An automated algorithm that assesses heart-surrounding fat and predicts heart failure could one day help clinicians to better support patients.
Summary
Researchers used heart images from more than 1,000 UK Biobank participants to create an algorithm that predicts heart failure by analysing fatty tissue around the organ. Automatic assessment of this heart-surrounding fat in routine heart scans could eventually help doctors to make better decisions about how to treat people who are at risk of heart disease.
An algorithm, developed with heart images from more than 1,000 UK Biobank participants, can predict heart failure by analysing the fatty tissue around the organ. Large amounts of this heart-surrounding (pericardial) fat have been linked to poor heart health – regardless of someone’s body weight.
“Not all fat is equal,” says study team member Zahra Raisi-Estabragh from Queen Mary University of London, UK. “You can have deposition of fat under the skin, you can also have deposition around the heart, around the internal organs, elsewhere in the body. The different patterns of obesity have different levels of risk, and this is something that is not properly understood.”
The different patterns of obesity have different levels of risk, and this is something that is not properly understood.
Dr Zahra Raisi-Estabragh, Queen Mary University of London, UK
Raisi-Estabragh and her team created an algorithm that analyses the amount and texture of pericardial fat, using heart images from 1,204 UK Biobank participants – including 300 who would develop heart failure after their scans. The algorithm could correctly predict whether someone would develop heart failure in the next few years 74% of the time.
Currently, clinicians don’t routinely report pericardial fat. An AI algorithm that automatically analyses pericardial fat in heart scans could change that, and help doctors to identify patients who are likely to develop heart failure, says heart specialist Satish Kenchaiah from Veterans Affairs Medical Center, Indianapolis, US.
Kenchaiah suggests that a routine pericardial fat assessment could allow doctors to make better decisions about whether someone should start taking fat-lowering drugs, such as statins, for example. Statins can help to reduce someone’s risk of heart attack or stroke if they have high cholesterol.
Genetic factors
A genetic analysis of more than 28,000 UK Biobank participants revealed that our DNA determines, at least in part, the amount of pericardial fat. Fat around the heart increases the risk of heart failure, irrespective of body weight. For example, some people have little fat under the skin but a lot around their internal organs – or vice versa.
[Researching] these patterns will allow us to better understand why some people with obesity develop certain diseases while others don’t. This will have implications in terms of public health messaging.
Dr Zahra Raisi-Estabragh, Queen Mary University of London, UK
“We’re trying to understand why some people have inconsistent obesity patterns,” explains Raisi-Estabragh, who was part of the team behind the study. “[Researching] these patterns will allow us to better understand why some people with obesity develop certain diseases while others don’t,” she says. “That this will have implications in terms of public health messaging.”
It’s not yet entirely clear why pericardial fat is so unhealthy. It could be because a fat layer acts like a band around the heart, preventing it from relaxing properly, Kenchaiah suggests. Or it could be that fat cells stiffen the heart muscles, drive inflammation or secrete hormones that impact the heart’s health.
“If we understand this better, we may be able to better prevent and treat disease,” Raisi-Estabragh says.
Correction: Satish Kenchaiah’s affiliation was changed. The way fat layers around the heart act on the organ was clarified.
Additional publication
- Journal of the American Heart Association, October 2023