Aerobic and resistance exercise may cut down excess cardiac adiposity: JAMA

Cardiac adiposity or excessive fat around the heart possesses high cardiovascular risk. Aerobic and resistance exercise have the potential to reduce cardiac adipose tissue mass and may have clinical potential, revealed a study published in a high impact journal, JAMA.

Exercise is a cost-effective non-pharmaceutical measure for enhancing heart health.

Epicardial and pericardial adipose tissues are emerging as important risk factors for cardiovascular disease, and there is a growing interest in discovering strategies to reduce the accumulation of fat in these stations.

There are numerous invasive approaches such as pharmaceutical drugs including glucagon-like peptide 1 analogs, sodium-glucose transporter 2 inhibitors, and lipid-lowering drugs, as well as bariatric surgery are found to decrease adiposity of heart. But, as well as having unwanted side effects, these procedures are expensive.

Therefore, scientists are continuously looking for a cost-effective and noninvasive strategy to reduce cardiovascular risks. Until now, few studies have investigated the effect of exercise on epicardial and pericardial adipose tissue mass and the existing literature is inconsistent, to our knowledge. For instance, it is unclear whether exercise training, both endurance and resistance training, facilitates changes in both epicardial and pericardial adipose tissue.

Taking a cue from the existing evidence that exercise targets visceral adipose tissue and lowers cardiovascular risk, this study set out to investigate the effects of a 12-week endurance exercise and resistance exercise intervention on epicardial and pericardial adipose tissue mass in physically inactive individuals with abdominal obesity.

The authors hypothesized that both endurance and resistance exercise training would reduce epicardial and pericardial fat compared with an inactive control group.

For investigation participants were randomized to a supervised high-intensity interval endurance training (3 times a week for 45 minutes), resistance training (3 times a week for 45 minutes), or no exercise (control group). Main outcomes included in the study were changed in epicardial and pericardial adipose tissue mass assessed by magnetic resonance imaging, based on a prespecified secondary analysis plan including 3 of 5 parallel groups and the study included a total of 50 participants.

Key findings

• Endurance training and resistance exercise training reduced epicardial adipose tissue mass by 32% and 24%, respectively, compared with the no exercise control group and 48%.


• While there was a nonsignificant reduction in pericardial adipose tissue mass after endurance training, resistance training significantly reduced pericardial adipose tissue mass by 31% when compared with the no exercise control group.


• Compared with the no exercise control group, there was an increase in left ventricular mass by endurance and resistance training. Other cardiometabolic outcomes remained unchanged after the 12-week trial period.

Based on the findings of the study the authors conclude: In individuals with abdominal obesity, both endurance and resistance training exercise reduced epicardial adipose tissue mass, while only resistance training reduced pericardial adipose tissue mass. These data highlight the potential preventive importance of different exercise modalities as a means to reduce cardiac fat in individuals with abdominal obesity.

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(doi:10.1001/jamacardio.2019.2074)