PMID- 38545037 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240329 IS - 2223-4292 (Print) IS - 2223-4306 (Electronic) IS - 2223-4306 (Linking) VI - 14 IP - 3 DP - 2024 Mar 15 TI - Association of epicardial fat volume with subclinical myocardial damage in patients with type 2 diabetes mellitus. PG - 2627-2639 LID - 10.21037/qims-23-1413 [doi] AB - BACKGROUND: In type 2 diabetes mellitus (T2DM) patients, left ventricular systolic dyssynchrony (LVSD) with normal left ventricular ejection fraction (LVEF) and normal myocardial perfusion could referred to as subclinical myocardial damage, which is difficult to diagnose at an early stage. Epicardial adipose tissue, a distinctive heart-specific visceral fat, is closely related to various cardiovascular diseases. The objective of this study was to investigate the correlation between epicardial fat volume (EFV) and subclinical myocardial damage in T2DM patients. METHODS: This retrospective cross-sectional study included 117 T2DM patients with normal myocardial perfusion by single photon emission computed tomography-computed tomography (SPECT-CT) and normal LVEF by echocardiography. The study was conducted from January 2018 to December 2022. Patient data were collected through electronic medical records including basic patient information, medical history, laboratory tests, and medication data. The EFV was quantified through a non-contrast CT scan. Quantitative indicators of LVSD including phase standard deviation (PSD) and phase histogram bandwidth (PBW) were obtained through phase analysis of the gated rest myocardial perfusion imaging (MPI). Additionally, 83 healthy individuals at the same time were selected to gain the reference threshold of LVSD indicators (13.1 degrees for PSD and 37.6 degrees for PBW). Univariate and multivariable logistic regression models were performed to analyze factors influencing LVSD. A generalized additive model (GAM) was applied to explore the relationship between EFV and LVSD. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of EFV for LVSD. RESULTS: Among all patients, 32 (27.4%) patients had LVSD. Compared with the non-LVSD group, the body mass index (BMI) and EFV were higher in the LVSD group (25.83+/-2.66 vs. 23.94+/-3.13 kg/m(2); 142.41+/-44.17 vs. 108.01+/-38.24 cm(3), respectively, both P<0.05). Multivariate regression analysis revealed that EFV was independently associated with LVSD [odds ratio (OR) =1.19; 95% confidence interval (CI): 1.06-1.34; P=0.003]. Age, BMI, incidence of hypertension, and LVSD were increased with tertiles of EFV (all P<0.05). The GAM indicated a linear association between EFV and LVSD. The ROC curve analysis concluded that the area under the curve (AUC) of EFV for predicting subclinical myocardial damage in T2DM patients was 0.732 (95% CI: 0.633-0.831, P<0.001), with the optimal threshold of 122.26 cm(3), sensitivity of 71.9%, and specificity of 69.4%. CONCLUSIONS: EFV is an independent risk factor for LVSD in T2DM patients with normal LVEF and normal MPI, which could potentially serve as a novel imaging marker and a potential therapeutic target for subclinical myocardial damage. CI - 2024 Quantitative Imaging in Medicine and Surgery. All rights reserved. FAU - Hu, Yurui AU - Hu Y AD - Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China. AD - Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China. FAU - Yu, Wenji AU - Yu W AD - Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China. AD - Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China. FAU - Zhang, Feifei AU - Zhang F AD - Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China. AD - Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China. FAU - Wang, Yufeng AU - Wang Y AD - Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China. AD - Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China. FAU - Wang, Jingwen AU - Wang J AD - Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China. AD - Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China. FAU - Wan, Peng AU - Wan P AD - Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China. FAU - Shao, Xiaoliang AU - Shao X AD - Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China. AD - Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China. FAU - Wang, Jianfeng AU - Wang J AD - Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China. AD - Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China. FAU - Sun, Yonghong AU - Sun Y AD - Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China. AD - Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China. FAU - Wang, Yuetao AU - Wang Y AUID- ORCID: 0000-0003-2859-8625 AD - Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China. AD - Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China. LA - eng PT - Journal Article DEP - 20240307 PL - China TA - Quant Imaging Med Surg JT - Quantitative imaging in medicine and surgery JID - 101577942 PMC - PMC10963843 OTO - NOTNLM OT - Epicardial fat volume (EFV) OT - gated myocardial perfusion imaging (GMPI) OT - left ventricular systolic dyssynchrony (LVSD) OT - subclinical myocardial damage OT - type 2 diabetes mellitus (T2DM) COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-1413/coif). The authors have no conflicts of interest to declare. EDAT- 2024/03/28 06:45 MHDA- 2024/03/28 06:46 PMCR- 2024/03/15 CRDT- 2024/03/28 04:02 PHST- 2023/10/10 00:00 [received] PHST- 2024/01/22 00:00 [accepted] PHST- 2024/03/28 06:46 [medline] PHST- 2024/03/28 06:45 [pubmed] PHST- 2024/03/28 04:02 [entrez] PHST- 2024/03/15 00:00 [pmc-release] AID - qims-14-03-2627 [pii] AID - 10.21037/qims-23-1413 [doi] PST - ppublish SO - Quant Imaging Med Surg. 2024 Mar 15;14(3):2627-2639. doi: 10.21037/qims-23-1413. Epub 2024 Mar 7.