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Myocardial tissue remodeling in early adult obesity and its association with regional adipose tissue distribution and ectopic fat deposits: a prospective study

  • Cardiac
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Abstract

Objectives

To evaluate the left ventricular (LV) myocardial tissue characteristics in early adult obesity and its association with regional adipose tissue and ectopic fat deposition.

Methods

Forty-nine obese adults (mean body mass index: 29.9 ± 2.0 kg/m2) and 44 healthy controls were prospectively studied. LV native and post-contrast T1 values, extracellular volume fraction (ECV), regional adipose tissue (epicardial, visceral, and subcutaneous adipose tissue (EAT, VAT, and SAT)), and ectopic fat deposition (hepatic and pancreatic proton density fat fractions (H-PDFF and P-PDFF)) based on magnetic resonance imaging were compared. The association was assessed by multivariable linear regression.

Results

The obese participants showed reduced global ECV compared to the healthy controls (p < 0.05), but there was no significant difference in global native or post-contrast T1 values between the two groups. Additionally, the obese individuals exhibited higher EAT, VAT, SAT, H-PDFF, and P-PDFF than the controls (p < 0.05). ECV was associated with insulin resistance, dyslipidemia, and systolic blood pressure (SBP) (p < 0.05). Multiple linear regression demonstrated that H-PDFF and SAT were independently associated with ECV in entire population (β =  − 0.123 and − 0.012; p < 0.05).

Conclusions

Reduced myocardial ECV in patients with mild-to-moderate obesity and its relationship to SBP may indicate that cardiomyocyte hypertrophy, rather than extracellular matrix expansion, is primarily responsible for myocardial tissue remodeling in early adult obesity. Our findings further imply that H-PDFF and SAT are linked with LV myocardial tissue remodeling in this cohort beyond the growth difference and cardiovascular risk factors.

Clinical trials registration

Effect of lifestyle intervention on metabolism of obese patients based on smart phone software (ChiCTR1900026476).

Clinical relevance statement

Myocardial fibrosis in severe obesity predicts poor prognosis. We showed that cardiomyocyte hypertrophy, not myocardial fibrosis, is the main myocardial tissue characteristic of early obesity. This finding raises the possibility that medical interventions, like weight loss, may prevent cardiac fibrosis.

Key Points

• Myocardial tissue characteristics in early adult obesity are unclear.

• Myocardial extracellular volume fraction (ECV) can be quantitatively evaluated using T1 mapping based on cardiac magnetic resonance imaging (MRI).

• Cardiac MRI-derived ECV may noninvasively evaluate myocardial tissue remodeling in early adult obesity.

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Abbreviations

BMI:

Body mass index

CO:

Cardiac output

DBP:

Diastolic blood pressure

EAT:

Epicardial adipose tissue

ECV:

Extracellular volume fraction

EDV:

End-diastolic volume

EF:

Ejection fraction

ESV:

End-systolic volume

FFA:

Free fatty acid

H-PDFF:

Hepatic proton density fat fraction

HDL:

High-density lipoprotein

HOMA-IR:

Homeostasis model assessment of insulin resistance

LDL:

Low-density lipoprotein

LV:

Left ventricular

MRI:

Magnetic resonance imaging

P-PDFF:

Pancreatic proton density fat fraction

SAT:

Subcutaneous adipose tissue

SBP:

Systolic blood pressure

SV:

Stroke volume

VAT:

Visceral adipose tissue

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Acknowledgements

We are very grateful to Fanfan Shi’s assistance with the statistical analysis for this study.

Funding

This study has received funding by the National Natural Science Foundation of China (Grant No. 81601462); the Key Research & Development Project of Science and Technology of Sichuan Province (Grant No. 2021YFS0142); the China Postdoctoral Science Foundation (Grant No. 2022M712256); the Post-Doctor Research Project, West China Hospital, Sichuan University (Grant No. 2021HXBH043); and the 1.3.5. Project for Disciplines of Excellence, West China Hospital, Sichuan University (Grant No. ZYGD18017).

Author information

Author notes

  1. Jing Liu and Yali Qu contributed equally to this work

Authors and Affiliations

  1. Department of Radiology, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, China

    Jing Liu, Yali Qu, Wenzhang He, Xiaoyi Chen, Xue Li, Yinqiu Wang, Hehan Tang, Yuan Yuan, Liping Deng, Guoyong Chen, Tianying Zheng, Bin Song & Liqing Peng

  2. Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, China

    Jing Li & Nanwei Tong

  3. GE Healthcare, MR Research China, Beijing, China

    Lisha Nie

  4. MR Collaboration, Siemens Healthineers Ltd., Shanghai, 200126, China

    Xiaoyue Zhou

  5. Department of Radiology, Sanya People’s Hospital, Sanya, Hainan, China

    Bin Song

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Corresponding authors

Correspondence to Nanwei Tong or Liqing Peng.

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Guarantor

The scientific guarantor of this publication is Liqing Peng.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: GE Healthcare, MR Research China, Beijing, China, and MR Collaboration, Siemens Healthineers Ltd., Shanghai, 200126, China.

Statistics and biometry

Fanfan Shi, a statistician, assisted us with the article’s statistical analysis. She has been mentioned in the Acknowledgements.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

None.

Methodology

• prospective

• cross-sectional study

• performed at one institution

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Liu, J., Qu, Y., Li, J. et al. Myocardial tissue remodeling in early adult obesity and its association with regional adipose tissue distribution and ectopic fat deposits: a prospective study. Eur Radiol 34, 970–980 (2024). https://doi.org/10.1007/s00330-023-10081-9

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