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Upadhaya S, Le Jemtel TH. Epicardial Adipose Tissue and Heart Failure. Trends Cardiovasc Med 2025:S1050-1738(25)00029-5. [PMID: 40020796 DOI: 10.1016/j.tcm.2025.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2025] [Accepted: 02/20/2025] [Indexed: 03/03/2025]
Affiliation(s)
- Sunil Upadhaya
- Section of Cardiology, John W. Deming Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, SL-48, New Orleans, LA 70112, USA
| | - Thierry H Le Jemtel
- Section of Cardiology, John W. Deming Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, SL-48, New Orleans, LA 70112, USA.
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Celik MS, Arpa A. Evaluation of epicardial fat tissue thickness in patients with seborrheic dermatitis. Arch Dermatol Res 2025; 317:364. [PMID: 39920495 DOI: 10.1007/s00403-025-03909-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Revised: 01/18/2025] [Accepted: 01/27/2025] [Indexed: 02/09/2025]
Abstract
Seborrheic dermatitis is a common inflammatory skin disease that primarily affects the scalp, face, and body folds. Recent studies have shown that seborrheic dermatitis may be associated with inflammation and cardiometabolic conditions. We aimed to investigate this relationship in our study. Fifty patients with seborrheic dermatitis who came to the dermatology outpatient clinic and completely healthy patients in a similar age group were included in the study. Echocardiographic findings and heart rates of the patient and control groups were recorded on previously prepared forms. The mean epicardial fat tissue thickness of the patient group was 0.72 ± 0.04, while the mean of the control group was 0.62 ± 0.05, and this difference was considered significant (P < 0.001). There was no significant difference between the patient and control groups in terms of left atrium (p = 0.759), interventricular septum thickness (p = 0.252), and heart rate (p = 0.835). Epicardial fat tissue loses its protective role in pathological processes and plays a role in cardiovascular diseases, especially coronary artery disease, in inflammatory processes. In this respect, SD patients should be carefully monitored for long-term, especially for coronary artery disease.
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Affiliation(s)
- Mehmet Semih Celik
- Department of Dermatology, University of Health Sciences, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakir, Turkey.
| | - Abdulkadir Arpa
- Department of Cardiology, Bismil State Hospital, Diyarbakir, Turkey
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Poniedziałek B, Perek B, Proch A, Komosa A, Niedzielski P, Buczkowski P, Jemielity M, Rzymski P. Mineral composition and ratios in aortic valves, serum, and epicardial fat among patients with aortic stenosis undergoing aortic valve replacement. Sci Rep 2025; 15:1233. [PMID: 39775052 PMCID: PMC11707200 DOI: 10.1038/s41598-025-85141-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Accepted: 01/01/2025] [Indexed: 01/11/2025] Open
Abstract
Aortic stenosis (AS) is a leading cause of surgical intervention in adults with acquired heart disease, driven by an aging population and advancements in diagnostic and treatment approaches. This study aimed to investigate levels of macroelements (Ca, K, Na, Mg, and P) in aortic valve tissues, serum, and epicardial fat in patients undergoing aortic valve replacement due to degenerative disease. Elemental composition was determined using inductively coupled plasma mass spectrometry. Analyses revealed a distinct accumulation of Ca and P in aortic valve tissues, not correlated to and exceeding that in epicardial adipose tissue, suggesting localized mineralization. Significant relationships between serum and aortic valve element concentrations were found, with serum K and Mg levels inversely correlated with Ca and P deposition and Ca/P ratio in the valve, highlighting their potential role as calcification inhibitors. Moreover, serum and valvular Na/K ratios were positively correlated. Furthermore, patient age was associated with increased Ca, Mg, Na, P levels, and Ca/P ratio in valve tissues, reinforcing age as a risk factor for valvular calcification. Creatinine and lipoprotein (a) levels correlated positively with valvular K content and Ca/P ratio, respectively, while high-density lipoprotein cholesterol concentration was positively associated with Ca, Mg, and P content in epicardial fat. Patients with increased transvalvular systolic pressure gradient revealed higher valvular Na content. Future longitudinal research should address mineralization across earlier disease stages, exploring additional trace elements and molecular contributors to advance understanding of calcification mechanisms, ultimately aiding in developing biomarkers or therapeutic strategies for postponing or preventing AS onset.
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Affiliation(s)
- Barbara Poniedziałek
- Department of Environmental Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Bartłomiej Perek
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Proch
- Department of Analytical Chemistry, Adam Mickiewicz University, Poznań, Poland
| | - Anna Komosa
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Piotr Buczkowski
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Jemielity
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, Poznan, Poland.
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Lee JE, Kim BG, Won JC. Molecular Pathways in Diabetic Cardiomyopathy and the Role of Anti-hyperglycemic Drugs Beyond Their Glucose Lowering Effect. J Lipid Atheroscler 2025; 14:54-76. [PMID: 39911956 PMCID: PMC11791414 DOI: 10.12997/jla.2025.14.1.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 09/02/2024] [Accepted: 09/27/2024] [Indexed: 02/07/2025] Open
Abstract
Epidemiological evidence has shown that diabetes is associated with overt heart failure (HF) and worse clinical outcomes. However, the presence of a distinct primary diabetic cardiomyopathy (DCM) has not been easy to prove because the association between diabetes and HF is confounded by hypertension, obesity, microvascular dysfunction, and autonomic neuropathy. In addition, the molecular mechanisms underlying DCM are not yet fully understood, DCM usually remains asymptomatic in the early stage, and no specific biomarkers have been identified. Nonetheless, several mechanistic associations at the systemic, cardiac, and cellular/molecular levels explain different aspects of myocardial dysfunction, including impaired cardiac relaxation, compliance, and contractility. In this review, we focus on recent clinical and preclinical advances in our understanding of the molecular mechanisms of DCM and the role of anti-hyperglycemic agents in preventing DCM beyond their glucose lowering effect.
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Affiliation(s)
- Jie-Eun Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Byung Gyu Kim
- Division of Cardiology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jong Chul Won
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Wang J, Li C, Li W, Tao Y, Li Y. Epicardial adipose tissue thickness associated with preeclampsia and birth weight in early pregnancy. Hypertens Pregnancy 2024; 43:2390531. [PMID: 39129211 DOI: 10.1080/10641955.2024.2390531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 08/04/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVE Preeclampsia (PE) increases the risk of many adverse maternal and fetal outcomes. This study was to investigate the correlation between epicardial adipose tissue (EAT) thickness and PE and birth weight. METHODS This was a single-center retrospective study, 221 patients with PE were selected, and 81 women without hypertension and proteinuria were selected as a comparison. Echocardiogram was performed in their first prenatal examinations at 11-13 gestational weeks, and the thickness of EAT was measured. At the subsequent follow-up, the birth weight was recorded. RESULTS EAT thickness was significantly elevated (6.60 ± 1.34 vs. 5.71 ± 1.79 mm, p < 0.001) in severe PE compared to mild PE. In the multivariate analysis, EAT thickness (OR 5.671, 95% CI, 1.991-16.150, p = 0.001), and C reactive protein (OR 4.097, 95% CI, 2.323-7.224, p < 0.001) were found as significant independent predictors of severe PE after adjusting for other risk factors. Linear regression analysis showed that hs-CRP, EAT thickness, and severe PE significantly negatively affected birth weight. CONCLUSION EAT thickness can be used to identify pregnant women with severe PE risks and low birth weight. It is an independent risk factor for severe PE but is not a valuable sign of mild PE.
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Affiliation(s)
- Jing Wang
- Department of obstetrics and gynecology, The First People's Hospital of Yuhang District, Hangzhou, Zhejiang, China
| | - Chunfeng Li
- Department of obstetrics and gynecology, The First People's Hospital of Yuhang District, Hangzhou, Zhejiang, China
| | - Wen Li
- Department of Cardiology, The First People's Hospital of Yuhang District, Hangzhou, Zhejiang, China
| | - Yexiao Tao
- Department of Cardiology, The First People's Hospital of Yuhang District, Hangzhou, Zhejiang, China
| | - Yong Li
- Department of Cardiology, The First People's Hospital of Yuhang District, Hangzhou, Zhejiang, China
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Zou R, Zhang M, Lv W, Ren J, Fan X. Role of epicardial adipose tissue in cardiac remodeling. Diabetes Res Clin Pract 2024; 217:111878. [PMID: 39366641 DOI: 10.1016/j.diabres.2024.111878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 09/14/2024] [Accepted: 09/30/2024] [Indexed: 10/06/2024]
Abstract
Epicardial adipose tissue, or epicardial fat, is a type of visceral fat located between the heart and the pericardium. Due to its anatomical proximity to the heart, EAT plays a significant role in both cardiac physiology and pathologies, including cardiac remodeling and cardiovascular diseases (CVD). However, our understanding of how EAT pathology is influenced by risk factors such as obesity and type 2 diabetes mellitus and how altered EAT can drive cardiac remodeling and CVD, remains limited. Herein, we aimed to summarize and discuss the latest findings on EAT and its role in cardiac remodeling, highlighting the outcomes of clinical and observational studies, provide mechanistic insights, and finally introduce emerging therapeutic agents and nutritional guidelines aimed at preventing these conditions.
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Affiliation(s)
- Rongjun Zou
- Department of Cardiovascular Surgery, Guangdong Provincial Hospital of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Key Laboratory of TCM Emergency Research, Guangzhou 510120, Guangdong, China; State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China
| | - Miao Zhang
- Department of Cardiovascular Surgery, Guangdong Provincial Hospital of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Key Laboratory of TCM Emergency Research, Guangzhou 510120, Guangdong, China
| | - Weihui Lv
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China.
| | - Jun Ren
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai 200032, China; National Clinical Research Center for Interventional Medicine, Shanghai 200032, China.
| | - Xiaoping Fan
- Department of Cardiovascular Surgery, Guangdong Provincial Hospital of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China; Guangdong Provincial Key Laboratory of TCM Emergency Research, Guangzhou 510120, Guangdong, China.
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Dal Y, Akkuş F, Karagün Ş, Nessar AZ, Karaca SG, Kıllı MÇ, Coşkun A. Fetal epicardial fat thickness and modified myocardial performance index in late-onset fetal growth restriction. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:1321-1328. [PMID: 39189700 DOI: 10.1002/jcu.23804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 06/14/2024] [Accepted: 08/07/2024] [Indexed: 08/28/2024]
Abstract
AIM In our study, we aimed to investigate the value of fetal epicardial fat thickness (EFT) and modified myocardial performance index (mod-MPI) in fetal growth restriction (FGR) that develops after the 32nd week of gestation. MATERIALS AND METHODS Fifty-six pregnant women who met the inclusion and exclusion criteria were included in the study and were divided into two groups: pregnancies diagnosed with FGR after the 32nd week of gestation (FGR group) and those without (control group). Demographic and obstetric histories, ultrasonographic and clinical characteristics, fetal EFT and mod-MPI values, and neonatal outcomes of the groups were recorded, and comparisons were made between the groups. Additionally, the diagnostic performance of fetal EFT value in late FGR was investigated. RESULTS The FGR group had fetal EFT that was statistically significantly lower (1.11 ± 0.21 vs. 1.34 ± 0.23, p = 0.001). The FGR group had a significantly lower isovolumetric contraction time (ICT) (31.04 ± 6.88 vs. 35.14 ± 7.58, p = 0.048). The two groups' isovolumetric relaxation time (IRT), ejection time (ET), and mod-MPI values (p values 0.871, 0.55, and 0.750, respectively) were comparable. Receiver operating characteristic (ROC) analysis at a cutoff of 1.2 revealed 76.1% sensitivity and 74.2% specificity, respectively, for the diagnostic performance of the fetal EFT value in late-onset FGR. There was a positive predictive value (PPV) and negative predictive value (NPV) of 64.0% and 83.8%, respectively. CONCLUSION We found that fetal EFT was significantly lower in FGR and may be useful in diagnosing FGR. However, we observed that mode-MPI did not change in FGR.
