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Heart failure and cardiomyopathies
Original article
Cardiac steatosis in patients with dilated cardiomyopathy
  1. Marit Granér1,
  2. Markku O Pentikäinen1,
  3. Kristofer Nyman2,
  4. Reijo Siren3,
  5. Jesper Lundbom2,
  6. Antti Hakkarainen2,
  7. Kirsi Lauerma2,
  8. Nina Lundbom2,
  9. Markku S Nieminen1,
  10. Max Petzold4,
  11. Marja-Riitta Taskinen1
  1. 1Division of Cardiology, Diabetes and Obesity Research Program, Heart and Lung Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
  2. 2Department of Radiology, University of Helsinki and HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland
  3. 3Department of General Practice and Primary Health Care, University of Helsinki and Health Center of City of Helsinki, Helsinki, Finland
  4. 4Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  1. Correspondence to Dr Marit Granér, Division of Cardiology, Heart and Lung Center, Helsinki University Central Hospital, Haartmaninkatu 4, HUCH FIN-00290, Finland; marit.graner{at}hus.fi

Abstract

Objective Ectopic fat accumulation within and around the heart has been related to increased risk of heart disease. Limited data exist on cardiac adiposity in subjects with dilated cardiomyopathy (DCM). The aim of the study was to examine the components of cardiac steatosis and their relationship to LV structure and function in non-diabetic DCM patients.

Methods Myocardial and hepatic triglyceride (TG) contents were measured with 1.5 T magnetic resonance spectroscopy (MRS), and LV function, visceral adipose (VAT) and abdominal subcutaneous tissue (SAT), epicardial and pericardial fat by MRI in 10 non-diabetic men with DCM and in 20 controls.

Results In face of comparable intra-abdominal fat depots, myocardial TG [0.41% (0.21–2.19) vs 0.86% (0.31–2.24), p=0.038] was markedly lower and epicardial (895 mm2±110 vs 664 mm2±180, p=0.002) and pericardial fat [2173 mm2 (616–3673) vs 1168 mm2 (266–2319), p=0.039] depots were larger in patients with DCM compared with controls. In subjects with DCM, the LV global function index was decreased to a greater extent than the LV EF [21%±6 vs 34% (16–40)].

Conclusions Myocardial TG content decreased and epicardial and pericardial fat depots increased in non-diabetic subjects with DCM. Although recognised as a site of ectopic fat accumulation, the derangement of myocardial TG seems to play a specific role in the myocardial energy metabolism in congestive heart failure.

  • CARDIAC FUNCTION
  • LIPIDS

https://doi.org/10.1136/heartjnl-2013-304961

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