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Submitted on March 15, 2006
Accepted on August 15, 2006
Turku PET Centre, and Departments of Clinical Physiology, Radiology and Medicine, University of Turku, Turku, Finland; PET Centre, Institute of Clinical Physiology, CNR National Research Council, and Department of Internal Medicine, University of Pisa School of Medicine, Pisa, Italy
* To whom correspondence should be addressed. E-mail: patricia.iozzo{at}ifc.cnr.it.
Context/Objective: Ectopic fat accumulation within and around the myocardial wall has been implicated in the pathogenesis of heart disease in obesity. We evaluated myocardial and epicardial fat, left ventricular (LV) function, and metabolic risk factors in nine (five lean, four moderately obese) men. Methods: Myocardial fat % was quantified in the septum by proton magnetic resonance spectroscopy; reproducibility was assessed by triplicate systolic and diastolic measurements; LV parameters and epicardial fat were determined by magnetic resonance imaging. Waist-to-hip ratio (WHR) and liver enzymes (alanine transaminase, ALT) were used as surrogate markers of visceral and liver fat contents.
Results: Myocardial fat (2.1 ± 0.5 vs. 0.8 ± 0.1, P = 0.03) and epicardial fat (120 ± 33 vs. 55 ± 12 g, P = 0.08) were higher in obese than lean subjects. Individuals with above-median ALT values had a 4-fold elevation in myocardial fat. The coefficient of variation of repeated myocardial fat % determinations was 17 ± 3 and 23 ± 3% in systole and diastole, respectively. Myocardial fat was correlated with FFA levels (r=0.76, P = 0.017), epicardial fat (r=0.69, P = 0.042), and WHR (r=0.70, P = 0.035), and it showed a tendency to positively associate with LV work; epicardial fat was associated with peripheral vascular resistance (positively), and the cardiac index (negatively); FFA levels were significantly correlated with LV mass (r=0.72, P = 0.030) and forward work (r=0.74, P = 0.023).
Conclusions/Interpretation: The accumulation of triglyceride in and around the myocardium of moderately obese individuals is significant, and it is related to FFA exposure, generalized ectopic fat excess, and peripheral vascular resistance. These changes precede LV overload and hypertrophy.
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