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Affiliation(s)
- Yusuf Dal
- Division of Perinatology, Department of Obstetrics and Gynecology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Fatih Akkuş
- Division of Perinatology, Department of Obstetrics and Gynecology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Şebnem Karagün
- Division of Perinatology, Department of Obstetrics and Gynecology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Ahmet Zeki Nessar
- Division of Perinatology, Department of Obstetrics and Gynecology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Sefanur Gamze Karaca
- Division of Perinatology, Department of Obstetrics and Gynecology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Mürşide Çevikoğlu Kıllı
- Division of Gynecological Oncology, Department of Obstetrics and Gynecology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Ayhan Coşkun
- Division of Perinatology, Department of Obstetrics and Gynecology, Mersin University Faculty of Medicine, Mersin, Turkey
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Doğru Ş, Akkuş F, Metin ÜS, Acar A. Fetal Epicardial Fat Thickness in Obese Pregnant Women: Its Effect on Fetal Cardiac Function and Neonatal Outcomes. Z Geburtshilfe Neonatol 2024; 228:439-445. [PMID: 38503305 DOI: 10.1055/a-2267-5478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVE This study aimed to evaluate fetal epicardial fat thickness (EFT) together with fetal myocardial performance index (MPI) and its effects on neonatal outcomes in obese pregnant women. MATERIALS AND METHODS A total of 102 pregnant women, 51 obese and 51 of normal weight, were included in this prospective study. Fetal EFT, and MPI measurements were performed for all patients. RESULTS Fetal EFT and Mod-MPI showed a statistically significant difference between obese pregnant women and the control group (p=0.0001, p=0.001). The optimal fetal EFT predictive cut-off value for the 5th-minute APGAR score below 7 was 1.22 mm, with a sensitivity of 86.96% and a specificity of 54.43% (p=0.001). CONCLUSION Fetal EFT and mod-MPI were higher in obese pregnant women. It is encouraging that fetal EFT predicts low APGAR, but more important information can be obtained if postnatal follow-up of these cardiac changes caused by obesity can be performed.
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Affiliation(s)
- Şükran Doğru
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Meram, Turkey
| | - Fatih Akkuş
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Meram, Turkey
| | - Ülfet Sena Metin
- Obstetrics and Gynecology, Necmettin Erbakan Universitesi Meram Tip Fakultesi, Konya, Turkey
| | - Ali Acar
- Obstetrics and Gynecology, Necmettin Erbakan Universitesi Meram Tip Fakultesi, Konya, Turkey
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Sidhu GS, Rabkin SW. Epicardial Fat in Heart Failure with Preserved Ejection Fraction Compared with Reduced Ejection Fraction. J Clin Med 2024; 13:5533. [PMID: 39337020 PMCID: PMC11432675 DOI: 10.3390/jcm13185533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 09/08/2024] [Accepted: 09/11/2024] [Indexed: 09/30/2024] Open
Abstract
Background: The role of epicardial adipose tissue (EAT) in heart failure with preserved ejection fraction (HFpEF) remains to be defined. Methods: A consecutive series of outpatients with chronic heart failure-heart failure with reduced ejection fraction (HFrEF) and HFpEF and/or diastolic dysfunction-had EAT assessed by echocardiographic measurement and related to indices of cardiac structure and function. Results: Epicardial fat thickness was significantly (p < 0.05) greater in HFpEF (N = 141) with a mean of 6.7 ± 1.6 mm compared with a mean of 5.1 ± 1.0 mm in HFrEF (n = 40). After adjusting for the relationship with BMI, in HFpEF, epicardial fat was significantly (p < 0.05) negatively correlated with left ventricular internal diameter end diastole (LVIDd), left ventricular internal diameter end systole (LVIDs), left ventricular (LV) end-diastolic volume (EDV) index, lateral e', septal e', right atrial (RA) volume index, and hemoglobin (Hgb). The association with Hgb was no longer significant after adjusting for the effect of age. HFpEF was associated with smaller LVIDd, LVIDs, LV EDV indexes, and left atrial (LA) and RA volume indexes. Conclusions: Epicardial fat is significantly (p < 0.05) greater in HFpEF than HFrEF. Epicardial fat is associated with smaller cardiac chamber sizes in HFpEF suggesting that epicardial fat acts as a constraint to cardiac dilation.
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Affiliation(s)
- Gurwinder S Sidhu
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Simon W Rabkin
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Department of Medicine, Division of Cardiology, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
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Venkataraman S, Katchi F. A Sweet and Heavy Affair: Glucose, Epicardial Fat, and Heart Trouble. Acad Radiol 2024; 31:3557-3559. [PMID: 39142975 DOI: 10.1016/j.acra.2024.07.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 08/16/2024]
Affiliation(s)
| | - Farhan Katchi
- Washington University School of Medicine, St. Louis, Missouri, USA.
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Gustafsson B, Rovio SP, Ruohonen S, Hutri-Kähönen N, Kähönen M, Viikari JSA, Pahkala K, Raitakari OT. Determinants of echocardiographic epicardial adipose tissue in a general middle-aged population - The Cardiovascular Risk in Young Finns Study. Sci Rep 2024; 14:11982. [PMID: 38796541 PMCID: PMC11127977 DOI: 10.1038/s41598-024-61727-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/08/2024] [Indexed: 05/28/2024] Open
Abstract
Epicardial adipose tissue (EAT) is the cardiac visceral fat depot proposed to play a role in the etiology of various cardiovascular disease outcomes. Little is known about EAT determinants in a general population. We examined cardiometabolic, dietary, lifestyle and socioeconomic determinants of echocardiograpghically measured EAT in early adulthood. Data on cardiometabolic, dietary, lifestyle and socioeconomic factors were collected from participants of the Cardiovascular Risk in Young Finns Study (YFS; N = 1667; age 34-49 years). EAT thickness was measured from parasternal long axis echocardiograms. Multivariable regression analysis was used to study potential EAT determinants. Possible effect modification of sex was addressed. Mean EAT thickness was 4.07 mm (95% CI 4.00-4.17). Multivariable analysis [β indicating percentage of change in EAT(mm) per one unit increase in determinant variable] indicated female sex (β = 11.0, P < 0.0001), type 2 diabetes (β = 14.0, P = 0.02), waist circumference (cm) (β = 0.38, P < 0.0001), systolic blood pressure (mmHg) (β = 0.18, P = 0.02) and red meat intake (g/day) (β = 0.02, P = 0.05) as EAT determinants. Sex-specific analysis revealed age (year) (β = 0.59, P = 0.01), alcohol intake (drinks/day) (β = 4.69, P = 0.006), heavy drinking (yes/no) (β = 30.4, P < 0.0001) as EAT determinants in women and fruit intake (g/day) (β = -1.0, P = 0.04) in men. In the YFS cohort, waist circumference, systolic blood pressure and red meat intake were directly associated with EAT among all participants. In women, age, alcohol intake, heavy drinking and type 2 diabetes associated directly with EAT, while an inverse association was observed between fruit intake and EAT in men.
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Affiliation(s)
- Behnoush Gustafsson
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
- Center for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
| | - Suvi P Rovio
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Center for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
| | - Saku Ruohonen
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Orion Pharma, Turku, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Katja Pahkala
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Center for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Paavo Nurmi Centre, Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Olli T Raitakari
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Center for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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Krauz K, Kempiński M, Jańczak P, Momot K, Zarębiński M, Poprawa I, Wojciechowska M. The Role of Epicardial Adipose Tissue in Acute Coronary Syndromes, Post-Infarct Remodeling and Cardiac Regeneration. Int J Mol Sci 2024; 25:3583. [PMID: 38612394 PMCID: PMC11011833 DOI: 10.3390/ijms25073583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Epicardial adipose tissue (EAT) is a fat deposit surrounding the heart and located under the visceral layer of the pericardium. Due to its unique features, the contribution of EAT to the pathogenesis of cardiovascular and metabolic disorders is extensively studied. Especially, EAT can be associated with the onset and development of coronary artery disease, myocardial infarction and post-infarct heart failure which all are significant problems for public health. In this article, we focus on the mechanisms of how EAT impacts acute coronary syndromes. Particular emphasis was placed on the role of inflammation and adipokines secreted by EAT. Moreover, we present how EAT affects the remodeling of the heart following myocardial infarction. We further review the role of EAT as a source of stem cells for cardiac regeneration. In addition, we describe the imaging assessment of EAT, its prognostic value, and its correlation with the clinical characteristics of patients.
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Affiliation(s)
- Kamil Krauz
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Marcel Kempiński
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Paweł Jańczak
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Karol Momot
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Maciej Zarębiński
- Department of Invasive Cardiology, Independent Public Specialist Western Hospital John Paul II, Lazarski University, Daleka 11, 05-825 Grodzisk Mazowiecki, Poland; (M.Z.); (I.P.)
| | - Izabela Poprawa
- Department of Invasive Cardiology, Independent Public Specialist Western Hospital John Paul II, Lazarski University, Daleka 11, 05-825 Grodzisk Mazowiecki, Poland; (M.Z.); (I.P.)
| | - Małgorzata Wojciechowska
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
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Al-Mosawi AA, Nafakhi H, Alabayechi YS. Pericardial fat volume and coronary risk factors as predictors of non-calcified coronary plaque presence among patients with coronary calcium score = 0. Indian Heart J 2024; 76:51-53. [PMID: 38128878 PMCID: PMC10943564 DOI: 10.1016/j.ihj.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/05/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION There is scarce data linking pericardial fat volume (PFV) and classical coronary risk factors with non-calcified plaque presence among patients with CAC = 0 in the literature. MATERIAL AND METHOD A total of 811 patients with chest pain suggestive of angina underwent CT coronary angiography for the assessment of coronary artery disease were collected. Of these, 417 with CAC = 0 were included in the analysis. RESULT Patients with non-calcified plaque were older (54 ± 9 versus 50 ± 10, P = 0.01) and had a higher prevalence of diabetes mellitus (31% versus 17%, P = 0.02), high BMI (29.9 versus 28.3, P = 0.04), and increased PFV (123 cm3 versus 99 cm3, P < 0.01) compared to patients without plaque. In multivariate regression analysis, high BMI[OR(CI) = 1.1(1-1.3), P = 0.02] was an independent predictor of non-calcified coronary plaque presence among patients with CAC = 0 after adjustment to variables with P < 0.05 in the univariate analysis. CONCLUSION In patients with a CAC score of 0, advanced age, diabetes mellitus, increased PFV, and high BMI were all associated with the presence of non-calcified plaque. After multivariate adjustment, increased BMI remained a significant independent predictor for non-calcified plaque presence.
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Affiliation(s)
| | - Hussein Nafakhi
- Internal Medicine Department, Medicine College, University of Kufa, P.O. 21, Kufa, Najaf, Iraq.
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Romano AD, La Marca A, Villani R, Sangineto M, Manuppelli V, Brunetti ND, Vendemiale G, Serviddio G. Exploring the Relationship between Epicardial Fat Thickness and Coronary Revascularization: Implications for Cardiovascular Health. J Clin Med 2023; 13:247. [PMID: 38202255 PMCID: PMC10779954 DOI: 10.3390/jcm13010247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/21/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND this study aimed to assess the complex relationship between EAT thickness, as measured with echocardiography, and the severity of coronary artery disease (CAD). We investigated whether individuals with higher EAT thickness underwent coronary revascularization. Subsequently, we conducted a three-year follow-up to explore any potential modifications in EAT depots post-angioplasty. METHODS we conducted a prospective and retrospective cross-sectional observational study involving 150 patients consecutively referred for acute coronary syndrome, including ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and unstable angina. Upon admission (T0), all patients underwent coronary angiography to assess the number of pathologic coronary vessels. Percutaneous transluminal coronary angioplasty (PTCA) was performed based on angiogram results if indicated. The sample was categorized into two groups: non-revascularized (no-PTCA) and revascularized (PTCA). Transthoracic echocardiograms to measure epicardial fat thickness were conducted at admission (T0) and after a 3-year follow-up (T1). RESULTS AND CONCLUSIONS findings revealed a positive correlation between EAT thickness and the severity of coronary artery disease (CAD), with patients undergoing PTCA showing decreased EAT thickness after three years. Echocardiography demonstrated reliability in assessing EAT, offering potential for risk stratification. The study introduces a cut-off value of 0.65 cm as a diagnostic tool for cardiovascular risk. Incorporating EAT measurements into clinical practice may lead to more precise risk stratification and tailored treatment strategies, ultimately reducing the burden of cardiovascular disease.
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Affiliation(s)
- Antonino Davide Romano
- Internal Medicine and Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti 71122 Foggia, Italy; (A.L.M.); (R.V.); (M.S.); (G.S.)
| | - Antonella La Marca
- Internal Medicine and Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti 71122 Foggia, Italy; (A.L.M.); (R.V.); (M.S.); (G.S.)
| | - Rosanna Villani
- Internal Medicine and Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti 71122 Foggia, Italy; (A.L.M.); (R.V.); (M.S.); (G.S.)
| | - Moris Sangineto
- Internal Medicine and Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti 71122 Foggia, Italy; (A.L.M.); (R.V.); (M.S.); (G.S.)
| | - Vincenzo Manuppelli
- Cardiology Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti, 71122 Foggia, Italy
| | - Natale Daniele Brunetti
- Cardiology Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti, 71122 Foggia, Italy
| | - Gianluigi Vendemiale
- Internal Medicine and Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti 71122 Foggia, Italy; (A.L.M.); (R.V.); (M.S.); (G.S.)
| | - Gaetano Serviddio
- Internal Medicine and Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti 71122 Foggia, Italy; (A.L.M.); (R.V.); (M.S.); (G.S.)
