The Influence of Pericardial Fat on Left Ventricular Diastolic Function.

BACKGROUND: Heart failure is a major cause of morbidity and mortality worldwide; left ventricular diastolic dysfunction plays a leading role in this clinical context. Diastolic dysfunction may be predisposed by increased abdominal fat and, consequently, increased pericardial and epicardial adiposity. This study aimed to determine whether pericardial fat (PF) and epicardial fat (EF) are associated with left ventricular diastolic function.

METHODS: A total of 82 patients had their abdominal circumference measured and underwent transthoracic echocardiography to measure the thickness of PF and EF and assess the left ventricular diastolic function. Two groups were created based on mean pericardial fat (PF) thickness (4.644 mm) and were related to abdominal circumference and echocardiographic parameters.

RESULTS: Subjects in the PF High group showed a significant decrease in septal e' ( p < 0.0001), lateral e' ( p < 0.0001), and E/A ratio ( p = 0.003), as well as a significant increase in E/e' ratio ( p < 0.0001), E wave deceleration time ( p = 0.013), left atrial volume ( p < 0.0001), the left ventricle mass ( p = 0.003), tricuspid regurgitant jet velocity ( p < 0.0001), and the left ventricle diameter ( p = 0.014) compared to the PF Low group. Correlations were found between pericardial fat and nine echocardiographic parameters in the study, while epicardial fat (EP) only correlated with eight.

CONCLUSIONS: Measurement of abdominal circumference, PF, and EF is an early indicator of diastolic changes with transthoracic echocardiography being the gold standard exam.