张期压力时间积分（=-0.22，=0.22）无关。 VAT 密度与 SEVR 或任何 CV 血液动力学终点均无相关性（均>0.05）。 此外，在调整主动脉僵硬（=-0.66，=0.01）后，aPVAT 密度与 SEVR 之间的关系仍然存在，但与年龄无关（=-0.24，>0.05）。 这些数据为 aPVAT 作为一种新的但研究不足的局部脂肪库提供了初步证据，该脂肪库与衰老的健康成年人中较低的心肌灌注有关。 主动脉周围脂肪组织（aPVAT）密度与人类的衰老和主动脉僵硬有关，因此可能导致较低的心肌灌注。 我们证明，更大的 aPVAT，但不是内脏脂肪组织密度与较低的心肌灌注和增强压力有关，与主动脉僵硬无关，但与年龄无关。 这些数据为 aPVAT 作为改善衰老人群心肌灌注和心血管功能的潜在治疗靶点提供了新的证据。
