Background Left ventricular diastolic dysfunction (LVDD) plays an important role in
heart failure with normal left ventricular ejection fraction (LVEF). Obesity is one of
the major comorbid conditions of LVDD. Pericardial fat (PF) is an ectopic fat depot
with possible paracrine or mechanical effects on the coronary circulation and
35 myocardial function.
Methods We measured PF volume on 64 slice computed tomography and analyzed
echocardiographic parameters to confirm LVDD in 229 consecutive patients suspected
of coronary artery disease with LVEF of more than 50% and no symptomatic heart
failure (59% men, 67±12 years). LVDD was defined as the ratio of transmitral
40 Doppler early filling velocity to tissue Doppler early diastolic mitral annular velocity
(E/e’) >10.
Results PF volume correlated significantly with E/e’ (r=0.21, p<0.01), left ventricular
mass index (r=0.23, p<0.001), and left atrial diameter (r=0.32, p<0.001). The mean PF
volume was significantly greater in patients with LVDD (184±61 cm3, n=141) than in
45 those without LVDD (154±58, n=88, p<0.001). Multivariate logistic regression
analysis indicated that PF volume correlated significantly with the presence of LVDD
(odds ratio: 2.00 per 100 cm3 increase in PF volume, p=0.02) independent of age,
gender, abdominal obesity, hypertension, and diabetes.
Conclusions PF volumes are significantly associated with LVDD, independent of
50 other factors such as hypertension or diabetes. PF may be implicated in the pathogenesis of LVDD in patients with normal LVEF.
Accumulation of Pericardial Fat Correlates with Left Ventricular Diastolic Dysfunction in Patients with Normal Ejection Fraction
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