‘Ectopic fat infiltration’ refers to the pathological process in which fat accumulates in tissues not normally adapted to fat storage. This process, which is more common in type 2 diabetes and obesity, can occur for example in and around the heart, in the liver and in skeletal muscle. Apart from being associated with elevated risk of atherosclerotic cardiovascular disease, several studies have also linked ectopic fat infiltration to structural alterations and impaired function in the heart (i.e. cardiac remodeling).
Sites with ectopic fat can also undergo fibrotic transformation. One such example is metabolic dysfunction-associated steatotic liver disease (MASLD, formerly known as NAFLD), where a subset of patients can develop progressive inflammation and fibrosis in the liver, which in turn increases the risk of both liver-related and cardiovascular complications. Another example is epicardial fat, where fibrotic transformation of adipose tissue is associated with atrial fibrillation, a disease capable of inducing cardiac remodeling.
My PhD thesis aims to study the amount and distribution of ectopic fat and fibrosis, primarily in individuals with type 2 diabetes. By using advances imaging methods from MR, we are able to quantify ectopic fat and fibrosis in different anatomical sites, and study how these two processes are related to adverse cardiac remodeling.