Pericardial Adiposity Trajectory during Long-term Lifestyle Intervention: CENTRAL-HEART MRI RCT Sub-study

Gal Tsaban ^1,2 Arik Wolak ³ Hila Avni-Hasid ¹ Yftah Gepner ¹ Ilan Shelef ² Dan Schwartzfuchs ^2,4 Noa Cohen ¹ Nitzan Bril ¹ Michal Lerner ¹ Dana Serfaty ¹ Shira Kenigsbuch ¹ Lilac Tene ¹ Hila Zelicha ¹ Anat Yaskolka-Meir ¹ Oded Komy ¹ Yoash Chassidim ² Benjamin Sarusy ⁴ Uta Ceglarek ⁶ Michael Stumvoll ⁶ Matthias Blüher ⁶ Joachim Thiery ⁶ Yaakov Henkin ² Dror Diker ⁵ Assaf Rudich ¹ Meir J Stampfer ⁷ Iris Shai ¹

¹Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva
²Soroka University, Medical Center, Be'er-Sheva
³Division of Cardiology, Sha'are-Tzedek Medical Center, Jerusalem
⁴Nuclear Research Center, Negev, Dimona
⁵Internal Medicine D, Rabin Medical Center, Campus Golda, Petach Tikva
⁶Department of Medicine, University of Leipzig, Leipzig, Saxony
⁷Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard School of Public Health, Boston, MA

Background: Recent emerging evidence suggesting differential association of fat compartments surrounding the heart in cardiovascular pathology and obesity-related disease have raised a need to examine the impact of different lifestyle and weight-reduction interventions on composition of pericardial fat. In this CENTRAL-HEART sub-study we aimed to examine trajectory of pericardial fat tissue, intrapericardial (IPF) and extrapericardial (EPF), during differential dietary intervention.

Methods: We randomly assigned 80 overweight participants into two isocaloric dietary groups: low-fat (LF) diet and low-carbohydrate/Mediterranean (LC/MED) diet. Anthropomorphic measurements, laboratory data as well as Cardiac-MRI in addition to total-body-MRI were performed on baseline, after 6-months, and after 18-months. All subjects were with abdominal obesity or abnormal lipid profile. This trial is registered with ClinicalTrials.gov (number NCT01530724).

Results: Participants (age=48.6 years; body-mass-index=31.7kg/m²; 93% men; baseline visceral-adipose-tissue (VAT)=32.3%, IPF=169.9mL; EPF=195.8mL) had 82% adherence to the diets at 6-months and 77% at-18-months. After 18 months, weight moderately decreased by 3.7kg and VAT by 24.6%. EPF reduced by 39.6mL (-20.8%; p

Conclusion: Pericardial-fat-tissues can be modulated by dietary intervention. Higher IPF reduction correlated with better lipid-profile under LC/MED diet may suggest a more effective dietary strategy for treating in-risk population.

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