Asteria Carmela, Secchi Francesco, Morricone Lelio, Malavazos Alexis Elias, Francesconi Simona, Milani Valentina, Giovanelli Alessandro
National Institute of Obesity Cure (INCO)-Bariatric Unit, IRCCS, Policlinico San Donato, Piazza Edmondo Malan, 2, 20097, San Donato Milanese, Milan, Italy.
Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milano, Italy.
Endocr Metab Immune Disord Drug Targets. 2025;25(2):173-188. doi: 10.2174/0118715303310680240607114244.
The recognition of epicardial adipose tissue (EAT) as a cardiac risk factor has increased the interest in strategies that target cardiac adipose tissue.
The effect of bariatric and metabolic surgery (BMS)-induced weight loss on EAT volume was evaluated in this study.
Fifteen bariatric patients, with (MS) or without (wMS) Metabolic Syndrome, underwent magnetic resonance imaging (MRI) using an open-bore scanner to assess EAT volume, visceral adipose tissue (VAT) thickness, and other cardiac morpho-functional parameters at baseline and 12 months after BMS. Nine patients underwent laparoscopic sleeve gastrectomy (LSG), and 6 patients underwent Roux-en-Y Gastric Bypass (RYGBP).
EAT volume significantly decreased in all the patients 12 months post-BMS from 91.6 cm to 67.1 cm; p = 0.0002 in diastole and from 89.4 cm to 68.2 cm; p = 0.0002 in systole. No significant difference was found between the LSG and RYGBP group. Moreover, EAT volume was significantly reduced among wMS compared with MS. In particular, EAT volume in diastole was significantly reduced from 80.9 cm to 54.4 cm; p = 0.0156 in wMS and from 98.3 cm to 79.5 cm; p = 0.031 in MS. The reduction was also confirmed in systole from 81.2 cm to 54.1 cm; p = 0.0156 in wMS and from 105.7 cm to 75.1 cm; p = 0.031 in MS. Finally, a positive correlation was found between EAT loss, BMI (r = 0.52; p = 0.0443) and VAT (r = 0.66; p = 0.008) reduction after BMS.
These findings suggest that EAT reduction may be a fundamental element for improving the cardio-metabolic prognosis of bariatric patients. Moreover, this is the first study performed with an open-bore MRI scanner to measure EAT volume.
将心外膜脂肪组织（EAT）视为心脏危险因素，这增加了人们对针对心脏脂肪组织的策略的兴趣。
本研究评估了减重代谢手术（BMS）诱导的体重减轻对EAT体积的影响。
15例患有（MS）或未患有（wMS）代谢综合征的肥胖患者，在基线时和BMS术后12个月，使用开放式磁共振成像（MRI）扫描仪评估EAT体积、内脏脂肪组织（VAT）厚度以及其他心脏形态功能参数。9例患者接受了腹腔镜袖状胃切除术（LSG），6例患者接受了Roux-en-Y胃旁路术（RYGBP）。
所有患者在BMS术后12个月时，EAT体积显著减小，舒张期从91.6立方厘米降至67.1立方厘米；p = 0.0002，收缩期从89.4立方厘米降至68.2立方厘米；p = 0.0002。LSG组和RYGBP组之间未发现显著差异。此外，与MS患者相比，wMS患者的EAT体积显著减小。具体而言，wMS患者舒张期EAT体积从80.9立方厘米显著降至54.4立方厘米；p = 0.0156，MS患者从98.3立方厘米降至79.5立方厘米；p = 0.031。收缩期的减小也得到证实，wMS患者从81.2立方厘米降至54.1立方厘米；p = 0.0156，MS患者从105.7立方厘米降至75.1立方厘米；p = 0.031。最后，发现BMS术后EAT减少与BMI降低（r = 0.52；p = 0.0443）和VAT降低（r = 0.66；p = 0.008）之间存在正相关。
这些发现表明，减少EAT可能是改善肥胖患者心脏代谢预后的一个基本要素。此外，这是首次使用开放式MRI扫描仪测量EAT体积的研究。
