Introduction
Methods
Post-mortem cases
Post-mortem computed tomography
Heart weight measurement
Statistical analysis
Results
Post-mortem case characteristics
Variable | Mean/median | Range |
---|---|---|
Female (N, %) | 24 | 28% |
Age (years) | 56 | 18 – 86 |
Body height (cm) | 172 | 148 – 192 |
Body weight (kg) | 80 | 34 – 148 |
BMI (kg/m2) | 28.0 | 13.0 – 48.9 |
BSA (m2) | 2.0 | 1.3 – 2.6 |
FFM (kg) | 56 | 34 – 77 |
Heart weight (g) | 435 | 215 – 865 |
EAT volume (cm3) | 66 | 12 – 221 |
EAT mass (g) | 61 | 11 – 204 |
ePAT volume (cm3) | 54 | 2 – 101 |
VAT volume (cm3) | 30 | 4 – 79 |
Univariable associations of body size metrics and adipose volumes with heart weight
Response variable: Heart weight vs | rho | P value |
---|---|---|
Female sex | − 0.36 | 0.001 |
Age | − 0.02 | 0.89 |
Body height | 0.51 | < 0.0001 |
Body weight | 0.71 | < 0.0001 |
BSA | 0.73 | < 0.0001 |
FFM | 0.70 | < 0.0001 |
BMI | 0.64 | < 0.0001 |
EAT volume/mass | 0.60 | < 0.0001 |
ePAT volume | 0.30 | 0.005 |
VAT volume | 0.50 | < 0.0001 |
Multivariable associations of body size metrics and adipose volumes with heart weight
Model | Independent variable(s) | R2adj. |
---|---|---|
(1) Variables: Age, female sex + height / weight / BSA / FFM / BMI / EAT volume / ePAT volume / VAT volume | Body height, age | 0.25 |
Body weight, age | 0.49 | |
BSA, age | 0.54 | |
FFM, age, female sex | 0.53 | |
BMI, age, female sex | 0.44 | |
EAT volume, female sex | 0.35 | |
ePAT volume, female sex | 0.17 | |
VAT volume, female sex | 0.23 | |
(2) Variables: As for Model 1 with inclusion of EAT volume | Body height, EAT volume | 0.41 |
Body weight, female sex, EAT volume | 0.54 | |
BSA, age, EAT volume | 0.57 | |
FFM, EAT volume | 0.55 | |
BMI, EAT volume | 0.50 |
Differential associations with heart weight in cardiac hypertrophy
Model | No hypertrophy | |
---|---|---|
Variables: Age, female sex + height / weight / BSA / FFM / BMI + EAT volume | Anthropometric variable(s) | R2 adj. |
Body height, female sex, EAT volume | 0.62 | |
Body weight, age, female sex, EAT volume | 0.81 | |
BSA, age, female sex, EAT volume | 0.86 | |
FFM, age, EAT volume | 0.86 | |
BMI, female sex, EAT volume | 0.68 | |
Hypertrophy | ||
Anthropometric variable(s) | R2 adj. | |
Body height | 0.21 | |
Body weight | 0.41 | |
BSA | 0.43 | |
FFM | 0.40 | |
BMI, female sex | 0.38 |
EAT/myocardium mass ratio in non-hypertrophied and hypertrophied hearts
Response variable: EAT/myocardium mass ratio | Simple regression | Multiple regression | ||||
---|---|---|---|---|---|---|
β | P value | R2 | β | P value | R2 adj. | |
Female sex | 2.1 | 0.2 | 0.02 | 2.8 | 0.04 | 0.45 |
Age | 0.2 | < 0.0001 | 0.17 | 0.1 | 0.02 | |
Pathological hypertrophy | 3.6 | 0.02 | 0.06 | |||
Body height | − 0.1 | 0.4 | 0.01 | |||
Body weight | 0.01 | 0.7 | 0.02 | |||
BMI | 0.09 | 0.4 | 0.01 | |||
BSA | 0.4 | 0.9 | 0.00 | |||
FFM | − 0.0 | 0.7 | 0.00 | |||
ePAT volume | 0.1 | < 0.0001 | 0.20 | 0.06 | 0.009 | |
VAT volume | 0.2 | < 0.0001 | 0.28 | 0.2 | < 0.0001 |
Discussion
Previous studies of EAT deposition and heart weight
EAT relationship with cardiac hypertrophy
EAT comprises a greater proportion of heart weight in hypertrophy
Comparison to other adipose volumes
Limitations
Conclusion
Key points
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The long-standing positive association between EAT volume and heart weight has recently been questioned. This study aimed to re-examine this association in a cohort of post-mortem cases with diverse heart weights.
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In the total post-mortem cohort, EAT comprised approximately 13% of overall heart weight, and EAT volume was positively associated with heart weight independent of age, female sex, and various body size metrics.
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Cases with heart weights within normal reference limits had robust and independent positive associations of EAT volume with heart weight.
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Conversely, despite having significantly greater median EAT volume and EAT/myocardium mass ratio than non-hypertrophic cases, cases with significant cardiac hypertrophy had no relationship between EAT volume and heart weight.
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These findings confirm that EAT volume and heart weight increase proportionally. However, this relationship is only present in individuals with normal heart weights; cardiac hypertrophy, especially extreme hypertrophy, confounds this relationship.