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15
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Rossi VA, Nebunu D, Haider T, Laptseva N, Naegele MP, Ruschitzka F, Sudano I, Flammer AJ. Diverging role of epicardial adipose tissue across the entire heart failure spectrum. ESC Heart Fail 2023; 10:3419-3429. [PMID: 37697706 PMCID: PMC10682858 DOI: 10.1002/ehf2.14483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/06/2023] [Indexed: 09/13/2023] Open
Abstract
AIMS Epicardial adipose tissue (EAT) is a metabolically highly active tissue modulating numerous pathophysiological processes. The aim of this study was to investigate the association between EAT thickness and endothelial function in patients with heart failure (HF) across the entire ejection fraction spectrum. METHODS AND RESULTS A total of 258 patients with HF with an ejection fraction across the entire spectrum [HF with reduced ejection fraction (HFrEF), n = 168, age 60.6 ± 11.2 years; HF with preserved ejection fraction (HFpEF), n = 50, mean age 65.1 ± 11.9 years; HF with mildly reduced ejection fraction (HFmrEF), n = 32, mean age 65 ± 12] were included. EAT was measured with transthoracic echocardiography. Vascular function was assessed with flicker-light-induced vasodilation of retinal arterioles (FIDart%) and flow-mediated dilatation (FMD%) in conduit arteries. Patients with HFrEF have less EAT compared with patients with HFpEF (4.2 ± 2 vs. 5.3 ± 2 mm, respectively, P < 0.001). Interestingly, EAT was significantly associated with impaired microvascular function (FIDart%; r = -0.213, P = 0.012) and FMD% (r = -0.186, P = 0.022), even after multivariate correction for confounding factors (age, body mass index, hypertension, and diabetes; standardized regression coefficient (SRC) = -0.184, P = 0.049 for FIDart% and SRC = -0.178, P = 0.043 for FMD%) in HFrEF but not in HFpEF. CONCLUSIONS Although less EAT is present in HFrEF than in HFpEF, only in HFrEF EAT is associated with vascular dysfunction. The diverging role of EAT in HF and its switch to a functionally deleterious tissue promoting HF progression provide the rationale to specifically target EAT, in particular in patients with reduced ejection fraction.
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Affiliation(s)
- Valentina A. Rossi
- Department of CardiologyUniversity Heart Centre, University Hospital of ZurichRaemistrasse 100Zurich8091Switzerland
- Centre for Translational and Experimental CardiologySchlierenSwitzerland
| | - Delia Nebunu
- Department of CardiologyUniversity Heart Centre, University Hospital of ZurichRaemistrasse 100Zurich8091Switzerland
| | - Thomas Haider
- Department of CardiologyUniversity Heart Centre, University Hospital of ZurichRaemistrasse 100Zurich8091Switzerland
| | - Natallia Laptseva
- Department of CardiologyUniversity Heart Centre, University Hospital of ZurichRaemistrasse 100Zurich8091Switzerland
- Centre for Translational and Experimental CardiologySchlierenSwitzerland
| | - Matthias P. Naegele
- Department of CardiologyUniversity Heart Centre, University Hospital of ZurichRaemistrasse 100Zurich8091Switzerland
| | - Frank Ruschitzka
- Department of CardiologyUniversity Heart Centre, University Hospital of ZurichRaemistrasse 100Zurich8091Switzerland
- Centre for Translational and Experimental CardiologySchlierenSwitzerland
- University of ZurichZurichSwitzerland
| | - Isabella Sudano
- Department of CardiologyUniversity Heart Centre, University Hospital of ZurichRaemistrasse 100Zurich8091Switzerland
- Centre for Translational and Experimental CardiologySchlierenSwitzerland
| | - Andreas J. Flammer
- Department of CardiologyUniversity Heart Centre, University Hospital of ZurichRaemistrasse 100Zurich8091Switzerland
- Centre for Translational and Experimental CardiologySchlierenSwitzerland
- University of ZurichZurichSwitzerland
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16
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Sakcak B, Farisoğulları N, Denizli R, Menekse Beser D, Tanacan A, Goncu Ayhan S, Öcal FD, Sahin D. Evaluation of the fetal myocardial performance ındex and Epicardial fat thickness in pregnant women with preterm prelabor rupture of membranes. J Matern Fetal Neonatal Med 2023; 36:2192322. [PMID: 36944418 DOI: 10.1080/14767058.2023.2192322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To assess the epicardial fat thickness (EFT) and modified myocardial performance index (Mod-MPI) measurements in fetuses at pregnant women with preterm prelabor rupture of membranes (pPROM) and compare them to healthy pregnant women's fetuses. METHODS Forty patients who presented to our clinic at 24-36 + 6 gestational weeks and were diagnosed with pPROM were included in the patient group. During the same period, 40 healthy pregnant women at similar gestational weeks were randomly selected as the control group. RESULTS The pPROM and control groups were similar in terms of demographics. In the pPROM group, EFT, Mod-MPI, and isovolumetric contraction(ICT) and relaxation times(IRT) were significantly higher and ejection time (ET) was significantly lower compared to the control group. In addition, Mod-MPI z-scores, IRT z-scores, ICT z-scores were significantly higher and ET z-scores was significantly lower in the pPROM. According to the ROC analysis, the optimal cutoff value of EFT was calculated as 1.55 mm, with 68% sensitivity and 71% specificity (AUC: 0.718, 95% CI: 0.550-0.786, p = .018) for predicting NICU requirement and the optimal cutoff value of EFT was calculated as 1.55 mm with 72% sensitivity and 73% specificity (AUC: 0.726, 95% CI: 0.556-0.896, p = .015) for predicting medication use in the pPROM group. CONCLUSION This study revealed differences in the EFT and Mod-MPI measurements of the fetuses of pregnant women with pPROM. Considering that EFT is an important energy source for the myocardium, as well as an endocrine structure in which inflammatory and anti-inflammatory markers are secreted, it is recommended to be evaluated in inflammatory conditions such as pPROM.
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Affiliation(s)
- Bedri Sakcak
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Nihat Farisoğulları
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ramazan Denizli
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Menekse Beser
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Sule Goncu Ayhan
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Fatma Doğa Öcal
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Division of Perinatology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
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17
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Sever B, Bayraktar B, Adıyaman D, Gölbaşı H, Ömeroğlu İ, Çolak S, Pala HG, Ekin A. Association of increased fetal epicardial fat thickness with maternal pregestational and gestational diabetes. J Matern Fetal Neonatal Med 2023; 36:2183474. [PMID: 36859818 DOI: 10.1080/14767058.2023.2183474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
OBJECTIVE To evaluate the changes of fetal epicardial fat thickness (EFT) in pregnancies with pregestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM) and to identify the diagnostic effectiveness of fetal EFT in differentiating PGDM and GDM from normal pregnancies. METHODS The study was conducted with pregnant women who admitted to perinatology department between October 2020 and August 2021. Patients were grouped as PGDM (n = 110), GDM (n = 110), and control (n = 110) for comparison of fetal EFT. EFT was measured in all three groups at 29 weeks of gestation. Demographic characteristics and ultrasonographic findings were recorded and compared. RESULTS The mean fetal EFT was significantly higher in PGDM (1.47 ± 0.083 mm, p < .001) and GDM (1.40 ± 0.082 mm, p < .001) groups compared to control group (1.19 ± 0.049 mm) and was also significantly higher in PGDM group than GDM group (p < .001). Fetal EFT was significantly positively correlated with maternal age, fasting, 1st hour, 2nd hour glucose values, HbA1c, fetal abdominal circumference, and deepest vertical pocket of amniotic fluid (p < .001). Fetal EFT value of 1.3 mm diagnosed PGDM patients with a sensitivity of 97.3% and a specificity of 98.2%. Fetal EFT value of 1.27 mm diagnosed GDM patients with a sensitivity of 94% and a specificity of 95%. CONCLUSIONS Fetal EFT is greater in pregnancies with diabetes than in normal pregnancies, and also greater in PGDM than in GDM. In addition, fetal EFT is strongly correlated with maternal blood glucose levels in diabetic pregnancies.
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Affiliation(s)
- Barış Sever
- Department of Obstetrics and Gynecology Division of Perinatology, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Burak Bayraktar
- Department of Obstetrics and Gynecology Division of Perinatology, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Duygu Adıyaman
- Department of Obstetrics and Gynecology Division of Perinatology, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | | | | | | | | | - Atalay Ekin
- Department of Obstetrics and Gynecology Division of Perinatology, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
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18
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Masson W, Barbagelata L, Lobo M, Berg G, Lavalle-Cobo A, Nogueira JP. Association between maternal epicardial adipose tissue, gestational diabetes mellitus, and pregnancy-related hypertensive disorders: a systematic review and meta-analysis. Arch Gynecol Obstet 2023; 308:1057-1066. [PMID: 36695898 DOI: 10.1007/s00404-023-06933-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/12/2023] [Indexed: 01/26/2023]
Abstract
Several small studies have evaluated the association between epicardial adipose tissue (EAT) and pregnancy-related cardiovascular risk factors such as gestational diabetes mellitus (GDM) or hypertensive disorders. The objective of this study was to quantitatively compare EAT thickening between patients with GDM or pregnancy-related hypertensive disorders and healthy controls. This systematic review and meta-analysis were performed according to PRISMA guidelines. A literature search was performed to detect studies that have quantified EAT in women with GDM and pregnancy-related hypertensive disorders compared to a control group. The primary outcome was EAT thickening estimated by ultrasound expressed in millimeters. Random or fixed effects models were used. Nine observational studies including 3146 patients were identified and considered eligible for this systematic review. The quantitative analysis showed that patients with GDM have a higher EAT thickness (mean difference: 1.1 mm [95% confidence interval: 1.0-1.2]; I2 = 24%) compared to the control group. Moreover, patients with pregnancy-related hypertensive disorders showed higher EAT thickness (mean difference: 1.0 mm [95% confidence interval: 0.6-1.4]; I2 = 83%) compared to the control group. In conclusion, this study demonstrated that EAT thickening is increased in patients with GDM and pregnancy-related hypertensive disorders compared with healthy controls. Whether or not this association is causal should be evaluated in prospective studies.
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Affiliation(s)
- Walter Masson
- Cardiology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - Leandro Barbagelata
- Cardiology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Martín Lobo
- Cardiology Department, Hospital Militar Campo de Mayo, Buenos Aires, Argentina
| | - Gabriela Berg
- Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Cátedra de Bioquímica Clínica I, Laboratorio de Lípidos y Aterosclerosis, Universidad de Buenos Aires, Buenos Aires, Argentina
- CONICET, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | - Juan P Nogueira
- Centro de Investigación en Endocrinología, Nutrición y Metabolismo (CIENM), Facultad de Ciencias de la Salud, Universidad Nacional de Formosa, Formosa, Argentina
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19
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Daou D, Gillette TG, Hill JA. Inflammatory Mechanisms in Heart Failure with Preserved Ejection Fraction. Physiology (Bethesda) 2023; 38:0. [PMID: 37013947 PMCID: PMC10396273 DOI: 10.1152/physiol.00004.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/27/2023] [Accepted: 04/02/2023] [Indexed: 04/05/2023] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is now the most common form of heart failure and a significant public health concern for which limited effective therapies exist. Inflammation triggered by comorbidity burden is a critical element of HFpEF pathophysiology. Here, we discuss evidence for comorbidity-driven systemic and myocardial inflammation and the mechanistic role of inflammation in pathological myocardial remodeling in HFpEF.
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Affiliation(s)
- Daniel Daou
- Department of Internal Medicine (Cardiology), University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Thomas G Gillette
- Department of Internal Medicine (Cardiology), University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Joseph A Hill
- Department of Internal Medicine (Cardiology), University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
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20
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Mukherjee AG, Renu K, Gopalakrishnan AV, Jayaraj R, Dey A, Vellingiri B, Ganesan R. Epicardial adipose tissue and cardiac lipotoxicity: A review. Life Sci 2023; 328:121913. [PMID: 37414140 DOI: 10.1016/j.lfs.2023.121913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/21/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023]
Abstract
Epicardial adipose tissue (EAT) has morphological and physiological contiguity with the myocardium and coronary arteries, making it a visceral fat deposit with some unique properties. Under normal circumstances, EAT exhibits biochemical, mechanical, and thermogenic cardioprotective characteristics. Under clinical processes, epicardial fat can directly impact the heart and coronary arteries by secreting proinflammatory cytokines via vasocrine or paracrine mechanisms. It is still not apparent what factors affect this equilibrium. Returning epicardial fat to its physiological purpose may be possible by enhanced local vascularization, weight loss, and focused pharmacological therapies. This review centers on EAT's developing physiological and pathophysiological dimensions and its various and pioneering clinical utilities.
