ORCID Identifier(s)

0000-0003-1484-5226

Graduation Semester and Year

Summer 2024

Language

English

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Kinesiology

Department

Kinesiology

First Advisor

Michael D. Nelson

Abstract

Obesity is a major contributor to cardiovascular disease; however, the exact mechanism remains incompletely understood. Conventional metrics, like body mass index, fail to represent fat distribution and its impact on health. A growing body of literature suggest differences between subcutaneous and visceral fat in relation to cardiovascular risk. This specificity has also been extended to the fat surrounding the heart, collectively known as pericardial fat, which includes epicardial adipose tissue (EAT)— located between the myocardium and the visceral layer of the pericardium— and paracardial adipose tissue (PAT)—found outside the parietal pericardium in the mediastinum. Importantly, these two depots have distinct characteristics, potentially contributing to heart disease in different ways.

This dissertation uses advanced imaging, specifically magnetic resonance imaging (MRI), to evaluate the pathophysiologic consequences of excess pericardial fat. Specifically, in Chapter 2, we evaluate the role of epicardial Fat on coronary vascular function, cardiac morphology and cardiac function in a cohort of women with signs and symptoms of ischemia but no obstructive coronary artery disease – all of whom underwent invasive coronary angiography with coronary

function testing. In Chapter 3, we evaluate whether excess adipose tissue can be mechanically constraining and contribute to adverse cardio-mechanical interaction in heart failure with preserved ejection fraction. Chapter 4 provides a detailed literature review, including findings from Chapters 2 and 3. Finally, Chapter 5 summarizes the major findings and offers a brief interpretation of results and future directions.

Keywords

Magnetic Resonance Imaging (MRI), Heart Failure with Preserved Ejection Fraction (HFpEF), Coronary Vascular Function, Cardio-Mechanical Interaction, Epicardial Fat, Ischemia with No Obstructive Coronary Artery Disease (INOCA)

Disciplines

Medical Physiology

License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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