Author + information
- Received July 15, 2019
- Revision received February 26, 2020
- Accepted February 28, 2020
- Published online April 15, 2020.
- Ian J. Neeland, MDa,∗ (, )
- Takeshi Yokoo, MD, PhDb,
- Olof Dahlqvist Leinhard, PhDc and
- Carl J. Lavie, MDd
- aDivision of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- bDepartment of Radiology and Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
- cAMRA Medical AB, Centre for Medical Image Science and Visualization and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- dDepartment of Cardiology, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, the University of Queensland School of Medicine, New Orleans, Louisiana
- ↵∗Address for correspondence:
Dr. Ian J. Neeland, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas 75390-8830.
• Anthropometric and laboratory markers of obesity have limited utility for personalized treatment. Direct imaging measures of obesity may improve diagnosis, guide decision-making for appropriate interventions, and monitor responses to treatment.
• Multimodality imaging is used to assess visceral and ectopic fat depots (such as within the heart, liver, skeletal muscle, pancreas, and kidney) to improve evaluation of metabolic disease and CVD risk.
• Future studies will combine body fat assessment with physical activity/cardiorespiratory fitness to further improve efforts to prevent and treat obesity and its progression to CVD.
Although obesity is typically defined by body mass index criteria, this does not differentiate true body fatness, as this includes both body fat and muscle. Therefore, other fat depots may better define cardiometabolic and cardiovascular disease (CVD) risk imposed by obesity. Data from translational, epidemiological, and clinical studies over the past 3 decades have clearly demonstrated that accumulation of adiposity in the abdominal viscera and within tissue depots lacking physiological adipose tissue storage capacity (termed "ectopic fat") is strongly associated with the development of a clinical syndrome characterized by atherogenic dyslipidemia, hyperinsulinemia/glucose intolerance/type 2 diabetes mellitus, hypertension, atherosclerosis, and abnormal cardiac remodeling and heart failure. This state-of-the-art paper discusses the impact of various body fat depots on cardiometabolic parameters and CVD risk. Specifically, it reviews novel and emerging imaging techniques to evaluate adiposity and the risk of cardiometabolic diseases and CVD.
Dr. Neeland is supported by the National Institute of Diabetes and Digestive and Kidney Diseases (K23 DK106520) of the National Institutes of Health and by the Dedman Family Scholarship in Clinical Care from UT Southwestern; has received fees for consulting/speaking from Boehringer Ingelheim/Lilly Alliance; has served on a scientific advisory board for Boehringer Ingelheim/Lilly Alliance and AMRA Medical AB; and has received a research grant from Novo Nordisk. Dr. Leinhard is founder of and a stockholder in AMRA Medical AB. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors' institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Cardiovascular Imaging author instructions page.
- Received July 15, 2019.
- Revision received February 26, 2020.
- Accepted February 28, 2020.
- 2020 American College of Cardiology Foundation
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