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Epicardial adipose tissue volume is associated with impaired left ventricular strain in patients with metabolic syndrome: the mediating role of myocardial energetic efficiency.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101147637 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-2840 (Electronic) Linking ISSN: 14752840 NLM ISO Abbreviation: Cardiovasc Diabetol Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2002-
    • Subject Terms:
      Metabolic Syndrome*/physiopathology ; Metabolic Syndrome*/complications ; Metabolic Syndrome*/diagnosis ; Metabolic Syndrome*/diagnostic imaging ; Metabolic Syndrome*/metabolism ; Adipose Tissue*/diagnostic imaging ; Adipose Tissue*/physiopathology ; Adipose Tissue*/metabolism ; Pericardium*/diagnostic imaging ; Pericardium*/physiopathology ; Pericardium*/metabolism ; Ventricular Dysfunction, Left*/physiopathology ; Ventricular Dysfunction, Left*/diagnostic imaging ; Ventricular Dysfunction, Left*/etiology ; Ventricular Dysfunction, Left*/metabolism ; Ventricular Function, Left* ; Energy Metabolism* ; Adiposity* ; Myocardial Contraction*; Humans ; Male ; Female ; Middle Aged ; Case-Control Studies ; Aged ; Adult ; Magnetic Resonance Imaging, Cine ; Cross-Sectional Studies ; Myocardium/metabolism ; Epicardial Adipose Tissue
    • Abstract:
      Competing Interests: Declarations. Ethics approval and consent to participate: The study protocol was approved by the Biomedical Research Ethics Committee of West China Hospital, Sichuan University. The requirement for written informed consent was waived because of the retrospective nature of the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
      Background: Epicardial adipose tissue volume (EATV) has been linked to cardiac dysfunction in metabolic syndrome (MetS), but the underlying mechanisms remain unclear. The aim of this study was to investigate whether myocardial energetic efficiency partially explains the relationship between EATV and impaired left ventricular (LV) myocardial strain in MetS patients using cardiac magnetic resonance (CMR).
      Methods: A total of 225 patients with MetS and 68 age - and sex - matched controls underwent CMR. LV myocardial energetic efficiency index (MEEI), EATV, and myocardial strain-including global radial, circumferential, and longitudinal peak strain (GLPS)-were measured. Pearson correlation analysis, multivariable linear regression and mediation analysis (bootstrapped 95% confidence intervals) were performed to evaluate the direct and MEEI-mediated effects of EATV on LV myocardial strain.
      Results: MetS patients exhibited impaired myocardial strain and lower MEEI compared to controls. EATV negatively correlated with MEEI (r =  - 0.224, P < 0.001) and with LV myocardial peak strain in all three directions (r =  - 0.174 to - 0.332, P < 0.01). Multivariable regression analysis confirmed EATV as an independent predictor of lower LV GLPS (β =  - 0.178, P = 0.01) and MEEI (β =  - 0.268, P < 0.01). Mediation analysis revealed that approximately 29% of the total negative effect of EATV on GLPS was accounted for reduced MEEI (standardized indirect effect β = - 0.081, 95% CI - 0.137 to - 0.0029, P < 0.01).
      Conclusions: In patients with metabolic syndrome, increased EATV was independently associated with impaired LV myocardial strain, with reduced MEEI partly explaining the observed EATV-LV dysfunction association.
      (© 2025. The Author(s).)
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    • Grant Information:
      82402231 National Natural Science Foundation of China; 82371925 National Natural Science Foundation of China; 2024NSFSC1774 Sichuan Provincial Science and Technology Support Program; 2024YFFK0259 Sichuan Provincial Science and Technology Support Program; ZYGD23019 1·3·5 project for disciplines of excellence, West China Hospital, Sichuan University
    • Contributed Indexing:
      Keywords: Epicardial adipose tissue; Metabolic syndrome; Myocardial energetic efficiency; Myocardial strain
    • Publication Date:
      Date Created: 20250810 Date Completed: 20250810 Latest Revision: 20250813
    • Publication Date:
      20250813
    • Accession Number:
      PMC12335042
    • Accession Number:
      10.1186/s12933-025-02859-6
    • Accession Number:
      40783739