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Objectives: Prior studies have identified a relationship between body mass index (BMI) and intraperitoneal (IP) fat with heart failure; however, in prior studies of cancer patients receiving potentially cardiotoxic chemotherapy, elevations in BMI have not necessarily been associated with decrements in heart function. This study tested the hypothesis that IP fat may be associated with left ventricular ejection fraction (LVEF) decline among cancer patients receiving potentially cardiotoxic chemotherapy. Methods: In this prospective study of 61 cancer patients (23 breast cancer, 32 lymphoma, and 6 sarcoma), IP fat and other assessments of body composition, and changes in LVEF from pre‐ to postcancer treatment using noninvasive magnetic resonance imaging was ascertained. Results: After accounting for age, baseline LVEF, and confounding variables, pre‐ to 24‐month post‐treatment LVEF changes were inversely correlated with IP fat (r = −0.33; p = 0.02) and positively correlated with measures of subcutaneous (SQ) fat (r = 0.33; p = 0.01). These LVEF changes were not correlated with BMI (r = 0.12; p = 0.37). Conclusion: Among patients receiving potentially cardiotoxic chemotherapy, pretreatment IP fat was associated with subsequent declines in LVEF. There was no association between BMI and LVEF decline. These findings may be related to a potential protective effect of SQ fat. [ABSTRACT FROM AUTHOR]

Introduction: Accumulation of excess intra-peritoneal fat is associated with left ventricular (LV) dysfunction in those not receiving treatment for cancer. We sought to determine if increases in intra-peritoneal fat were associated with declines in LV ejection fraction (LVEF) after receipt of potentially cardio-toxic chemotherapy. Methods: In 61 patients (32 lymphoma, 23 breast cancer, 6 sarcoma) we obtained magnetic resonance imaging (MRI) assessments of abdominal fat (intra-peritoneal [IP], retroperitoneal [RP] and subcutaneous [SQ]) at the level of the L2 vertebra, as well as LVEF prior to and 24 months after initiating cardio-toxic chemotherapy (70% doxorubicin, 1% trastuzumab, 5% taxol, 26% docetaxel, and 67% cyclophosphamide). Correlations between 24-month change in LVEF and baseline measures of body mass index (BMI), IP, RP & SQ fat were identified after accounting for baseline LVEF, height, gender, anthracycline use, and time. Results: A total of 61 participants (age 53 ± 15 yrs; 32% men, 78% Caucasian) exhibited an average baseline BMI of 30 ± 6 kg/m2, height of 170 ± 11cm, and a baseline LVEF of 62 ± 8%. After accounting for height, baseline LVEF, anthracycline use, gender and time between visits, baseline IP fat volume was associated with a LVEF decline (r=-0.27, p=0.047) while BMI, RP and SC fat were not (p= 0.09 to 0.41 for all). Those older than median age of 52 yrs. with high IP fat trended toward greater declines in LVEF (r=0.31, p=0.082) when compared to younger individuals (<52 yrs.) (r=0.24, p=0.346). Within the entire cohort, those with high IP/low SQ fat experienced marked declines in LVEF (p= 0.026). Conclusions: Pre-chemotherapy intra-peritoneal fat (not necessarily reflected in an assessment of BMI) is associated with declines in LVEF 2 years after receipt of cardio-toxic chemotherapy. These findings suggest those with larger amounts of intra-peritoneal fat are at higher risk for developing left ventricular dysfunction upon receipt of cardio-toxic chemotherapy. [ABSTRACT FROM AUTHOR]