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Fat Deposits Around the Heart
Is Crucial Indication For Doctors
Evaluating Cardiovascular Problems
Cardiac imaging researchers at Cedars-Sinai Heart
Institute are recommending that physicians not overlook
fatty deposits around the heart when evaluating patients
for risk of major heart problems.
Although abdominal fat is often considered in making these key
assessments, recent research suggests that measuring fatty tissue
around the heart is an even better predictor, and noninvasive CT
scanning may provide this important information.
The recommendation appeared in an editorial comment published
in the Journal of the American College of Cardiology (JACC):
Cardiovascular Imaging.
The published report was prompted by another article in the journal
in which researchers provide new evidence linking abdominal fat to
instability of coronary arterial plaques. In current theory, people with
excess abdominal fat are at higher risk of plaque buildup and heart
disease, and plaque that is vulnerable to rupture poses a greater
threat than that which is stable.
Various studies that link fat around the heart and coronary arteries
to inflammation and plaque development and suggests that fat around
the heart and coronary arteries “may be more potent determinants of
coronary plaque development and progression than visceral abdominal
fat.” This fat around the heart also has been implicated in the
development of major adverse cardiac events (MACE), defined as
cardiac-related death, nonfatal heart attack, surgery to bypass blocked
heart arteries,or repeated percutaneous coronary intervention
(angioplasty) to reopen blocked arteries.
Cedars-Sinai recently completed the largest randomized trial of
coronary artery calcium CT scanning, following 2,137 subjects over
four years. More than 20,000 patients are now enrolled in an ongoing
data registry. This technology identifies plaque deposits in heart
arteries by detecting bits of calcium, one of the components of plaque.
Additionally, by using software methods, coronary artery calcium
CT scanning can also be used to measure fat around the heart and
coronary arteries. The two measurements considered together...
plaque and increased fat around the heart , appear to improve the
prediction of patient risk for major heart problems.
In their studies on coronary artery calcium CT scanning, researchers
at Cedars-Sinai and at other sites found that patients who had no
symptoms of heart disease but experienced a major adverse cardiac
event had more fat around the heart than did control subjects who
had no events. When they included a measurement of fat volume
around the heart with conventional risk factors and coronary calcium
scans, they were better able to predict which patients were more
likely to experience major heart problems. In another study,
researchers found that the amount of fat around the heart was
strongly associated with the narrowing of coronary arteries caused
by plaque.
“Measurement of pericardial fat from cardiac CT appears primed to
ultimately become a routine complement to the information gained
from plaque evaluation,” the researchers conclude. “This assessment
could generate CT information regarding the activity of the
atherosclerotic (plaque buildup) process, potentially adding
meaningfully to clinical risk assessment.”
The work was supported in part by grants from the Eisner Foundation,
the Glazer Foundation, the Lincy Foundation, and the National Institute
of Biomedical Imaging and Bioengineering (National Institute of Health).
Journal References:
“Not All Body Fat Weighs Equally in the Acceleration of Coronary Artery
Disease.” Journal of the American College of Cardiology (JACC)
Cardiovascular Imaging, 2010;
“Association Between Visceral Adipose Tissue Area and Coronary Plaque
Morphology Assessed by CT Angiography”. Journal of the American College
of Cardiology (JACC) Cardiovascular Imaging, 2010;
“Doctors evaluating heart problems should consider checking fat deposits
around the heart” Cedars-Sinai Medical Center (2010, October 8).
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