Open-bore MRI Scanner Assessment of Epicardial Adipose Tissue after Bariatric Surgery: A Pilot Study.

Carmela Asteria, Francesco Secchi, Lelio Morricone, Alexis Elias Malavazos, Simona Francesconi, Valentina Milani, Alessandro Giovanelli
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Abstract

Background: The recognition of epicardial adipose tissue (EAT) as a cardiac risk factor has increased the interest in strategies that target cardiac adipose tissue.

Aim: The effect of bariatric and metabolic surgery (BMS)-induced weight loss on EAT volume was evaluated in this study.

Methods: Fifteen bariatric patients, with (MS) or without (wMS) Metabolic Syndrome, underwent magnetic resonance imaging (MRI) using an open-bore scanner to assess EAT volume, visceral adipose tissue (VAT) thickness, and other cardiac morpho-functional parameters at baseline and 12 months after BMS. Nine patients underwent laparoscopic sleeve gastrectomy (LSG), and 6 patients underwent Roux-en-Y Gastric Bypass (RYGBP).

Results: EAT volume significantly decreased in all the patients 12 months post-BMS from 91.6 cm3 to 67.1 cm3; p = 0.0002 in diastole and from 89.4 cm3 to 68.2 cm3; p = 0.0002 in systole. No significant difference was found between the LSG and RYGBP group. Moreover, EAT volume was significantly reduced among wMS compared with MS. In particular, EAT volume in diastole was significantly reduced from 80.9 cm3 to 54.4 cm3; p = 0.0156 in wMS and from 98.3 cm3 to 79.5 cm3; p = 0.031 in MS. The reduction was also confirmed in systole from 81.2 cm3 to 54.1 cm3; p = 0.0156 in wMS and from 105.7 cm3 to 75.1 cm3; p = 0.031 in MS. Finally, a positive correlation was found between EAT loss, BMI (r = 0.52; p = 0.0443) and VAT (r = 0.66; p = 0.008) reduction after BMS.

Conclusion: These findings suggest that EAT reduction may be a fundamental element for improving the cardio-metabolic prognosis of bariatric patients. Moreover, this is the first study performed with an open-bore MRI scanner to measure EAT volume.

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减肥手术后心外膜脂肪组织的开孔磁共振成像扫描评估:一项试点研究
背景:目的:本研究评估了减肥和代谢手术(BMS)导致的体重减轻对心外膜脂肪组织体积的影响:15名患有或不患有代谢综合征(MS)的减肥患者使用开孔扫描仪接受了磁共振成像(MRI)检查,以评估基线和BMS术后12个月时的EAT体积、内脏脂肪组织(VAT)厚度和其他心脏形态功能参数。9名患者接受了腹腔镜袖状胃切除术(LSG),6名患者接受了RYGBP(Roux-en-Y Gastric Bypass):所有患者在 BMS 术后 12 个月的 EAT 容量均明显下降,舒张期从 91.6 立方厘米降至 67.1 立方厘米(p = 0.0002),收缩期从 89.4 立方厘米降至 68.2 立方厘米(p = 0.0002)。LSG 组和 RYGBP 组之间无明显差异。此外,与 MS 相比,wMS 组的 EAT 容积明显减少。尤其是在舒张期,wMS 的 EAT 容积从 80.9 立方厘米大幅降至 54.4 立方厘米;p = 0.0156;MS 从 98.3 立方厘米降至 79.5 立方厘米;p = 0.031。收缩期也证实了这一减少,wMS 从 81.2 cm3 降至 54.1 cm3;p = 0.0156,MS 从 105.7 cm3 降至 75.1 cm3;p = 0.031。最后,在 BMS 后,EAT 减少、BMI(r = 0.52;p = 0.0443)和 VAT(r = 0.66;p = 0.008)减少之间存在正相关:这些研究结果表明,减少进食可能是改善减肥患者心血管代谢预后的一个基本要素。此外,这是首次使用开孔磁共振成像扫描仪测量 EAT 体积的研究。
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