(IN BRIEF) New research published in the European Heart Journal has shown that intermuscular fat, which accumulates between muscles, significantly increases the risk of heart disease, heart attack, and heart failure, regardless of body mass index (BMI). Led by Professor Viviany Taqueti, the study highlights that the amount of fat stored in muscles can damage the tiny blood vessels of the heart (coronary microvascular dysfunction or CMD) and lead to severe cardiovascular events. The study, involving 669 patients, found that higher levels of intermuscular fat were linked to increased risk of CMD and future heart disease, with women being particularly affected. The findings challenge the effectiveness of BMI as a comprehensive marker for heart disease risk and call for more precise measures, such as the fatty muscle fraction, to assess cardiovascular health. Further research is underway to explore treatments that can help reduce the risk for individuals with high intermuscular fat.
(PRESS RELEASE) SOPHIA ANTIPOLIS, 21-Jan-2025 — /EuropaWire/ — New research published in the European Heart Journal has revealed that people with fat stored within their muscles are at a significantly higher risk of experiencing heart attacks or heart failure, regardless of their body mass index (BMI). The study, the first of its kind to explore the impact of intermuscular fat on heart health, highlights a previously unrecognized factor that could affect cardiovascular risk.
Intermuscular fat, which is often prized in beef steaks for cooking, has been largely overlooked in human health research, despite its potential impact. This fat type, found between muscles, has now been shown to contribute to an increased risk of heart disease by causing damage to the tiny blood vessels of the heart (coronary microvascular dysfunction or CMD). People with higher levels of this fat are more likely to suffer adverse cardiovascular events, even if their BMI is not classified as high.
Professor Viviany Taqueti, Director of the Cardiac Stress Laboratory at Brigham and Women’s Hospital, Boston, and lead author of the study, explained, “Obesity is a leading global health threat, yet BMI remains a limited and often inaccurate indicator of heart disease risk. This study adds important insights into how muscle fat—regardless of BMI—affects heart health, particularly in women, where fat distribution can differ significantly.”
The study involved 669 patients, primarily women (70%), with an average age of 63, who were undergoing evaluation for chest pain or shortness of breath at Brigham and Women’s Hospital. These patients were found to have no obstructive coronary artery disease but had varying levels of intermuscular fat. Researchers used advanced imaging techniques to analyze body composition and track the patients’ health over six years.
The findings showed that for every 1% increase in the amount of fat stored in the muscles, there was a corresponding 2% increase in the likelihood of CMD and a 7% increased risk of serious heart disease, regardless of BMI. Individuals with both high intermuscular fat and CMD were at an especially elevated risk of heart attack, heart failure, and death. In contrast, those with more lean muscle mass had a lower risk, while subcutaneous fat did not show the same association.
Professor Taqueti noted, “Intermuscular fat seems to contribute to inflammation, insulin resistance, and metabolic syndrome, which can further damage blood vessels and the heart muscle. This discovery offers a new way to identify people at high risk for heart disease, even when traditional metrics like BMI are normal.”
The study also raises important questions about how treatments, such as new weight-loss therapies, affect fat storage in muscles and their potential impact on heart health. Professor Taqueti’s team is now exploring various treatment strategies, including exercise, nutrition, and weight-loss drugs, to understand how body composition affects cardiovascular disease.
In an editorial accompanying the study, Dr. Ranil de Silva from Imperial College London and colleagues emphasized that while obesity is a major risk factor for cardiovascular disease, the relationship between fat storage, muscle quality, and heart disease risk is complex and warrants further research. They called for the integration of intermuscular fat markers into future cardiac risk assessments to help identify patients who might benefit from targeted interventions.
About the European Society of Cardiology
The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.
The European Heart Journal is the flagship journal of the European Society of Cardiology. It is published on behalf of the ESC by Oxford Journals, a division of Oxford University Press.
Funding: Lemann Cardiovascular Research Fellowship, Gilead Sciences Research Scholars Program in Cardiovascular Disease and the National Institutes of Health
Disclosures: None
References
[1] ‘Skeletal muscle adiposity, coronary microvascular dysfunction, and adverse cardiovascular outcomes’, by A.C. do A.H. Souza et al, European Heart Journal, doi: https://doi.org/10.1093/eurheartj/ehae827.
https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehae827
[2] ‘Skeletal muscle adiposity in patients with impaired coronary flow reserve: risk marker, treatment target, or bystander?’, by R de Silva and K Cheng, European Heart Journal, doi: https://doi.org/10.1093/eurheartj/ehae909.
https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehae909
Media Contact:
ESC Press Office
Tel: +33 6 61 40 18 84
Email: press@escardio.org
SOURCE: European Society of Cardiology (ESC)
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