{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:39:23Z","timestamp":1792093163216,"version":"4.4.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T00:00:00Z","timestamp":1653955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>We evaluated independent associations of cardiovascular magnetic resonance (CMR)-measured pericardial adipose tissue (PAT) with cardiovascular structure and function and considered underlying mechanism in 42 598 UK Biobank participants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We extracted PAT and selected CMR metrics using automated pipelines. We estimated associations of PAT with each CMR metric using linear regression adjusting for age, sex, ethnicity, deprivation, smoking, exercise, processed food intake, body mass index, diabetes, hypertension, height cholesterol, waist-to-hip ratio, impedance fat measures, and magnetic resonance imaging abdominal visceral adiposity measures. Higher PAT was independently associated with unhealthy left ventricular (LV) structure (greater wall thickness, higher LV mass, more concentric pattern of LV hypertrophy), poorer LV function (lower LV global function index, lower LV stroke volume), lower left atrial ejection fraction, and lower aortic distensibility. We used multiple mediation analysis to examine the potential mediating effect of cardiometabolic diseases and blood biomarkers (lipid profile, glycaemic control, inflammation) in the PAT-CMR relationships. Higher PAT was associated with cardiometabolic disease (hypertension, diabetes, high cholesterol), adverse serum lipids, poorer glycaemic control, and greater systemic inflammation. We identified potential mediation pathways via hypertension, adverse lipids, and inflammation markers, which overall only partially explained the PAT-CMR relationships.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>We demonstrate association of PAT with unhealthy cardiovascular structure and function, independent of baseline comorbidities, vascular risk factors, inflammatory markers, and multiple non-invasive and imaging measures of obesity. Our findings support an independent role of PAT in adversely impacting cardiovascular health and highlight CMR-measured PAT as a potential novel imaging biomarker of cardiovascular risk.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeac101","type":"journal-article","created":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:11:52Z","timestamp":1654042312000},"page":"1471-1481","source":"Crossref","is-referenced-by-count":34,"title":["Pericardial adiposity is independently linked to adverse cardiovascular phenotypes: a CMR study of 42 598 UK Biobank participants"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2654-8117","authenticated-orcid":false,"given":"Maddalena","family":"Ardissino","sequence":"first","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , Hammersmith Hospital, London W12 0NN , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celeste","family":"McCracken","sequence":"additional","affiliation":[{"name":"William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London , Charterhouse Square, London EC1M 6BQ , UK"},{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust , Oxford OX3 9DU UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Bard","sequence":"additional","affiliation":[{"name":"William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London , Charterhouse Square, London EC1M 6BQ , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charalambos","family":"Antoniades","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust , Oxford OX3 9DU UK"},{"name":"Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford , Oxford OX1 2JD , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9017-5645","authenticated-orcid":false,"given":"Stefan","family":"Neubauer","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust , Oxford OX3 9DU UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas C","family":"Harvey","sequence":"additional","affiliation":[{"name":"MRC Lifecourse Epidemiology Centre, University of Southampton , Southampton SO16 6YD , UK"},{"name":"NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust , Southampton SO16 6YD UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen E","family":"Petersen","sequence":"additional","affiliation":[{"name":"William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London , Charterhouse Square, London EC1M 6BQ , UK"},{"name":"Barts Heart Centre, St Bartholomew\u2019s Hospital, Barts Health NHS Trust , West Smithfield EC1A 7BE , UK"},{"name":"Health Data Research UK , London , UK"},{"name":"Alan Turing Institute , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7757-5465","authenticated-orcid":false,"given":"Zahra","family":"Raisi-Estabragh","sequence":"additional","affiliation":[{"name":"William Harvey Research Institute, NIHR Barts Biomedical 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