Effect of Aerobic and Resistance Exercise on Cardiac Adipose Tissues

Abstract

IMPORTANCE Epicardial and pericardial adipose tissues are emerging as important risk factors for cardiovascular disease, and there is a growing interest in discovering strategies to reduce the accumulation of fat in these depots. OBJECTIVE To investigate whether a 12-week endurance or resistance training intervention regulates epicardial and pericardial adipose tissue mass. DESIGN, SETTING, AND PARTICIPANTS Secondary analysis of a randomized, assessor-blinded clinical trial initiated on August 2016 and completed April 2018. This single-center, community-based study included 50 physically inactive participants with abdominal obesity. INTERVENTIONS Participants were randomized to a supervised high-intensity interval endurance training (3 times a week for 45 minutes), resistance training (3 times a week for 45 minutes), or no exercise (control group). MAIN OUTCOMES AND MEASURES Change in epicardial and pericardial adipose tissue mass assessed by magnetic resonance imaging, based on a prespecified secondary analysis plan including 3 of 5 parallel groups. RESULTS Of 50 participants (mean [SD] age, 41 [14] years, 10 men [26%]; mean [SD] body mass index [calculated as weight in kilograms divided by height in meters squared], 32 [5]), 39 [78%] completed the study. Endurance training and resistance training reduced epicardial adipose tissue mass by 32% (95% CI, 10%-53%) and 24% (95% CI, 1%-46%), respectively, compared with the no exercise control group (56% [95% CI, 24%-88%]; P = .001 and 48% [95% CI, 15%-81%]; P < .001, respectively). While there was a nonsignificant reduction in pericardial adipose tissue mass after endurance training (11% [95% CI, −5% to 27%]; P = .17), resistance training significantly reduced pericardial adipose tissue mass by 31% (95% CI, 16%-47%; P < .001) when compared with the no exercise control group. Compared with the no exercise control group, there was an increase in left ventricular mass by endurance (20 g [95% CI, 11%-30%]; P < .001) and resistance training (18 g [95% CI, 8%-28%]; P < .001). Other cardiometabolic outcomes remained unchanged after the 12-week trial period. CONCLUSIONS AND RELEVANCE In individuals with abdominal obesity, both endurance and resistance training reduced epicardial adipose tissue mass, while only resistance training reduced pericardial adipose tissue mass. These data highlight the potential preventive importance of different exercise modalities as means to reduce cardiac fat in individuals with abdominal obesity.

The Natural history of Epicardial Adipose Tissue Volume and Attenuation: A long-term prospective cohort follow-up study

“…Similar results were seen in a short-term evaluation of exercise testing in obese individuals with serial MRI. Both endurance and resistance training resulted in significant reductions in EATv without significant changes in other cardiometabolic parameters 20 . In another study that evaluated serial non-contrast CT change in EAT in an asymptomatic observational cohort, a greater percentage change in BMI on follow-up was associated with a greater percentage change in EAT 6 .…”

Epicardial adipose tissue predicts incident cardiovascular disease and mortality in patients with type 2 diabetes

“…Regarding pharmacological influences, EAT thickness at systole is a consistent independent predictor of new onset diabetes in patients with CAD treated with high-intensity statins [43]. Treatment with dapagliflozin or non-pharmacological exercise-based interventions might be means to improve systemic metabolic parameters and decrease the EAT volume in patients with/at risk of diabetes [44, 45].…”

Muscle-Organ Crosstalk: Focus on Immunometabolism

“…Recent evidence exists that exercise training decreases the amount of visceral and cardiac fat mass ( Christensen et al, 2019a , b ; Wedell-Neergaard et al, 2019 ) mediated by muscle-derived IL-6 ( Wedell-Neergaard et al, 2019 ) as described below.…”