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Affiliation(s)
- Anirban Goutam Mukherjee
- Department of Biomedical Sciences, School of Bio-Sciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, India
| | - Kaviyarasi Renu
- Centre of Molecular Medicine and Diagnostics (COMManD), Department of Biochemistry, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India
| | - Abilash Valsala Gopalakrishnan
- Department of Biomedical Sciences, School of Bio-Sciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, India.
| | - Rama Jayaraj
- Jindal Institute of Behavioral Sciences (JIBS), Jindal Global Institution of Eminence Deemed to Be University, 28, Sonipat 131001, India; Director of Clinical Sciences, Northern Territory Institute of Research and Training, Darwin, NT 0909, Australia
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata, West Bengal 700073, India
| | - Balachandar Vellingiri
- Stem cell and Regenerative Medicine/Translational Research, Department of Zoology, School of Basic Sciences, Central University of Punjab (CUPB), Bathinda 151401, Punjab, India
| | - Raja Ganesan
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon 24252, Republic of Korea
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Jehn S, Roggel A, Dykun I, Balcer B, Al-Rashid F, Totzeck M, Risse J, Kill C, Rassaf T, Mahabadi AA. Epicardial adipose tissue and obstructive coronary artery disease in acute chest pain: the EPIC-ACS study. EUROPEAN HEART JOURNAL OPEN 2023; 3:oead041. [PMID: 37143611 PMCID: PMC10152391 DOI: 10.1093/ehjopen/oead041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/01/2023] [Accepted: 04/14/2023] [Indexed: 05/06/2023]
Abstract
Aims We tested the hypothesis that epicardial adipose tissue (EAT) quantification improves the prediction of the presence of obstructive coronary artery disease (CAD) in patients presenting with acute chest pain to the emergency department. Methods and results Within this prospective observational cohort study, we included 657 consecutive patients (mean age 58.06 ± 18.04 years, 53% male) presenting to the emergency department with acute chest pain suggestive of acute coronary syndrome between December 2018 and August 2020. Patients with ST-elevation myocardial infarction, haemodynamic instability, or known CAD were excluded. As part of the initial workup, we performed bedside echocardiography for quantification of EAT thickness by a dedicated study physician, blinded to all patient characteristics. Treating physicians remained unaware of the results of the EAT assessment. The primary endpoint was defined as the presence of obstructive CAD, as detected in subsequent invasive coronary angiography. Patients reaching the primary endpoint had significantly more EAT than patients without obstructive CAD (7.90 ± 2.56 mm vs. 3.96 ± 1.91 mm, P < 0.0001). In a multivariable regression analysis, a 1 mm increase in EAT thickness was associated with a nearby two-fold increased odds of the presence of obstructive CAD [1.87 (1.64-2.12), P < 0.0001]. Adding EAT to a multivariable model of the GRACE score, cardiac biomarkers and traditional risk factors significantly improved the area under the receiver operating characteristic curve (0.759-0.901, P < 0.0001). Conclusion Epicardial adipose tissue strongly and independently predicts the presence of obstructive CAD in patients presenting with acute chest pain to the emergency department. Our results suggest that the assessment of EAT may improve diagnostic algorithms of patients with acute chest pain.
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Affiliation(s)
- Stefanie Jehn
- The West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Anja Roggel
- The West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Iryna Dykun
- The West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Bastian Balcer
- The West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Fadi Al-Rashid
- The West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Matthias Totzeck
- The West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Joachim Risse
- Center of Emergency Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Clemens Kill
- Center of Emergency Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Tienush Rassaf
- The West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Amir A Mahabadi
- Corresponding author. Tel: +49 (0)201/723 84822, Fax: +49 (0)201/723 5401,
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Rossi VA, Gruebler M, Monzo L, Galluzzo A, Beltrami M. The Different Pathways of Epicardial Adipose Tissue across the Heart Failure Phenotypes: From Pathophysiology to Therapeutic Target. Int J Mol Sci 2023; 24:6838. [PMID: 37047810 PMCID: PMC10095298 DOI: 10.3390/ijms24076838] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/28/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
Epicardial adipose tissue (EAT) is an endocrine and paracrine organ constituted by a layer of adipose tissue directly located between the myocardium and visceral pericardium. Under physiological conditions, EAT exerts protective effects of brown-like fat characteristics, metabolizing excess fatty acids, and secreting anti-inflammatory and anti-fibrotic cytokines. In certain pathological conditions, EAT acquires a proatherogenic transcriptional profile resulting in increased synthesis of biologically active adipocytokines with proinflammatory properties, promoting oxidative stress, and finally causing endothelial damage. The role of EAT in heart failure (HF) has been mainly limited to HF with preserved ejection fraction (HFpEF) and related to the HFpEF obese phenotype. In HFpEF, EAT seems to acquire a proinflammatory profile and higher EAT values have been related to worse outcomes. Less data are available about the role of EAT in HF with reduced ejection fraction (HFrEF). Conversely, in HFrEF, EAT seems to play a nutritive role and lower values may correspond to the expression of a catabolic, adverse phenotype. As of now, there is evidence that the beneficial systemic cardiovascular effects of sodium-glucose cotransporter-2 receptors-inhibitors (SGLT2-i) might be partially mediated by inducing favorable modifications on EAT. As such, EAT may represent a promising target organ for the development of new drugs to improve cardiovascular prognosis. Thus, an approach based on detailed phenotyping of cardiac structural alterations and distinctive biomolecular pathways may change the current scenario, leading towards a precision medicine model with specific therapeutic targets considering different individual profiles. The aim of this review is to summarize the current knowledge about the biomolecular pathway of EAT in HF across the whole spectrum of ejection fraction, and to describe the potential of EAT as a therapeutic target in HF.
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Affiliation(s)
- Valentina A. Rossi
- University Heart Center, Department of Cardiology, University Hospital of Zurich, 8091 Zurich, Switzerland
| | - Martin Gruebler
- Regional Hospital Neustadt, 2700 Wiener Neustadt, Austria
- Faculty of Medicine, Medical University of Graz, 8036 Graz, Austria
- Faculty of Medicine, Sigmund Freud University Vienna, 1020 Vienna, Austria
| | - Luca Monzo
- Centre d’Investigations Cliniques Plurithématique 1433 and Inserm U1116, Université de Lorraine, CHRU Nancy, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), 54035 Nancy, France
| | | | - Matteo Beltrami
- Azienda USL Toscana Centro, Cardiology Unit, San Giovanni di Dio Hospital, 50143 Florence, Italy;
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Singh A, Josan AS, Gupta K, Pahwa S. Fetal Epicardial Fat Thickness: Its Role as Marker for Gestational Diabetic Mellitus. Indian J Radiol Imaging 2023. [DOI: 10.1055/s-0043-1762936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
Abstract
Background There are very few studies on the association between fetal epicardial fat thickness (EFT) and gestational diabetes mellitus (GDM).
Aims To evaluate the role of fetal epicardial fat thickness as a marker and use it in pregnancies to screen for GDM.
Settings and Design A cross-sectional analytical study was conducted in the Department of Radiodiagnosis and Imaging at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, after the due clearance from the institutional research and ethics committee.
Materials and Methods The study included pregnant patients at 24 + 0/6 to 28 + 0/6 weeks of gestation scheduled for a 75 g oral glucose tolerance test from December 1, 2020 to March 30, 2022. Antenatal ultrasound was performed on Voluson E8 Expert BT12 (Wipro GE) ultrasound machine. Out of 180 patients, 60 patients were selected, that is, 30 patients with raised 75 g OGTT results (cases of GDM) and 30 patients with normal 75 g OGTT results.
Statistical Analysis The collected data were transformed into variables, coded, and entered into Microsoft Excel. Data were analyzed using the Shapiro–Wilk normality test, student's t-test or Mann–Whiney U test, chi-square test, or Fisher's exact test and statistically evaluated using the SPSS-PC-25 version.
Results Fetal EFT was found to be significantly more in the GDM group in comparison to controls without GDM, and the increased fetal EFT was positively associated with 2-hour OGTT serum glucose values.The mean fetal epicardial fat thickness (EFT) in mothers with GDM was significantly larger, i.e., 0.17 ± 0.02 cm than in mothers without GDM, i.e., 0.12 ± 0.01 cm (p < 0.001). The receiver operating characteristic (ROC) curve plotted from values calculated from our results shows high sensitivity (i.e., 96.67%) and specificity (i.e., 90%) of fetal EFT as a predictor for GDM with an AUROC value of 0.96 and 95% confidence interval of 0.92 to 1.0.
Conclusions EFT was significantly higher in fetuses of diabetic versus nondiabetic mothers. The mean difference in EFT of GDM cases and controls was relatively small but was statistically significant. The study concluded that measuring the epicardial fat thickness in fetuses can serve as a novel marker in GDM.
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Affiliation(s)
- Amandeep Singh
- Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Punjab, India
| | - Amitojveer S Josan
- Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Punjab, India
| | - Kamlesh Gupta
- Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Punjab, India
| | - Sangeeta Pahwa
- Department of Obstetrics and Gynaecology, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Punjab, India
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Kologrivova IV, Naryzhnaya NV, Koshelskaya OA, Suslova TE, Kravchenko ES, Kharitonova OA, Evtushenko VV, Boshchenko AA. Association of Epicardial Adipose Tissue Adipocytes Hypertrophy with Biomarkers of Low-Grade Inflammation and Extracellular Matrix Remodeling in Patients with Coronary Artery Disease. Biomedicines 2023; 11:biomedicines11020241. [PMID: 36830779 PMCID: PMC9953115 DOI: 10.3390/biomedicines11020241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
The aim of the study was to compare the morphological features of epicardial adipose tissue (EAT) adipocyte with the circulating inflammatory biomarkers and parameters of extracellular matrix remodeling in patients with coronary artery disease (CAD). We recruited 42 patients with CAD (m/f 28/14) who were scheduled for coronary artery bypass graft surgery (CABG). EAT adipocytes were obtained by the enzymatic method from intraoperative adipose tissue samples. Concentrations of secreted and lipoprotein-associated phospholipase A2 (sPLA2 and LpPLA2), TNF-α, IL-1β, IL-6, IL-10, high-sensitive C-reactive protein (hsCRP), metalloproteinase-9 (MMP-9), MMP-2, C-terminal cross-linking telopeptide of type I collagen (CTX-I), and tissue inhibitor of metalloproteinase 1 (TIMP-1) were measured in blood serum. Patients were divided into two groups: group 1-with mean EAT adipocytes' size ≤ 87.32 μm; group 2-with mean EAT adipocytes' size > 87.32 μm. Patients of group 2 had higher concentrations of triglycerides, hsCRP, TNF-α, and sPLA2 and a lower concentration of CTX-I. A multiple logistic regression model was created (RN2 = 0.43, p = 0.0013). Concentrations of TNF-α, sPLA2 and CTX-I appeared to be independent determinants of the EAT adipocyte hypertrophy. ROC analysis revealed the 78% accuracy, 71% sensitivity, and 85% specificity of the model, AUC = 0.82. According to our results, chronic low-grade inflammation and extracellular matrix remodeling are closely associated with the development of hypertrophy of EAT adipocytes, with serum concentrations of TNF-α, sPLA2 and CTX-I being the key predictors, describing the variability of epicardial adipocytes' size.
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Affiliation(s)
- Irina V. Kologrivova
- Correspondence: (I.V.K.); (N.V.N.); Tel.: +79-131-053-869 (I.V.K.); +79-039-542-139 (N.V.N.)
| | - Natalia V. Naryzhnaya
- Correspondence: (I.V.K.); (N.V.N.); Tel.: +79-131-053-869 (I.V.K.); +79-039-542-139 (N.V.N.)
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25
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Yaribeygi H, Maleki M, Butler AE, Jamialahmadi T, Sahebkar A. Sodium-glucose co-transporter-2 inhibitors and epicardial adiposity. Eur J Pharm Sci 2023; 180:106322. [PMID: 36336279 DOI: 10.1016/j.ejps.2022.106322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/18/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
Epicardial adipose tissue is a layer of adipocytes that physiologically surround the myocardium and play some physiologic roles in normal heart function. However, in pathologic conditions, the epicardial adipose tissue can present a potent cardiac risk factor that is capable of impairing heart function through several pathways, increasing the risk of dysrhythmia and creating an inflammatory milieu around the heart tissues. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are a relatively newly introduced class of antidiabetes drugs which effectively normalize blood glucose via overt glycosuria. Some recent reports suggest that these drugs are able to modulate epicardial adiposity and decrease the risk of cardiac complications in diabetic patients who are at higher risk of epicardial adiposity-dependent cardiac disorders. If proven to be true, these antidiabetic drugs can provide dual benefits as both hypoglycemic agents and as epicardial adiposity normalizing agents, thus providing cardiac benefits. In this study, we discuss the physiological and pathophysiological importance of epicardial adiposity and the potential positive effects of SGLT2is in the diabetic milieu.
