European Heart Journal Advance Access published online on January 9, 2009
European Heart Journal, doi:10.1093/eurheartj/ehn573
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Association of pericardial fat, intrathoracic fat, and visceral abdominal fat with cardiovascular disease burden: the Framingham Heart Study
1 Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School Boston, MA, USA
2 Department of Mathematics, Boston University, Boston, MA, USA
3 Departments of Medicine and Neurology, Boston University School of Medicine, Boston, MA, USA
4 Framingham Heart Study of the National Heart, Lung, and Blood Institute, Framingham, MA, USA
5 Federal Foundation School of Medical Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
6 Cardiology Division, Massachusetts General Hospital, Harvard Medical School Boston, MA, USA
7 Department of Medicine and Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
Received 6 August 2008; revised 23 November 2008; accepted 27 November 2008.
* Corresponding author. Massachusetts General Hospital, Cardiac MR PET CT Program, 165 Charles River Plaza, Suite 400, Boston, MA 02114, USA. Tel: +1 617 726 1255, Fax: +1 617 724 4152, Email: uhoffmann{at}partners.org
Aims: The aim of this study was to assess whether pericardial fat, intrathoracic fat, and visceral abdominal adipose tissue (VAT) are associated with the prevalence of cardiovascular disease (CVD).
Methods and results: Participants from the Framingham Heart Study Offspring cohort underwent abdominal and chest multidetector computed tomography to quantify volumes of pericardial fat, intrathoracic fat, and VAT. Relations between each fat depot and CVD were assessed using logistic regression. The analysis of 1267 participants (mean age 60 years, 53.8% women, 9.7% with prevalent CVD) demonstrated that pericardial fat [odds ratio (OR) 1.32, 95% confidence interval (CI) 1.11–1.57; P = 0.002] and VAT (OR 1.35, 95% CI 1.11–1.57; P = 0.003), but not intrathoracic fat (OR 1.14, 95% CI 0.93–1.39; P = 0.22), were significantly associated with prevalent CVD in age–sex-adjusted models and after adjustment for body mass index and waist circumference. After multivariable adjustment, associations were attenuated (P > 0.14). Only pericardial fat was associated with prevalent myocardial infarction after adjusting for conventional measures of adiposity (OR 1.37, 95% CI 1.03–1.82; P = 0.03).
Conclusion: Pericardial fat and VAT, but not intrathoracic fat, are associated with CVD independent of traditional measures of obesity but not after further adjustment for traditional risk factor. Taken together with our prior work, these findings may support the hypothesis that pericardial fat contributes to coronary atherosclerosis.
Key Words: Pericardial fat • Visceral abdominal fat • Cardiovascular disease • Framingham Heart Study • Epidemiology
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