Purpose: 
Visceral Adipose Tissue (VAT) as a source of pro
inflammatory and biological mediators is implicated in adverse 
cardiac structure remodeling, functional alternations, and results 
in Heart Failure (HF) in central obese patients. However, the 
impact of different distributions of visceral fat on cardiac 
structural/functional changes still remains unclear. 
Methods: 
This retrospective analysis includes 354 subjects free 
from previous myocardial infarction, coronary arterial disease, 
stroke, or clinical HF. Regional VAT including Pericardial Fat 
(PCF) and Thoracic Periaortic Fat (TAT) volumes, fatty liver 
grades were all measured by Multi-Detector Computed 
Tomography (MDCT) (Aquarius 3D Workstation, TeraRecon, 
San Mateo, CA, USA) and abdominal sonography (Toshiba 
Nemio SSA-550A). We measured Left ventricular mass/mass 
index (LVM/LVMI), LV Mass to Volume ratio (LVMVI), Left 
Atrium (LA) diameter represented as cardiac remodeling, and 
analyzed their association with adiposity measures.  

Results:  
All VAT are significantly associated with worsening 
cardio-metabolic profiles (hs-CRP, metabolic scores, coronary 
calcium score) (all P<0.05). Excess PCF/TAT wassignificantly 
associated with larger LVM/LVMI, LVMVI, and LA diameter 
(all P<0.05); presented in LV concentric remodeling, it further 
worsens LV diastolic function. In multivariate models, this effect 
on LA remodeling was attenuated in TAT after adjusting for the 
clinical variable (P=0.052). However, there was no correlation 
between hepatic fat and LV/LA structural/functional alternations.  
Conclusion: 
Accumulated visceral adiposity, especially PCF deposits, 
was associated with certain cardiac structural/functional 
remodeling characterized by impaired LV diastolic function. PCF 
may exhibit a local effect on adjacent cardiac structure more than 
TAT and hepatic fat. Our data suggested that PCF may serve as 
an independent predictor to screen subclinical heart failure in 
asymptomatic population.