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Affiliation(s)
- Habib Yaribeygi
- Research Center of Physiology, Semnan University of Medical Sciences, Semnan, Iran.
| | - Mina Maleki
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alexandra E Butler
- Research Department, Royal College of Surgeons in Ireland Bahrain, Adliya 15503, Bahrain
| | - Tannaz Jamialahmadi
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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26
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Huang S, Li Y, Jiang L, Ren Y, Wang J, Shi K, Yan WF, Qian WL, Yang ZG. Impact of Type 2 Diabetes Mellitus on Epicardial Adipose Tissue and Myocardial Microcirculation by MRI in Postmenopausal Women. J Magn Reson Imaging 2022; 56:1404-1413. [PMID: 35179821 DOI: 10.1002/jmri.28121] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) often occurs conjunctly with the menopausal transition in female patients. In addition, epicardial adipose tissue (EAT) has an unfavorable impact on the myocardium and coronary arteries under the influence of metabolic disorders. PURPOSE To investigate the impact of T2DM on EAT and myocardial microvascular function in postmenopausal women. STUDY TYPE Retrospective. POPULATION One-hundred sixty-one postmenopausal women divided into three groups: newly diagnosed (≤5 years) T2DM (n = 56, 58.6 ± 7.7 years), long-term (>5 years) T2DM (n = 57, 61.9 ± 7.9 years), and healthy controls (n = 48, 59.4 ± 7.4 years). FIELD STRENGTH/SEQUENCE 3.0 T; balanced steady-state free precession and inversion recovery prepared echo-planar sequences. ASSESSMENT EAT volume was quantified by delineating the epicardial border and the visceral layer of pericardium on the short-axis cine stacks. Perfusion parameters including upslope, maximum signal intensity (MaxSI) and time to maximum signal intensity (TTM) were derived from the first-pass perfusion signal intensity-time curves. STATISTICAL TESTS One-way analysis of variance, Pearson's and Spearman correlation, and multivariable linear regression. Two-sided P < 0.05 was considered statistically significant. RESULTS EAT volume was significantly increased in diabetic postmenopausal women compared to the controls (48.4 ± 13.4 mL/m2 [newly diagnosed T2DM] vs. 58.4 ± 17.3 mL/m2 [long-term T2DM] vs. 35.8 ± 12.3 mL/m2 [controls]). Regarding perfusion parameters, upslope and MaxSI were significantly reduced (2.6 ± 1.0 [newly diagnosed T2DM] vs. 2.1 ± 0.8 [long-term T2DM] vs. 3.6 ± 1.3 [controls]; and 21.4 ± 6.9 [newly diagnosed T2DM] vs. 18.7 ± 6.4 [long-term T2DM] vs. 28.4 ± 8.6 [controls]), whereas TTM was significantly increased in the T2DM groups compared to the control group (23.6 ± 8.7 [newly diagnosed T2DM] vs. 27.1 ± 9.4 [long-term T2DM] vs. 21.4 ± 6.0 [controls]). Multivariable analysis (adjusted coefficient of determination [R2 ] = 0.489) showed that EAT volume (β = -0.610) and menopausal age (β = 0.433) were independently correlated with decreased perfusion upslope. DATA CONCLUSION Diabetic postmenopausal women had significantly higher EAT volume and more impaired microcirculation compared to the controls. Increased EAT volume and earlier menopausal age were independently associated with microvascular dysfunction in these patients. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- Shan Huang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuan Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Jiang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yan Ren
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jin Wang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ke Shi
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei-Feng Yan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wen-Lei Qian
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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27
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Patel V, Patel J. Cellular cross talk between epicardial fat and cardiovascular risk. J Basic Clin Physiol Pharmacol 2022; 33:683-694. [PMID: 36220013 DOI: 10.1515/jbcpp-2022-0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 09/14/2022] [Indexed: 11/15/2022]
Abstract
A variety of fat compartments have several local and systemic effect and play a crucial role in the maintenance of health and development of disease. For the past few years, special attention has been paid to epicardial fat. It is the visceral fat compartment of the heart and has several local and systemic effects. It can perform a role in the development of cardiometabolic risk. The epicardial adipose tissue (EAT) is a unique and multifunctional fat compartment of the heart. It is located between the myocardium and the visceral pericardium. During normal physiological conditions, the EAT has metabolic, thermogenic, and mechanical (cardioprotective) characteristics. The EAT can produce several adipocytokines and chemokines depending on microenvironments. It can influence through paracrine and vasocrine mechanism and participate in the development and progression of cardiovascular (CVS) diseases. In addition, metabolic disease leads to changes in both thickness and volume of the EAT, and it can modify the structure and the function of heart. It has been associated with various CVS diseases such as, cardiomyopathy, atrial fibrillation, and coronary artery disease. Therefore, EAT is a potential therapeutic target for CVS risk.
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Affiliation(s)
- Vishwa Patel
- University of Texas at Austin, Austin 78712, Texas, USA
| | - Jimik Patel
- Thomas Jefferson University, 4201 Henry Ave, Philadelphia, PA 19144, USA
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28
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Wang J, Sun X, Liu W, Xiaomei Zhu, Yinsu Zhu, Shushen Lin, Hongwu Chen, Xu Y. Cardiac Computed Tomography-Based Epicardial Adipose Tissue Assessment Reveals Association With Electroanatomical Voltage Mapping in Patients With Atrial Fibrillation. Heart Lung Circ 2022; 31:1385-1392. [PMID: 35963813 DOI: 10.1016/j.hlc.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/04/2022] [Accepted: 07/07/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Epicardial adipose tissue (EAT) around the left atrium (LA) can change the electric conduction of the LA, potentially leading to atrial fibrillation (AF). AIM The aim of this study was to evaluate whether an association existed between EAT and the electrophysiological properties of adjacent atrial myocardium in patients with AF. METHOD A total of 201 consecutive patients referred for initial AF catheter ablation were prospectively included. A preprocedural computed tomography scan was performed to assess total and LA-EAT parameters. Detailed point-by-point voltage mapping using an electroanatomical mapping system was realised to assess the LA low-voltage zone (LVZ), defined as an area with bipolar electrograms ≤0.5 mV during sinus rhythm. RESULTS Ninety-one (91) patients (45.3%) presented at least one LVZ. They had a significantly more severe AF pattern (p=0.04) than patients without LVZ, and little difference existed with regard to other clinical variables. Patients with LVZ presented significantly more total EAT volume (162.4±71.3 mL vs 135.5±57.2 mL; p=0.03) and LA-EAT volume (26.4±15.9 mL vs 20.9±10.5 mL; p<0.01) than no-LVZ patients. Multivariable logistic regression analyses revealed total EAT volume index to be an independent predictor of the presence of LVZ (odds ratio [OR] 1.01; 95% confidence interval [CI] 1.01-1.04; p<0.01) and LA-EAT percentage to be an independent predictor of severe LVZ (OR 1.34; 95% CI 1.18-1.64; p<0.001). CONCLUSIONS The EAT volume and its distribution around the LA may indicate the presence and severity of LVZ. The assessment of the volume of EAT and its distribution may lead to better risk stratification in patients with AF.
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Affiliation(s)
- Jun Wang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xingxing Sun
- The Second People's Hospital of Lianyungang, Jiangsu, China
| | - Wangyan Liu
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaomei Zhu
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yinsu Zhu
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shushen Lin
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hongwu Chen
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Yi Xu
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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29
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Shao Y, Chen L, Chen W, Sang C, Xu C, Zhang C. Left atrial epicardial adipose tissue is associated with low voltage zones in the left atrium in patients with non-valvular atrial fibrillation. Front Cardiovasc Med 2022; 9:924646. [PMID: 35911525 PMCID: PMC9333900 DOI: 10.3389/fcvm.2022.924646] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/28/2022] [Indexed: 12/22/2022] Open
Abstract
Objective Epicardial adipose tissue (EAT) is related to atrial fibrillation (AF), but the specific mechanism is still unclear. Left atrial (LA) low voltage zones (LVZ) can well reflect atrial fibrosis. This study investigated the relationship between EAT and LVZ in non-valvular AF (NVAF) patients. Methods This observational study including patients with NVAF (n = 214) undergoing radiofrequency ablation (RFCA) for the first time in our hospital and 62 matched controls. The EAT volume and attenuation were measured by contrast-enhanced computed tomography. A three-dimensional mapping system was used to map the left atrial endocardium and evaluate LA-LVZ. Patients were divided into LVZ and non-LVZ groups according to the presence or absence of LVZ. Results Patients with AF showed higher LA-EAT volume and lower attenuation value than controls (29.7 ± 11.2 cm3 vs. 20.9 ± 8.6 cm3, P = 0.021; −91.2 ± 5.6 HU vs. −88.7 ± 5.9 HU, P < 0.001). Compared with the group without LVZ, there were significant differences in age [65 (59–71) vs. 60 (52–69), P = 0.006], LAVI [75.1 ± 20.7 ml/m2 vs. 67.2 ± 20.9 ml/m2, P = 0.018], LA-EAT volume (34.8 ± 11.5 cm3 vs. 28.1 ± 10.6 cm3, P < 0.001) and LA-EAT attenuation (−93.9 ± 5.3 HU vs. −90.4 ± 5.5 HU, P < 0.001). Multivariate regression analysis showed that age (OR = 1.040; 95%CI: 1.001–1.078, P = 0.042), LAVI (OR = 1.019; 95%CI: 1.002–1.037, P = 0.032), LA-EAT volume (OR = 1.193; 95%CI: 1.015–1.402, P = 0.034) and attenuation value (OR = 0.801; 95%CI: 0.701–0.916 P = 0.001) were independent predictors of LVZ. After LA-EAT attenuation was incorporated into the clinical model, the comprehensive discrimination and net reclassification tended to improve (IDI and NRI > 0, P < 0.05). Conclusion LA-EAT volume and attenuation values can independently predict the presence of LVZ, and LA-EAT attenuation has a better predictive value than LA-EAT volume.
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Affiliation(s)
- Yameng Shao
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Lei Chen
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Wensu Chen
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Chuanyi Sang
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Changjiang Xu
- Department of Cardiology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, China
| | - Chaoqun Zhang
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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30
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Epicardial Adipose Tissue: A Novel Potential Imaging Marker of Comorbidities Caused by Chronic Inflammation. Nutrients 2022; 14:nu14142926. [PMID: 35889883 PMCID: PMC9316118 DOI: 10.3390/nu14142926] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/09/2022] [Indexed: 12/11/2022] Open
Abstract
The observation of correlations between obesity and chronic metabolic and cardiovascular diseases has led to the emergence of strong interests in “adipocyte biology”, in particular in relation to a specific visceral adipose tissue that is the epicardial adipose tissue (EAT) and its pro-inflammatory role. In recent years, different imaging techniques frequently used in daily clinical practice have tried to obtain an EAT quantification. We provide a useful update on comorbidities related to chronic inflammation typical of cardiac adiposity, analyzing how the EAT assessment could impact and provide data on the patient prognosis. We assessed for eligibility 50 papers, with a total of 10,458 patients focusing the review on the evaluation of EAT in two main contexts: cardiovascular and metabolic diseases. Given its peculiar properties and rapid responsiveness, EAT could act as a marker to investigate the basal risk factor and follow-up conditions. In the future, EAT could represent a therapeutic target for new medications. The assessment of EAT should become part of clinical practice to help clinicians to identify patients at greater risk of developing cardiovascular and/or metabolic diseases and to provide information on their clinical and therapeutic outcomes.
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31
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Iskender C, Yakut Yücel K, Dereli ML, Sağlam E, Çelen Ş, Çağlar T, Engin-Üstün Y. Increased fetal epicardial fat thickness: A reflecting finding for GDM and perinatal outcomes. Echocardiography 2022; 39:1082-1088. [PMID: 35808919 DOI: 10.1111/echo.15416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/25/2022] [Accepted: 06/07/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To study the value of fetal epicardial fat thickness (EFT) in gestational diabetes mellitus in the third trimester of pregnancy and its relationship with clinical parameters and perinatal outcomes. METHODS A total of 80 participants, including 40 with diagnosed GDM and 40 healthy pregnant women, were included in the study. Demographic data were obtained from medical records. Sonographic examinations were performed, such as amniotic fluid value, fetal biometric measurements, and Doppler parameters of the umbilical artery. Fetal EFT values were measured at the free wall of the right ventricle using a reference line with echocardiographic methods. Correlation tests were performed to evaluate the relationship between fetal EFT and clinical and perinatal parameters. p < .05 were interpreted as statistically significant. RESULTS The fetal EFT value was statistically higher in the GDM group than in the control group (p: .000). Spearman and Pearson correlation tests revealed statistically significant but weak positive correlations between fetal EFT value, 1-h 100-g OGTT, birth weight, and BMI (r: .198, p: .047; r: .395, p: .012; r: .360, p: .042, respectively). The optimal fetal EFT threshold for predicting GDM disease was found as 1.55 mm, with a specificity of 74.4% and sensitivity of 75.0%. Statistically significant differences between the two groups in umbilical artery Doppler resistance index (RI), pulsatility index (PI), and systolic/diastolic ratio (S/D) were not found (p: .337; p: .503; p: .155;). BMI and amniotic fluid volume were higher in the GDM group compared to the control group (p: .009; p < .01). CONCLUSION This study demonstrated that increased fetal EFT may occur as a reflection of changes in glucose metabolism in intrauterine life. Future studies with larger series, including the study of neonatal metabolic parameters, will contribute to the understanding of the importance of fetal EFT in determining the metabolic status of the fetus.
