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Pericardial adiposity is independently linked to adverse cardiovascular phenotypes: a CMR study of 42,598 UK Biobank participants

Pericardial adiposity is independently linked to adverse cardiovascular phenotypes: a CMR study of 42,598 UK Biobank participants
Pericardial adiposity is independently linked to adverse cardiovascular phenotypes: a CMR study of 42,598 UK Biobank participants
Aims
We evaluated independent associations of cardiovascular magnetic resonance (CMR)-measured pericardial adipose tissue (PAT) with cardiovascular structure and function and considered underlying mechanism in 42 598 UK Biobank participants.

Methods and results
We extracted PAT and selected CMR metrics using automated pipelines. We estimated associations of PAT with each CMR metric using linear regression adjusting for age, sex, ethnicity, deprivation, smoking, exercise, processed food intake, body mass index, diabetes, hypertension, height cholesterol, waist-to-hip ratio, impedance fat measures, and magnetic resonance imaging abdominal visceral adiposity measures. Higher PAT was independently associated with unhealthy left ventricular (LV) structure (greater wall thickness, higher LV mass, more concentric pattern of LV hypertrophy), poorer LV function (lower LV global function index, lower LV stroke volume), lower left atrial ejection fraction, and lower aortic distensibility. We used multiple mediation analysis to examine the potential mediating effect of cardiometabolic diseases and blood biomarkers (lipid profile, glycaemic control, inflammation) in the PAT-CMR relationships. Higher PAT was associated with cardiometabolic disease (hypertension, diabetes, high cholesterol), adverse serum lipids, poorer glycaemic control, and greater systemic inflammation. We identified potential mediation pathways via hypertension, adverse lipids, and inflammation markers, which overall only partially explained the PAT-CMR relationships.

Conclusion
We demonstrate association of PAT with unhealthy cardiovascular structure and function, independent of baseline comorbidities, vascular risk factors, inflammatory markers, and multiple non-invasive and imaging measures of obesity. Our findings support an independent role of PAT in adversely impacting cardiovascular health and highlight CMR-measured PAT as a potential novel imaging biomarker of cardiovascular risk.
2047-2404
1471-1481
Ardissino, Maddalena
2cfd4d91-f405-4ed0-912b-313b0316c0fb
McCracken, Celeste
5d772e9e-3aaa-41da-a5ef-3943b1631fd9
Bard, Andrew
5ace4cbc-98c0-4419-b317-0b062358b237
Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
Antoniades, Charalambos
e8a31952-ef39-474e-9864-70b0b530e447
Neubauer, Stefan
c8a34156-a4ed-4dfe-97cb-4f47627d927d
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Petersen, Steffen E.
04f2ce88-790d-48dc-baac-cbe0946dd928
Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
Ardissino, Maddalena
2cfd4d91-f405-4ed0-912b-313b0316c0fb
McCracken, Celeste
5d772e9e-3aaa-41da-a5ef-3943b1631fd9
Bard, Andrew
5ace4cbc-98c0-4419-b317-0b062358b237
Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
Antoniades, Charalambos
e8a31952-ef39-474e-9864-70b0b530e447
Neubauer, Stefan
c8a34156-a4ed-4dfe-97cb-4f47627d927d
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Petersen, Steffen E.
04f2ce88-790d-48dc-baac-cbe0946dd928
Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a

Ardissino, Maddalena, McCracken, Celeste, Bard, Andrew, Raisi-Estabragh, Zahra, Antoniades, Charalambos, Neubauer, Stefan, Harvey, Nicholas, Petersen, Steffen E. and Raisi-Estabragh, Zahra (2022) Pericardial adiposity is independently linked to adverse cardiovascular phenotypes: a CMR study of 42,598 UK Biobank participants. European Heart Journal - Cardiovascular Imaging, 23 (11), 1471-1481. (doi:10.1093/ehjci/jeac101).

Record type: Article

Abstract

Aims
We evaluated independent associations of cardiovascular magnetic resonance (CMR)-measured pericardial adipose tissue (PAT) with cardiovascular structure and function and considered underlying mechanism in 42 598 UK Biobank participants.

Methods and results
We extracted PAT and selected CMR metrics using automated pipelines. We estimated associations of PAT with each CMR metric using linear regression adjusting for age, sex, ethnicity, deprivation, smoking, exercise, processed food intake, body mass index, diabetes, hypertension, height cholesterol, waist-to-hip ratio, impedance fat measures, and magnetic resonance imaging abdominal visceral adiposity measures. Higher PAT was independently associated with unhealthy left ventricular (LV) structure (greater wall thickness, higher LV mass, more concentric pattern of LV hypertrophy), poorer LV function (lower LV global function index, lower LV stroke volume), lower left atrial ejection fraction, and lower aortic distensibility. We used multiple mediation analysis to examine the potential mediating effect of cardiometabolic diseases and blood biomarkers (lipid profile, glycaemic control, inflammation) in the PAT-CMR relationships. Higher PAT was associated with cardiometabolic disease (hypertension, diabetes, high cholesterol), adverse serum lipids, poorer glycaemic control, and greater systemic inflammation. We identified potential mediation pathways via hypertension, adverse lipids, and inflammation markers, which overall only partially explained the PAT-CMR relationships.

Conclusion
We demonstrate association of PAT with unhealthy cardiovascular structure and function, independent of baseline comorbidities, vascular risk factors, inflammatory markers, and multiple non-invasive and imaging measures of obesity. Our findings support an independent role of PAT in adversely impacting cardiovascular health and highlight CMR-measured PAT as a potential novel imaging biomarker of cardiovascular risk.

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Accepted/In Press date: 12 May 2022
e-pub ahead of print date: 31 May 2022

Identifiers

Local EPrints ID: 467600
URI: http://eprints.soton.ac.uk/id/eprint/467600
ISSN: 2047-2404
PURE UUID: 9ede7141-a8cc-44f5-9566-cc58fc7e640f
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

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Date deposited: 14 Jul 2022 17:19
Last modified: 02 Nov 2022 02:39

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Contributors

Author: Maddalena Ardissino
Author: Celeste McCracken
Author: Andrew Bard
Author: Zahra Raisi-Estabragh
Author: Charalambos Antoniades
Author: Stefan Neubauer
Author: Nicholas Harvey ORCID iD
Author: Steffen E. Petersen
Author: Zahra Raisi-Estabragh

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