A pericardial fat volume ≥143 mL was associated with a significantly increased likelihood of prolonged myocardial T2 relaxation time (OR 5.94; 95% CI 1.52-23.18; p=0.019).
Cross-Sectional (n=41)
Does increased pericardial fat volume correlate with prolonged myocardial T2 relaxation time in patients with CAD and HFpEF?
Higher pericardial fat volume is independently associated with prolonged myocardial T2 relaxation time, suggesting a link between pericardial adiposity and subclinical myocardial inflammation in patients with CAD and HFpEF.
Odds Ratio: 5.94 (95% CI 1.52–23.18)
p-value: p=0.019
Abstract Background Pericardial fat is metabolically active and has been linked to local myocardial inflammation. It correlates with inflammatory and haemostatic biomarkers, including a positive association with interleukin-6 (IL-6) levels. Cardiac MRI–derived T2 relaxation time reflects myocardial inflammation and oedema, but its relationship with pericardial fat volume (PFV) remains unclear. Understanding this association may help clarify mechanisms of fat-related myocardial injury and cardiovascular risk. Purpose To investigate the association between PFV and myocardial inflammation, as assessed by T2 relaxation time on cardiac MRI. Methods This cross-sectional study included patients with coronary artery disease and heart failure with preserved ejection fraction (HFpEF), without evidence of scar on late gadolinium enhancement (LGE) imaging. Imaging was performed between November 2023 and December 2024 using a 1.5T MRI scanner. T2 relaxation time was measured from three short-axis slices using T2-prepared balanced steady-state free precession sequences. PFV was calculated as the volume difference between the pericardial and myocardial borders on short-axis images. Additional volumetric measurements followed the Society for Cardiovascular Magnetic Resonance (SCMR) guidelines. Patients were categorised by T2 relaxation time into prolonged (≥55 ms) and normal (55 ms) groups to assess associations with PFV. Results A total of 41 patients were included (median age 64 years; range 41–78); 73.2% were male, with a mean body mass index (BMI) of 25.9 ± 3.7 kg/m². Hypertension was present in 58.5%, and diabetes mellitus in 19.5%. Prolonged T2 relaxation time (≥55 ms) was observed in 18 patients. No significant differences were noted between the prolonged and normal T2 groups regarding BMI, hypertension, or diabetes. However, patients with prolonged T2 had significantly lower left ventricular end-diastolic volume index (LVEDVi: 66 ± 10 vs. 72 ± 10 mL/m², p = 0.040), lower left ventricular cardiac output index (LVCOi: 2.7 0.2–5.4 vs. 3.3 2.2–4.4 L/min/m², p = 0.015), and higher PFV (161 ± 38 vs. 128 ± 33 mL, p = 0.006). Moderate-to-severe ischaemic burden was observed in 41.5% of patients, with no significant difference between T2 groups (p = 0.981). Bivariate and multivariate analyses identified PFV as the only independent predictor of prolonged T2 (OR 1.03; 95% CI: 1.01–1.05; p = 0.013). Receiver operating characteristic (ROC) curve analysis yielded an AUC of 0.745 (p = 0.008), with a PFV cut-off of 143 mL providing 72.2% sensitivity and 69.6% specificity. A PFV ≥143 mL was associated with a 5.94-fold increased likelihood of prolonged T2 (OR 5.94; 95% CI: 1.52–23.18; p = 0.019). Conclusion Higher PFV was significantly associated with prolonged myocardial T2 relaxation time, indicating a link between increased pericardial adiposity and subclinical myocardial inflammation.Results 1 Results 2
Vidianti et al. (2026) conducted a cross-sectional in Coronary artery disease and heart failure with preserved ejection fraction (HFpEF) (n=41). Pericardial fat volume ≥143 mL vs. Pericardial fat volume <143 mL was evaluated on Prolonged myocardial T2 relaxation time (≥55 ms) (OR 5.94, 95% CI 1.52-23.18, p=0.019). A pericardial fat volume ≥143 mL was associated with a significantly increased likelihood of prolonged myocardial T2 relaxation time (OR 5.94; 95% CI 1.52-23.18; p=0.019).
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