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Affiliation(s)
- Cantekin Iskender
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
| | - Kadriye Yakut Yücel
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
| | - Murat Levent Dereli
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
| | - Erkan Sağlam
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
| | - Şevki Çelen
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
| | - Turhan Çağlar
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
| | - Yaprak Engin-Üstün
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
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Scarano Pereira JP, Owen E, Martinino A, Akmal K, Abouelazayem M, Graham Y, Weiner S, Sakran N, Dekker LR, Parmar C, Pouwels S. Epicardial adipose tissue, obesity and the occurrence of atrial fibrillation: an overview of pathophysiology and treatment methods. Expert Rev Cardiovasc Ther 2022; 20:307-322. [PMID: 35443854 DOI: 10.1080/14779072.2022.2067144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Obesity is a chronic disease, which has significant health consequences and is a staggering burden to health care systems. Obesity can have harmful effects on the cardiovascular system, including heart failure, hypertension, coronary heart disease, and atrial fibrillation (AF). One of the possible substrates might be epicardial adipose tissue (EAT), which can be the link between AF and obesity. EAT is a fat deposit located between the myocardium and the visceral pericardium. Numerous studies have demonstrated that EAT plays a pivotal role in this relationship regarding atrial fibrillation. AREAS COVERED This review will focus on the role of obesity and the occurrence of atrial fibrillation (AF) and examine the connection between these and epicardial adipose tissue (EAT). The first part of this review will explain the pathophysiology of EAT and its association with the occurrence of AF. Secondly, we will review bariatric and metabolic surgery and its effects on EAT and AF. EXPERT COMMENTARY In this review, the epidemiology, pathophysiology, and treatments methods of AF are explained. Secondly the effects on EAT were elucidated. Due to the complex pathophysiological link between EAT, AF, and obesity, it is still uncertain which treatment strategy is superior.
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Affiliation(s)
| | - Eloise Owen
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | | | - Kiran Akmal
- Faculty of Medicine, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Mohamed Abouelazayem
- Department of Surgery, Royal Free London Hospitals NHS Foundation, London, United Kingdom
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, United Kingdom.,Facultad de Psucologia, Universidad Anahuac Mexico, Mexico City, Mexico
| | - Sylvia Weiner
- Department of Bariatric and Metabolic Surgery, Krankenhaus Nordwest, Frankfurt am Main, Germany
| | - Nasser Sakran
- Department of Surgery, Holy Family Hospital, Nazareth, Israel.,Azrieli, Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Lukas R Dekker
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | - Chetan Parmar
- Department of Surgery, Whittington Health NHS Trust, London, United Kingdom
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
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Ihara K, Sasano T. Role of Inflammation in the Pathogenesis of Atrial Fibrillation. Front Physiol 2022; 13:862164. [PMID: 35492601 PMCID: PMC9047861 DOI: 10.3389/fphys.2022.862164] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/21/2022] [Indexed: 12/15/2022] Open
Abstract
Atrial fibrillation (AF) is one of the most common arrhythmias encountered in clinical practice. AF is a major risk factor for stroke, which is associated with high mortality and great disability and causes a significant burden on society. With the development of catheter ablation, AF has become a treatable disease, but its therapeutic outcome has been limited so far. In persistent and long-standing AF, the expanded AF substrate is difficult to treat only by ablation, and a better understanding of the mechanism of AF substrate formation will lead to the development of a new therapeutic strategy for AF. Inflammation is known to play an important role in the substrate formation of AF. Inflammation causes and accelerates the electrical and structural remodeling of the atria via pro-inflammatory cytokines and other inflammatory molecules, and enhances the AF substrate, leading to the maintenance of AF and further inflammation, which forms a vicious spiral, so-called "AF begets AF". Breaking this vicious cycle is expected to be a key therapeutic intervention in AF. In this review, we will discuss the relationship between AF and inflammation, the inflammatory molecules included in the AF-related inflammatory process, and finally the potential of those molecules as a therapeutic target.
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Affiliation(s)
- Kensuke Ihara
- Department of Bio-informational Pharmacology, Medical Research Institute, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tetsuo Sasano
- Department of Cardiovascular Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Akbulut T, Şaylık F, Şengül C. The epicardial fat thickness is associated with fragmented QRS in patients with newly diagnosed metabolic syndrome. Rev Assoc Med Bras (1992) 2022; 68:250-255. [PMID: 35239891 DOI: 10.1590/1806-9282.20211065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/05/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The metabolic syndrome involves both metabolic and cardiovascular risk factors and is associated with cardiovascular mortality. Epicardial fat tissue plays a crucial role in deleterious effects of metabolic syndrome on the heart, including myocardial fibrosis. The fragmented QRS reflects heterogeneous depolarization of the myocardium and occurs as a result of fibrosis. Thus, we aimed to investigate whether there is an association between fragmented QRS and epicardial fat tissue in patients with metabolic syndrome. METHODS This study enrolled 140 metabolic syndrome patients, of whom 35 patients with fragmented QRS (+) and 105 patients with fragmented QRS (-). The two groups were compared with respect to clinical, laboratory, electrocardiographic, and echocardiographic indexes. RESULTS Fragmented QRS (+) patients had higher waist circumference, red cell distribution width, creatinine, left ventricular end-systolic diameter, left atrium diameter, septal a velocity, QRS duration, and epicardial fat tissue compared with fragmented QRS (-) patients. Waist circumference, red cell distribution width, QRS duration, left ventricular end-systolic diameter, left atrium diameter, septal a velocity, and epicardial fat tissue were significantly associated with the presence of fragmented QRS. The QRS duration and epicardial fat tissue were independently associated with the presence of fragmented QRS on surface electrocardiographic in metabolic syndrome patients. CONCLUSIONS Epicardial fat tissue and QRS duration were independently associated with the presence of fragmented QRS. Basic echocardiographic and electrocardiographic parameters might be used for the risk stratification in metabolic syndrome patients.
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Affiliation(s)
- Tayyar Akbulut
- Van Training and Research Hospital, Department of Cardiology - Van, Turkey
| | - Faysal Şaylık
- Van Training and Research Hospital, Department of Cardiology - Van, Turkey
| | - Cihan Şengül
- Van Training and Research Hospital, Department of Cardiology - Van, Turkey
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35
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Yang M, Cao Q, Xu Z, Ge Y, Li S, Yan F, Yang W. Development and Validation of a Machine Learning-Based Radiomics Model on Cardiac Computed Tomography of Epicardial Adipose Tissue in Predicting Characteristics and Recurrence of Atrial Fibrillation. Front Cardiovasc Med 2022; 9:813085. [PMID: 35310976 PMCID: PMC8927627 DOI: 10.3389/fcvm.2022.813085] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/08/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose This study aimed to evaluate the feasibility of differentiating the atrial fibrillation (AF) subtype and preliminary explore the prognostic value of AF recurrence after ablation using radiomics models based on epicardial adipose tissue around the left atrium (LA-EAT) of cardiac CT images. Method The cardiac CT images of 314 patients were collected wherein 251 and 63 cases were randomly enrolled in the training and validation cohorts, respectively. Mutual information and the random forest algorithm were used to screen for the radiomic features and construct the radiomics signature. Radiomics models reflecting the features of LA-EAT were built to differentiate the AF subtype, and the multivariable logistic regression model was adopted to integrate the radiomics signature and volume information. The same methodology and algorithm were applied to the radiomic features to explore the ability for predicting AF recurrence. Results The predictive model constructed by integrating the radiomic features and volume information using a radiomics nomogram showed the best ability in differentiating AF subtype in the training [AUC, 0.915; 95% confidence interval (CI), 0.880–0.951] and validation (AUC, 0.853; 95% CI, 0.755–0.951) cohorts. The radiomic features have shown convincible predictive ability of AF recurrence in both training (AUC, 0.808; 95% CI, 0.750–0.866) and validation (AUC, 0.793; 95% CI, 0.654–0.931) cohorts. Conclusions The LA-EAT radiomic signatures are a promising tool in the differentiation of AF subtype and prediction of AF recurrence, which may have clinical implications in the early diagnosis of AF subtype and disease management.
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Affiliation(s)
- Min Yang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiqi Cao
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhihan Xu
- Siemens Healthineers Computed Tomography (CT) Collaboration, Shanghai, China
| | - Yingqian Ge
- Siemens Healthineers Computed Tomography (CT) Collaboration, Shanghai, China
| | - Shujiao Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjie Yang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Wenjie Yang
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Turkmen K, Ozer H, Kusztal M. The Relationship of Epicardial Adipose Tissue and Cardiovascular Disease in Chronic Kidney Disease and Hemodialysis Patients. J Clin Med 2022; 11:1308. [PMID: 35268399 PMCID: PMC8911356 DOI: 10.3390/jcm11051308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/14/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022] Open
Abstract
Cardiovascular diseases remain the most common cause of morbidity and mortality in chronic kidney disease patients undergoing hemodialysis. Epicardial adipose tissue (EAT), visceral fat depot of the heart, was found to be associated with coronary artery disease in cardiac and non-cardiac patients. Additionally, EAT has been proposed as a novel cardiovascular risk in the general population and in end-stage renal disease patients. It has also been shown that EAT, more than other subcutaneous adipose tissue deposits, acts as a highly active organ producing several bioactive adipokines, and proinflammatory and proatherogenic cytokines. Therefore, increased visceral adiposity is associated with proinflammatory activity, impaired insulin sensitivity, increased risk of atherosclerosis, and high morbidity and mortality in hemodialysis patients. In the present review, we aimed to demonstrate the role of EAT in the pathophysiological mechanisms of increased cardiovascular morbidity and mortality in hemodialysis patients.
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Affiliation(s)
- Kultigin Turkmen
- Division of Nephrology, Department of Internal Medicine, Meram Medical Faculty, Necmettin Erbakan University, Konya 42090, Turkey;
| | - Hakan Ozer
- Division of Nephrology, Department of Internal Medicine, Meram Medical Faculty, Necmettin Erbakan University, Konya 42090, Turkey;
| | - Mariusz Kusztal
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland;
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Lorenzo-Almorós A, Cepeda-Rodrigo J, Lorenzo Ó. Diabetic cardiomyopathy. Rev Clin Esp 2022; 222:100-111. [DOI: 10.1016/j.rceng.2019.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 10/21/2019] [Indexed: 12/24/2022]
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Glezer A, Santana MR, Bronstein MD, Donato J, Jallad RS. The interplay between prolactin and cardiovascular disease. Front Endocrinol (Lausanne) 2022; 13:1018090. [PMID: 36704037 PMCID: PMC9871591 DOI: 10.3389/fendo.2022.1018090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/20/2022] [Indexed: 01/12/2023] Open
Abstract
Hyperprolactinemia can be caused by several conditions and its effects on the hypothalamic-pituitary-gonadal axis are understood in more detail. Nevertheless, in recent decades, other metabolic effects have been studied and data pointed to a potential increased cardiovascular disease (CVD) risk. A recent study showed a decrease in total and LDL- cholesterol only in men with prolactinoma treated with dopamine agonists (DA) supporting the previous results of a population study with increased CVD risk in men harboring prolactinoma. However, other population studies did not find a correlation between prolactin (PRL) levels and CVD risk or mortality. There is also data pointing to an increase in high-density lipoprotein levels, and decreases in triglycerides, carotid-intima-media thickness, C-reactive protein, and homocysteine levels in patients with prolactinoma on DA treatment. PRL was also implicated in endothelial dysfunction in pre and postmenopausal women. Withdrawal of DA resulted in negative changes in vascular parameters and an increase in plasma fibrinogen. It has been shown that PRL levels were positively correlated with blood pressure and inversely correlated with dilatation of the brachial artery and insulin sensitivity, increased homocysteine levels, and elevated D-dimer levels. Regarding possible mechanisms for the association between hyperprolactinemia and CVD risk, they include a possible direct effect of PRL, hypogonadism, and even effects of DA treatment, independently of changes in PRL levels. In conclusion, hyperprolactinemia seems to be associated with impaired endothelial function and DA treatment could improve CVD risk. More studies evaluating CVD risk in hyperprolactinemic patients are important to define a potential indication of treatment beyond hypogonadism.
