Excess Muscle Fat Linked to Higher Heart Disease Risk, Study Finds

According to the European Heart Journal, excess muscle fat conveys a link between coronary microvascular dysfunction (CMD) and adverse cardiovascular outcomes
Excess muscle fat conveys a link to the risk of heart disease. Stay with fitness to maintain a normal BMI.
According to European Heart Disease, excess muscle fat conveys a link between coronary microvascular dysfunction (CMD) and adverse cardiovascular outcomes.(Representational Image: Freepik)
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One of the most significant threats to public health worldwide is overweight/obesity, which prevails in over 71% of US adults. When compared to individuals with normal weight and people with obesity, the body mass index (BMI) is ≥ 30 kg/m2, were the incidents of cardiovascular disease (CVD) occurs at a younger age and have a shorter average lifespan.

Rising BMI is associated with a high risk of morbidity and mortality across populations. Also, Cardiovascular disease risk is not for individuals with identical BMI, they vary substantially across sex and racial/ethnic groups.

Increased adiposity accelerates atherosclerosis and facilitates adverse changes in cardiac structure and function. It has deleterious effects on the myocardium and the vasculature and also on obesity-related comorbidities, including hypertension, dyslipidemia, and type-2 diabetes mellitus.

Besides BMI, there are other discriminators to access cardiovascular outcomes. Imaging technologies like computed tomography (CT) are used to assess body composition and differentiate between fat and lean mass directly in-vivo through their respective radio densities, or attenuation, within anatomical compartments.

Newly, Intermuscular adipose tissue (IMAT) has arisen as a distinct adipose depot reflecting skeletal muscle (SM) fat infiltration with unique and evolving biological properties.

Skeletal muscle quantity and quality are associated with cardio microvascular dysfunction and alter its effect on the development of future adverse cardiovascular events independent of body mass index (BMI).

Souza and colleagues

Souza and colleagues hypothesize that skeletal muscle quantity and quality are associated with Cardio microvascular dysfunction and alter its effect on the development of future adverse cardiovascular events independent of body mass index (BMI). (1)

They researched around 669 patients guided for positron emission tomography (PET) perfusion imaging for investigating chest pain or dyspnoea for more than 6 years. Thoracic computed tomography (CT) imaging was routinely acquired for attenuation modification of PET images.(2)

Coronary microvascular dysfunction quantified non-invasively using positron emission tomography as an impaired global coronary flow reserve (CFR < 2) with normal myocardial perfusion imaging that is independently associated with very high BMI and future risk of heart failure, myocardial infarction and death.

A person with ishemia and no obstructive coronary heart disease, elevated BMI had increased visceral fat deposits.
Patients undergoing cardiac PET/CT with ischemia and no-obstructive coronary arterial disease (INOCA) and elevated BMI had increased multi-visceral fat deposits with BMI greater than 30kg/m2 (increased intramuscular fat, increased epicardial fat and increased hepatic fat).(Representational Image: Freepik)
The study predicted that those who had reduced blood flow to their heart, but showed no signs of blocked arteries and found that assessing how much fat they had in muscles around their chest enhanced predictions for who would experience major heart problems years later. The researchers discovered that every 1% increase in fat deposition in a person’s muscle fibres is associated with a 2% greater chance of having reduced blood flow to their heart.

Also, Patients undergoing cardiac PET/CT with ischemia and non-obstructive coronary arterial disease (INOCA) and elevated BMI had increased multi-visceral fat deposits with BMI greater than 30kg/m2 (increased intramuscular fat, increased epicardial fat and increased hepatic fat).

The study predicted that those who had reduced blood flow to their heart but showed no signs of blocked arteries and found that assessing how much fat they had in muscles around their chest enhanced predictions for who would experience major heart problems years later.(1)

The researchers discovered that every 1% increase in fat deposition in a person’s muscle fibers is associated with a 2% greater chance of having reduced blood flow to their heart.

This 1% rise in muscle fat also shares a link to a 7% greater chance of having heart problems, which was calculated for up to nearly six years. Heart problems were defined in this study as having a heart failure, heart attack or heart-related death.

The forecasts from muscle fat were not connected to other factors such as fat around a person’s heart or liver and body weight.

More research is yet to be carried out to understand the risk of cardiovascular outcomes to muscle fat.

References:

  1. Souza, Ana C., Amelie S. Troschel, Jan P. Marquardt, Ibrahim Hadžić, Borek Foldyna, Filipe A. Moura, Jon Hainer, et al. "Skeletal Muscle Adiposity, Coronary Microvascular Dysfunction, and Adverse Cardiovascular Outcomes." European Heart Journal. Accessed February 13, 2025. https://doi.org/10.1093/eurheartj/ehae827.

  2. De Silva, Ranil, and Kevin Cheng. "Skeletal Muscle Adiposity in Patients with Impaired Coronary Flow Reserve: Risk Marker, Treatment Target, or Bystander?" European Heart Journal. Accessed February 13, 2025. https://doi.org/10.1093/eurheartj/ehae909.

  3. "Extra Fat in Muscles Linked to Heart Disease Risks." NHLBI in the Press, February 12, 2025. https://www.nhlbi.nih.gov/news/2025/extra-fat-muscles-linked-heart-disease-risks.

(Input from various media sources)

(Rehash/Dr. Lakshmisahithi Tanneru/SSK)

Excess muscle fat conveys a link to the risk of heart disease. Stay with fitness to maintain a normal BMI.
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