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Myocardial tissue characterization by cardiovascular magnetic resonance T1 mapping and pericardial fat quantification in adolescents with morbid obesity. Cardiac dimorphism by gender

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Abstract

Purpose

Changes in the myocardial extracellular matrix (ECM) identified using T1 mapping cardiovascular magnetic resonance (CMR) have been only reported in obese adults, but with opposite conclusions. The objectives are to assess the composition of the myocardial ECM in an obese pediatric population without type 2 diabetes by quantifying native T1 time, and to quantify the pericardial fat index (PFI) and their relationship with cardiovascular risk factors.

Methods

Observational case-control research of 25 morbidly obese adolescents and 13 normal-weight adolescents. Native T1 and T2 times (ms), left ventricular (LV) geometry and function, PFI (g/ht3) and hepatic fat fraction (HFF, %) were calculated by 1.5-T CMR.

Results

No differences were noticed in native T1 between obese and non-obese adolescents (1000.0 vs. 990.5 ms, p0.73), despite showing higher LV mass values (28.3 vs. 22.9 g/ht3, p0.01). However, the T1 mapping values were significantly higher in females (1012.7 vs. 980.7 ms, p < 0.01) while in males, native T1 was better correlated with obesity parameters, particularly with triponderal mass index (TMI) (r = 0.51), and inflammatory cells. Similarly, the PFI was correlated with insulin resistance (r = 0.56), highly sensitive C-reactive protein (r = 0.54) and TMI (r = 0.77).

Conclusion

Female adolescents possess myocardium peculiarities associated with higher mapping values. In males, who are commonly more exposed to future non-communicable diseases, TMI may serve as a useful predictor of native T1 and pericardial fat increases. Furthermore, HFF and PFI appear to be markers of adipose tissue infiltration closely related with hypertension, insulin resistance and inflammation.

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Acknowledgements

The statistical analysis was carried out in the Statistics and Bioinformatics Unit (UEB) of the Vall d’Hebron Hospital Research Institute (VHIR). The project was funded by the Spanish Society of Paediatric Cardiology and Congenital Heart Disease.

Author information

Authors and Affiliations

  1. Hospital HM Nens. HM Hospitales, Barcelona, Spain

    Jose M. Siurana & Paula S. Ventura

  2. Autonomous University of Barcelona, Barcelona, Spain

    Jose M. Siurana, Elida Vazquez, Ferran Gran, Ferran Rosés-Noguer, Diego Yeste & Anna Sabaté-Rotés

  3. Vall d’Hebron University Hospital, Barcelona, Spain

    Lucia Riaza, Luis Riera, Elida Vazquez, Roser Ferrer-Costa, Marina Giralt, Ferran Gran, Ferran Rosés-Noguer, Diego Yeste & Anna Sabaté-Rotés

  4. CIBER of Rare Diseases (CIBERER) ISCIII, Barcelona, Spain

    Diego Yeste

  5. Cardiology Department, Hospital HM Nens. HM Hospitales, Consell de Cent 437, 08009, Barcelona, Spain

    Jose M. Siurana

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  1. Jose M. Siurana
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Contributions

Each author has contributed differently to the manuscript. Dr. Siurana, Dr. Sabaté-Rotés, Dr. Riaza, Dr. Yeste and Dr. Ventura designed the study, conducted the bibliographic search and wrote different parts of the manuscript. Dr. Riera and Dr. Vázquez contributed to gathering patient MRI data and to the discussion of the study results. Dr. Ferrer-Costa, Dr. Giralt, Dr. Gran and Dr. Rosés-Noguer participated in the laboratory and cardiac results evaluation and analysis. Dr. Siurana and Dr. Sabaté-Rotés coordinated all authors’ participation. All authors have critically reviewed and approved the manuscript.

Corresponding author

Correspondence to Jose M. Siurana.

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Funding

J.M.S. received the 2019 Juan V. Comas grant for this project from the Spanish Society of Paediatric Cardiology and Congenital Heart Disease.

Competing Interests

The authors have no relevant financial or non-financial interests to disclose.

Ethics Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Review Board at Vall d’Hebron Hospital approved the protocol (PR-AMI-273/2018).

Written informed consent for participation was obtained. All subjects provided assent and an informed consent was signed by their parents/legal guardians.

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Siurana, J.M., Riaza, L., Ventura, P.S. et al. Myocardial tissue characterization by cardiovascular magnetic resonance T1 mapping and pericardial fat quantification in adolescents with morbid obesity. Cardiac dimorphism by gender. Int J Cardiovasc Imaging 39, 781–792 (2023). https://doi.org/10.1007/s10554-022-02773-y

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