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Affiliation(s)
- Andrea Glezer
- Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clinicas, University of Sao Paulo Medical School, São Paulo, SP, Brazil
- Laboratory of Cellular and Molecular Endocrinology LIM-25, University of Sao Paulo Medical School, São Paulo, SP, Brazil
- *Correspondence: Andrea Glezer,
| | - Mariana Ramos Santana
- Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clinicas, University of Sao Paulo Medical School, São Paulo, SP, Brazil
| | - Marcello D. Bronstein
- Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clinicas, University of Sao Paulo Medical School, São Paulo, SP, Brazil
- Laboratory of Cellular and Molecular Endocrinology LIM-25, University of Sao Paulo Medical School, São Paulo, SP, Brazil
| | - Jose Donato
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Raquel Soares Jallad
- Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clinicas, University of Sao Paulo Medical School, São Paulo, SP, Brazil
- Laboratory of Cellular and Molecular Endocrinology LIM-25, University of Sao Paulo Medical School, São Paulo, SP, Brazil
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PINHO ARYANEC, BURGEIRO ANA, PEREIRA MARIAJOÃO, CARVALHO EUGENIA. Drug-induced metabolic alterations in adipose tissue - with an emphasis in epicardial adipose tissue. AN ACAD BRAS CIENC 2022. [DOI: 10.1590/0001-3765202220201819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2025] Open
Affiliation(s)
| | | | | | - EUGENIA CARVALHO
- University of Coimbra, Portugal; University of Coimbra, Portugal; APDP-Portuguese Diabetes Association, Portugal
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40
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Yazici D, Sunbul M, Yasar M, Deyneli O, Yavuz D. Is there an increased cardiovascular risk in patients with prolactinoma? A challenging question. JOURNAL OF CLINICAL ULTRASOUND : JCU 2021; 49:870-877. [PMID: 34131923 DOI: 10.1002/jcu.23030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 04/28/2021] [Accepted: 06/06/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Epicardial adipose tissue thickness (EATT) is considered to be a surrogate for visceral fat and a novel cardiovascular risk indicator. Hyperprolactinemia has been shown to be associated with increased cardiovascular risk. The aim was to evaluate the association between EATT, carotid intima media thickness (CIMT), and cardiac functions in patients with prolactinoma. METHODS Patients with the diagnosis of prolactinoma were included. The control group consisted of healthy age matched individuals with normal prolactin levels. Prolactin, fasting blood glucose (FBG), insulin, hemoglobin A1c (HbA1c), alanine aminotransferase (ALT), total cholesterol, triglycerides, and high (HDL) and low density lipoprotein (LDL) cholesterol were measured. EATT, CIMT, cardiac systolic, and diastolic functions were determined using echocardiography. RESULTS We evaluated 67 patients with prolactinoma (aged 40.7 ± 11.9 years, F/M: 51/16) and 57 controls (aged 42.5 ± 7.4 years, F/M: 36/21). Of the 67 patients, 24 had normal prolactin levels. FBG level was higher in prolactinoma patients than in controls. Patients and controls had similar HbA1c, HOMA-IR, ALT, total, HDL, LDL cholesterol, and triglycerides levels, and similar cardiac systolic and diastolic functions. Prolactinoma patients had greater EATT (3.0 ± 0.5 mm vs. 2.6 ± 0.4 mm, p < 0.001) and CIMT (0.57 ± 0.08 mm vs. 0.52 ± 0.04 mm, p = 0.03) than controls. EATT was correlated with body mass index, FBG, HbA1c, and triglyceride levels. CONCLUSIONS EATT and CIMT were greater in patients with prolactinoma, although they had normal cardiac systolic and diastolic functions.
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Affiliation(s)
- Dilek Yazici
- Section of Endocrinology and Metabolism, Koç University Medical School, Istanbul, Turkey
| | - Murat Sunbul
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Mehmet Yasar
- Section of Endocrinology and Metabolism, Marmara University School of Medicine, Istanbul, Turkey
| | - Oguzhan Deyneli
- Section of Endocrinology and Metabolism, Koç University Medical School, Istanbul, Turkey
| | - Dilek Yavuz
- Section of Endocrinology and Metabolism, Marmara University School of Medicine, Istanbul, Turkey
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Ferreira J, Martins R, Monteiro S, Teixeira R, Gonçalves L. Alternative sites of echocardiographic epicardial fat assessment and coronary artery disease. J Ultrasound 2021; 25:177-184. [PMID: 34105055 DOI: 10.1007/s40477-021-00598-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022] Open
Abstract
AIMS Increasing evidence points towards the use of epicardial fat (EF) as a reliable biomarker of coronary artery disease extent and severity. We aim to assess the different locations of echocardiographic EF thickness measurement and their relation with the presence, extent, and severity of coronary artery disease (CAD) in patients admitted with acute coronary syndromes (ACS). METHODS Prospective cohort study including patients admitted for ACS. EF was assessed by transthoracic echocardiography and compared with coronary angiography findings. Spearmen correlation analysis was used to search for EF correlations. Receiver-operating characteristic curve analysis was performed to assess the predictive value of the different sites of measurement of EF thickness for the presence of CAD. To evaluate other potential variables independently associated with CAD, we performed multivariate analysis employing logistic regression. RESULTS 196 patients were included. Significant CAD was diagnosed in 83.7% of patients. In all views, EF thickness was greater in patients with CAD (p < 0.001). We found a moderate correlation between EF thickness and CAD extent and severity. EF thickness measured at RV basal level showed a good performance in predicting significant CAD in patients with ACS (AUC = 0.885, 95% CI 0.80-0.97, p < 0.001). For a value of mean RV basal region EF thickness ≥ 12.57 mm, sensitivity was 85% and specificity was 80.8%. CONCLUSION In patients admitted with ACS, echocardiographic EF thickness predicted the presence of CAD, as well as its extent and severity. We found EF thickness measured at the RV basal region to be the best predictor of significant CAD.
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Affiliation(s)
- João Ferreira
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Praceta, R. Prof. Mota Pinto, 3004-561, Coimbra, Portugal.
| | - Rui Martins
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Praceta, R. Prof. Mota Pinto, 3004-561, Coimbra, Portugal
| | - Sílvia Monteiro
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Praceta, R. Prof. Mota Pinto, 3004-561, Coimbra, Portugal
| | - Rogério Teixeira
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Praceta, R. Prof. Mota Pinto, 3004-561, Coimbra, Portugal.,Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
| | - Lino Gonçalves
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Praceta, R. Prof. Mota Pinto, 3004-561, Coimbra, Portugal.,Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
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Yakut K, Öcal DF, Sanhal Yaşar C, Halıcı Öztürk F, Şanlı C, Çelen Ş. Fetal epicardial fat thickness in fetal growth restriction; effects on fetal heart function and relationship with the severity of disease. J Matern Fetal Neonatal Med 2021; 35:6946-6952. [PMID: 34058950 DOI: 10.1080/14767058.2021.1931676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate fetal epicardial fat thickness (EFT) value in fetal growth restriction (FGR) and its relationship with clinical parameters, fetal modified myocardial index (Mod-MPI), and the Doppler parameters. MATERIAL METHODS Eighty-five pregnant women, with 30 diagnosed with FGR and 55 healthy pregnant women as control group participated in this prospective case-control study. FGR group was divided into 2 subgroups as early (n = 9) and late FGR (n = 21) groups. Demographic data were taken from the medical records. Amnion fluid value, fetal biometric measurements, and Doppler parameters were obtained. Fetal EFT and fetal Mod-MPI were measured by using the echocardiographic methods. The correlation tests were performed to assess the association between EFT and clinical and ultrasonographic parameters. p < .05 was interpreted as statistically significant. RESULTS EFT value was found statistically lower in the early and late FGR groups than the control group (p = .003). Higher umbilical artery pulsatility index (PI) and lower cerebroplacental ratio (CPR) values were found in the early and late FGR (p < .001, p = .001). The optimal EFT cutoff level to predict FGR disease was measured as 1.25 with 63.3% specificity and 77.4% sensitivity. Lower ejection time (ET) and higher Mod-MPI and isovolumetric contraction time (ICT) values were found in the group FGR with absent UAEDF than in the group FGR with no absent UAEDF (p = .001, p < .000, p < .000, respectively). Correlation tests showed statistically negative and weak correlations among EFT, umbilical artery PI, and mean Ut A-PI (p = .019, p = .019). Positive correlations were found in regard to gestational age, EFW, and EFT (p = .002, p < .000). CONCLUSION Our study showed that the measurement of EFT may contribute to predicting the diagnosis of FGR. Moreover, lower EFT values can be related to the severity of FGR. Future randomized control studies are needed to understand the effects and pathways of fetal EFT on fetal cardiac function.
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Affiliation(s)
- Kadriye Yakut
- Perinatology Department, Turkish Ministry of Health, Fethi Sekin City Hospital, Elazığ, Turkey
| | - Doğa Fatma Öcal
- Perinatology Department, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | | | - Filiz Halıcı Öztürk
- Perinatology Department, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Cengiz Şanlı
- Obstetrics and Gynecology Department, Turkish Ministry of Health, Fethi Sekin City Hospital, Elazığ, Turkey
| | - Şevki Çelen
- Perinatology Department, Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey
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Iacobellis G. Aging Effects on Epicardial Adipose Tissue. FRONTIERS IN AGING 2021; 2:666260. [PMID: 35822028 PMCID: PMC9261330 DOI: 10.3389/fragi.2021.666260] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/28/2021] [Indexed: 01/01/2023]
Abstract
Epicardial fat is the visceral fat of the heart. Epicardial fat is a white adipose tissue, but it displays also brown-fat like or beige fat features. Under physiological conditions, epicardial fat has cardioprotective functions such as free fatty acids supply and thermoregulation of the adjacent myocardium. Epicardial adipose tissue encounters changes in the transition from embryological to childhood and then to adult life. Aging can affect the function and morphology of epicardial fat, more likely in women than in men. The effect of aging on the brown fat properties of the epicardial fat is the most prominent and with the greatest clinical implications. It is promising to know that epicardial fat responds to newer pharmaceutical drugs modulating the adipose tissue and potentially restoring its browning effects. Epicardial fat pro-inflammatory secretome is down-regulated in end-stage coronary artery disease. Chronic ischemia and adverse hemodynamic conditions can also affect the regulatory component of the epicardial fat. Epicardial fat may incur in apoptotic and fibrotic changes that alter its transcriptome and proteasome. In conclusion, aging and advanced stage of chronic diseases are likely to influence and affect epicardial fat genes and function. Whether the downregulation of the epicardial fat tissue is due more to aging than advancing stages of coronary artery disease, or more likely to the combination of both, would be object of future investigations.
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Machado CLR, Crespo-Lopez ME, Augusto-Oliveira M, Arrifano GDP, Macchi BDM, Lopes-Araújo A, Santos-Sacramento L, Souza-Monteiro JR, Alvarez-Leite JI, de Souza CBA. Eating in the Amazon: Nutritional Status of the Riverine Populations and Possible Nudge Interventions. Foods 2021; 10:1015. [PMID: 34066557 PMCID: PMC8148567 DOI: 10.3390/foods10051015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 12/11/2022] Open
Abstract
The Amazon is the largest tropical forest in the world and a source of healthy food, such as fruits and fish. Surprisingly, the Amazonian riverine population present an increased prevalence (as high as 58%) of non-communicable diseases, such as hypertension and insulin resistance, even higher than that described for the urban population of the Amazon. Therefore, this work aimed to analyze the nutritional status and associated risk of the riverine population. Body mass index, waist circumference (WC), waist-to-hip ratio, and neck circumference (NC) were evaluated, and risk analysis was assayed. Furthermore, data about occupation and the prevalence of consumers of the different groups of food were analyzed. All anthropometric parameters revealed high proportions of individuals at risk, WC and NC being the factors that had more high-risk women and men, respectively. Our data confirmed the characteristic profile of the riverine communities with a high number of fish consumers, but also observed different patterns probably associated to a phenomenon of nutrition transition. Based on our data, some nudge interventions that take into account the principles of behavior analysis are discussed and proposed for these populations, aiming to improve the nutritional status and avoid the long-term consequences of the results showed by this work.
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Affiliation(s)
- Camila Lorena Rodrigues Machado
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, 66075-110 Belém, PA, Brazil; (C.L.R.M.); (M.A.-O.); (G.d.P.A.); (A.L.-A.); (L.S.-S.)
| | - Maria Elena Crespo-Lopez
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, 66075-110 Belém, PA, Brazil; (C.L.R.M.); (M.A.-O.); (G.d.P.A.); (A.L.-A.); (L.S.-S.)
| | - Marcus Augusto-Oliveira
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, 66075-110 Belém, PA, Brazil; (C.L.R.M.); (M.A.-O.); (G.d.P.A.); (A.L.-A.); (L.S.-S.)
| | - Gabriela de Paula Arrifano
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, 66075-110 Belém, PA, Brazil; (C.L.R.M.); (M.A.-O.); (G.d.P.A.); (A.L.-A.); (L.S.-S.)
| | - Barbarella de Matos Macchi
- Laboratório de Neuroquímica Molecular e Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, 66075-110 Belém, PA, Brazil;
| | - Amanda Lopes-Araújo
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, 66075-110 Belém, PA, Brazil; (C.L.R.M.); (M.A.-O.); (G.d.P.A.); (A.L.-A.); (L.S.-S.)
| | - Letícia Santos-Sacramento
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, 66075-110 Belém, PA, Brazil; (C.L.R.M.); (M.A.-O.); (G.d.P.A.); (A.L.-A.); (L.S.-S.)
| | | | | | - Carlos Barbosa Alves de Souza
- Núcleo de Teoria e Pesquisa do Comportamento, Instituto Nacional de Ciência e Tecnologia Sobre Comportamento, Cognição e Ensino, Universidade Federal do Pará, 66075-110 Belém, PA, Brazil
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Muzurović EM, Vujošević S, Mikhailidis DP. Can We Decrease Epicardial and Pericardial Fat in Patients With Diabetes? J Cardiovasc Pharmacol Ther 2021; 26:415-436. [PMID: 33844605 DOI: 10.1177/10742484211006997] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Diabetes mellitus (DM) is a chronic and complex metabolic disorder and also an important cause of cardiovascular (CV) disease (CVD). Patients with type 2 DM (T2DM) and obesity show a greater propensity for visceral fat deposition (and excessive fat deposits elsewhere) and the link between adiposity and CVD risk is greater for visceral than for subcutaneous (SC) adipose tissue (AT). There is growing evidence that epicardial AT (EAT) and pericardial AT (PAT) play a role in the development of DM-related atherosclerosis, atrial fibrillation (AF), myocardial dysfunction, and heart failure (HF). In this review, we will highlight the importance of PAT and EAT in patients with DM. We also consider therapeutic interventions that could have a beneficial effect in terms of reducing the amount of AT and thus CV risk. EAT is biologically active and a likely determinant of CV morbidity and mortality in patients with DM, given its anatomical characteristics and proinflammatory secretory pattern. Consequently, modification of EAT/PAT may become a therapeutic target to reduce the CV burden. In patients with DM, a low calorie diet, exercise, antidiabetics and statins may change the quantity of EAT, PAT or both, alter the secretory pattern of EAT, improve the metabolic profile, and reduce inflammation. However, well-designed studies are needed to clearly define CV benefits and a therapeutic approach to EAT/PAT in patients with DM.
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Affiliation(s)
- Emir M Muzurović
- Department of Internal Medicine, Endocrinology Section, 274294Clinical Centre of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - Snežana Vujošević
- Department of Internal Medicine, Endocrinology Section, 274294Clinical Centre of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, 9687Royal Free Hospital Campus, University College London Medical School, University College London (UCL), Pond Street, London, UK.,Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Shan D, Dou G, Yang J, Wang X, Wang J, Zhang W, He B, Liu Y, Chen Y, Li Y. Epicardial Adipose Tissue Volume Is Associated with High Risk Plaque Profiles in Suspect CAD Patients. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6663948. [PMID: 33953836 PMCID: PMC8057896 DOI: 10.1155/2021/6663948] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/14/2021] [Accepted: 04/02/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To explore the association between EAT volume and plaque precise composition and high risk plaque detected by coronary computed tomography angiography (CCTA). METHODS 101 patients with suspected coronary artery disease (CAD) underwent CCTA examination from March to July 2019 were enrolled, including 70 cases acute coronary syndrome (ACS) and 31 cases stable angina pectoris (SAP). Based on CCTA image, atherosclerotic plaque precise compositions were analyzed using dedicated quantitative software. High risk plaque was defined as plaque with more than 2 high risk features (spotty calcium, positive remolding, low attenuation plaque, napkin-ring sign) on CCTA image. The association between EAT volume and plaque composition was assessed as well as the different of correlation between ACS and SAP was analyzed. Multivariable logistic regression analysis was used to explore whether EAT volume was independent risk factors of high risk plaque (HRP). RESULTS EAT volume in the ACS group was significantly higher than that of the SAP group (143.7 ± 49.8 cm3 vs. 123.3 ± 39.2 cm3, P = 0.046). EAT volume demonstrated a significant positive correlation with total plaque burden (r = 0.298, P = 0.003), noncalcified plaque burden (r = 0.245, P = 0.013), lipid plaque burden (r = 0.250, P = 0.012), and homocysteine (r = 0.413, P ≤ 0.001). In ACS, EAT volume was positively correlated with total plaque burden (r = 0.309, P = 0.009), noncalcified plaque burden (r = 0.242, P = 0.044), and lipid plaque burden (r = 0.240, P = 0.045); however, no correlation was observed in SAP. Patients with HRP have larger EAT volume than those without HRP (169 ± 6.2 cm3 vs. 130.6 ± 5.3 cm3, P = 0.002). After adjustment by traditional risk factors and coronary artery calcium score (CACS), EAT volume was an independent risk predictor of presence of HRP (OR: 1.018 (95% CI: 1.006-1.030), P = 0.004). CONCLUSIONS With the increasing EAT volume, more dangerous plaque composition burdens increase significantly. EAT volume is a risk predictor of HRP independent of convention cardiovascular risk factors and CACS, which supports the potential impact of EAT on progression of coronary atherosclerotic plaque.
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Affiliation(s)
- Dongkai Shan
- Department of Cardiovascular Medicine, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Guanhua Dou
- Department of Cardiology, Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Junjie Yang
- Department of Cardiovascular Medicine, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xi Wang
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jingjing Wang
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wei Zhang
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bai He
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yuqi Liu
- Department of Cardiovascular Medicine, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yundai Chen
- Department of Cardiovascular Medicine, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yang Li
- Department of Cardiovascular Medicine, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
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Brief Report: Adiponectin Levels Linked to Subclinical Myocardial Fibrosis in HIV. J Acquir Immune Defic Syndr 2021; 85:316-319. [PMID: 32639276 DOI: 10.1097/qai.0000000000002440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Persons living with HIV (PLWH) are at an increased risk of myocardial dysfunction and metabolic disturbances represent one of several potential contributing factors. Adiponectin is an adipokine that enhances insulin sensitivity with potential cardioprotective effects. We therefore investigated the relationship between myocardial fibrosis, adiponectin, and related metabolic parameters to better understand the pathophysiologic mechanisms of myocardial injury in PLWH. METHODS This is a prospective, cross-sectional study of PLWH without known cardiovascular disease (n = 87) and 28 healthy matched controls. Diffuse myocardial fibrosis and epicardial adipose tissue (EAT) were evaluated using cardiac magnetic resonance imaging and cardiac computed tomography. RESULTS Myocardial fibrosis was increased in PLWH and was correlated with adiponectin (r = 0.26, P = 0.004) and EAT (r = -0.42, P < 0.0001). Myocardial fibrosis was not associated with smoking pack years or CD4/CD8 ratio. In multivariate analysis that included body mass index, HIV status (P = 0.04), female sex (P < 0.0001), higher adiponectin (P = 0.046) and lower EAT (P = 0.01) were independently associated with myocardial fibrosis. CONCLUSION We describe a novel association between serum adiponectin and subclinical intramyocardial fibrosis, as well as a significant inverse relationship between intramyocardial fibrosis and EAT. Adiponectin may represent a target for preventing myocardial injury in the future; however, our findings reflect the complexity of the metabolic interactions of adiponectin and epicardial adipose as factors associated with the myocardial architecture.
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Kim YH, Jeong MK, Park H, Park SK. Effects of Regular Taekwondo Intervention on Health-Related Physical Fitness, Cardiovascular Disease Risk Factors and Epicardial Adipose Tissue in Elderly Women with Hypertension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2935. [PMID: 33809392 PMCID: PMC7999820 DOI: 10.3390/ijerph18062935] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 12/18/2022]
Abstract
Regular exercise has been proven to prevent hypertension and to help in the management of hypertension. There is a lack of studies examining changes in these issues as a result of Taekwondo training intervention. The aim of the current trial is to identify the effects of a regular Taekwondo (TKD) training program on health-related physical fitness (HRPF), cardiovascular disease (CVD) risk factors, inflammatory factors, and epicardial adipose tissue (EAT) in elderly women with hypertension. To accomplish this, 20 participants, who were older women with hypertension, were divided into a TKD group (n = 10) and a control group (n = 10). The TKD program was conducted in program for 90 min, three times a week, for 12 weeks. Outcomes, including body composition, blood pressure (BP), HRPF, cardiovascular risk factor and EAT, were measured before and after the Taekwondo program. The 12-week TKD program improved body composition, BP, HRPF, CVD risk factor, and EAT in elderly women with hypertension relative to controls. Meanwhile, EAT and interukin-1β (r = 0.530, p < 0.05), monocyte chemotactic protein-1 (r = 0.524, p < 0.05), triglyceride (r = 0.493, p < 0.05) and sedentary behavior (r = 0.459, p < 0.05) presented a positive correlation, while EAT and lean body mass (r = -0.453, p < 0.05) showed a negative correlation. The 12-week regular TKD training intervention was found to be effective in reducing the thickness of EAT measured by multi-detector computed tomography and can also enhance health-related physical fitness and risk factors of CVD in older individuals with hypertension.
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Affiliation(s)
- Yun Hwan Kim
- College of Arts and Sports, Dong-A University, Busan 49315, Korea; (Y.H.K.); (M.K.J.)
| | - Min Ki Jeong
- College of Arts and Sports, Dong-A University, Busan 49315, Korea; (Y.H.K.); (M.K.J.)
| | - Hyuntae Park
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea
- Institute of Convergence Bio-Health, Dong-A University, Busan 49315, Korea
| | - Sang Kab Park
- College of Arts and Sports, Dong-A University, Busan 49315, Korea; (Y.H.K.); (M.K.J.)
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Saraiva RM, Costa ARD. Epicardial Fat Thickness: a Promising Cardiovascular Risk Factor that Requires in-Depth Studies. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20200363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Venuraju SM, Lahiri A, Jeevarethinam A, Rakhit RD, Shah PK, Nilsson J. Association of Epicardial Fat Volume With the Extent of Coronary Atherosclerosis and Cardiovascular Adverse Events in Asymptomatic Patients With Diabetes. Angiology 2021; 72:442-450. [PMID: 33467865 DOI: 10.1177/0003319720984607] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Epicardial adipose tissue has a paracrine effect, enhancing coronary artery atherosclerotic plaque development. This study evaluated epicardial fat volume (EFV), adipokines, coronary atherosclerosis, and adverse cardiovascular events in a cohort of asymptomatic patients with type 2 diabetes mellitus (T2DM). Epicardial fat volume was calculated using data from computed tomography coronary angiograms. Adipokines and inflammatory cytokines were also assayed and correlated with EFV. Epicardial fat volume was also assessed as a predictor of coronary artery calcium (CAC) score, number of coronary artery plaques, and significant plaque (>50% luminal stenosis). Data from the EFV analysis were available for 221 (85.7%) participants. Median EFV was 97.4 cm3, mean body mass index was 28.1 kg/m2, and mean duration of T2DM was 13 years. Statistically significant, but weak, correlations were observed between several adipokines, inflammatory cytokines, and EFV. Epicardial fat volume was a significant univariate (P = .01), but not multivariate, predictor of the number of coronary plaques, but not of CAC score or significant plaque. After a mean follow-up of 22.8 months, 12 adverse cardiovascular events were reported, exclusively in participants with EFV >97.4 cm3. Epicardial fat volume has limited utility as a marker of coronary artery plaque in patients with T2DM and is weakly correlated with adipokine expression.
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Affiliation(s)
- Shreenidhi M Venuraju
- Institute of Cardiovascular Science, 4919University College London, United Kingdom
- 40531British Cardiac Research Trust, London, United Kingdom
- Bedford Hospital, Bedford, United Kingdom
| | - Avijit Lahiri
- 40531British Cardiac Research Trust, London, United Kingdom
- Cardiac Imaging and Research Centre, Wellington Hospital, London, United Kingdom
- Imperial College School of Medicine, Imperial College London, United Kingdom
- Healthcare Science, Middlesex University, London, United Kingdom
| | - Anand Jeevarethinam
- Institute of Cardiovascular Science, 4919University College London, United Kingdom
- 40531British Cardiac Research Trust, London, United Kingdom
- Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - Roby D Rakhit
- Institute of Cardiovascular Science, 4919University College London, United Kingdom
- Department of Cardiology, Royal Free Hospital, London, United Kingdom
| | | | - Jan Nilsson
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Lund University, Sweden
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