The impact of obesity on the relationship between epicardial adipose tissue, left ventricular mass and coronary microvascular function

Background: Epicardial Adipose Tissue (EAT) is recognized to be a cardiovascular risk factor. In addition to providing fuel to heart, it plays a pivotal role in the pathogenesis of atherosclerosis though the secretion of adipokines. This study aims to find the correlation of EAT with Left Ventricular Mass (LVM) and Left Ventricular Mass Index (LVMI) in patients with essential hypertension. Increasing LVM and LVMI are predictors of poor cardiovascular outcome. So, if we find a positive correlation, we can say that measurement of epicardial fat in essential hypertension may help us identify high risk hypertensive patients.Methods: This study was carried out in SMS Hospital, Jaipur, after approval from the Ethics Committee. 100 consecutive eligible patients were included in the study after application of inclusion and exclusion criteria and taking proper informed consent. After history, examination and routine laboratory investigations, all patients underwent transthoracic 2D and Doppler echocardiography. EAT thickness, LVM and LVMI were measured and correlated using Spearman correlation coefficient.Results: The mean LVM was 139±42.12 g and mean LVMI was 35.76±11.28 g/m2.7. The spearman correlation coefficient (r) was calculated to be 0.691 between EAT and LVM and 0.677 between EAT and LVMI, indicating strong positive correlation between EAT and both LVM and LVMI. This implies that as; EAT increases, LVM and LVMI increases significantly.Conclusions: Thus, authors have found that EAT is positively correlated with LVM and LVMI. So, we can say that increase in EAT may lead to adverse cardiovascular outcome in patients with essential hypertension.

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Epicardial adipose tissue is independently associated with increased left ventricular mass in untreated hypertensive patients: an observational study

Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology ◽

10.5152/akd.2013.099 ◽

2013 ◽

Cited By ~ 1

Author(s):

Turan Erdogan ◽

Mustafa Cetin ◽

Sinan Altan Kocaman ◽

Murtaza Emre Dorukoglugil ◽

Elif Ergul ◽

...

Keyword(s):

Adipose Tissue ◽

Observational Study ◽

Left Ventricular Mass ◽

Epicardial Adipose Tissue ◽

Left Ventricular ◽

Hypertensive Patients ◽

Ventricular Mass

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Relation between epicardial adipose tissue and left ventricular mass

The American Journal of Cardiology ◽

10.1016/j.amjcard.2004.06.075 ◽

2004 ◽

Vol 94 (8) ◽

pp. 1084-1087 ◽

Cited By ~ 184

Author(s):

Gianluca Iacobellis ◽

Maria Cristina Ribaudo ◽

Alessandra Zappaterreno ◽

Concetta Valeria Iannucci ◽

Frida Leonetti

Keyword(s):

Adipose Tissue ◽

Left Ventricular Mass ◽

Epicardial Adipose Tissue ◽

Left Ventricular ◽

Ventricular Mass

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Impact of epicardial adipose tissue accumulation on left ventricular mass and hypertrophy in non-obstructive coronary artery disease

European Heart Journal ◽

10.1093/eurheartj/ehab724.1266 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

I Khan ◽

I Eskerud ◽

T H Larsen ◽

C A Berge ◽

E R Pedersen ◽

...

Keyword(s):

Coronary Artery Disease ◽

Adipose Tissue ◽

Coronary Artery ◽

Left Ventricular Mass ◽

Epicardial Adipose Tissue ◽

Obstructive Coronary Artery Disease ◽

Calcium Score ◽

Left Ventricular ◽

Ventricular Mass ◽

Artery Disease

Abstract Introduction Increased left ventricular mass index (LVMi) and left ventricular hypertrophy (LVH) by echocardiography are common in obesity and important cardiovascular risk predictors associated with myocardial ischemia in non-obstructive coronary artery disease (CAD). Accumulation of epicardial adipose tissue (EAT) suggest a possible direct impact on LVMi and LVH. Purpose To explore the association between EAT volume, LVMi and LVH in patients with chest pain and non-obstructive CAD. Methods We included 129 patients with chest pain and non-obstructive CAD (<50% stenosis) by coronary computed tomography (CT) angiography. EAT volume was quantified using a semiautomatic analysis software on non-contrast cardiac CT images. Patients were grouped according to EAT volume, where high EAT volume was adjudicated when EAT volume was in the highest tertile (≥125 ml). Left ventricular mass was assessed by echocardiography, calculated by the Devereux formula and indexed for height in the allometric power of 2.7 (LVMi). LVH was defined as LVMi >46.7 g/m2.7 in women and >49.2 g/m2.7 in men. Coronary artery plaque burden was assessed as calcium score and segment involvement score on coronary CT angiography. Results High EAT volume was more common in men with higher BMI, waist circumference, serum triglycerides and higher prevalence of hypertension and obesity (all p<0.05). Age, coronary calcium score and coronary artery segment involvement score did not differ between groups. Patients with high EAT volume had higher LVMi compared to those with low EAT volume (42.5 g/m2.7 vs. 36.1 g/m2.7, p=0.003), while there was no difference in EAT volume among patients with or without LVH. In univariable logistic regression analysis, high EAT volume was associated with higher LVMi (OR 1.05 [95% CI 1.01–1.10] per g/m2.7, p=0.015). After adjusting for hypertension and obesity in a multivariable model, higher LVMi remained significantly associated with high EAT volume (Model 1, Table 1), but the association was attenuated after adjusting for sex (Model 2, Table 1). Conclusion High EAT volume was associated with increased LVMi in patients with non-obstructive CAD, independent of hypertension and obesity, while there was no association with LVH. This suggest that direct infiltration of adipose tissue in the myocardium may contribute to the development of increased LVMi. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Western Norwegian Regional Health Authorities Table 1

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The Relationship Between Syndrome X and Left Ventricular Hypertrophy: The Impact Of Different Methods of Adjusting Left Ventricular Mass.

Circulation ◽

10.1161/circ.103.suppl_1.9998-67 ◽

2001 ◽

Vol 103 (suppl_1) ◽

pp. 1363-1364

Author(s):

Heidi M Guyer ◽

Manel Pladevall ◽

Aina M Yanez ◽

Carles Falces ◽

Josep Sadurni ◽

...

Keyword(s):

Insulin Resistance ◽

Left Ventricular Hypertrophy ◽

Left Ventricular Mass ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Syndrome X ◽

Adjustment Method ◽

Ventricular Mass ◽

The Impact ◽

The Relationship

P67 Left ventricular hypertrophy is associated with the various elements of the insulin resistance syndrome (Syndrome X) including insulin resistance, hypertension, diabetes, dyslipidemia and obesity. There is no current consensus on the correct method of adjusting left ventricular mass (LVM). Objective: To determine the variation in the relationship between left ventricular hypertrophy (LVH)and Syndrome X when LVM is adjusted for height, height 2.7 and body surface area (BSA) in a population based study. Methods:LVM was measured echocardiographically in 442 participants aged 35 to 65 years. Results: The prevalence of LVH ranged from 15.6% to 33.9% depending on adjustment method. The correlation between LVH and Syndrome X components varied by adjustment criteria and by sex. In men, LVH was only correlated with blood pressure and obesity measurements. In women, LVH was correlated with all Syndrome X components except HDL cholesterol. Regardless of adjustment method, women with Syndrome X were more likely to have LVH than those without Syndrome X, although the magnitude of the relationship varied by LVM adjustment (LVM/height 2.7 : OR 16.6, 95% CI: 6.7 41.1; LVM/BSA: OR 5.8, 95% CI: 2.6-12.9). In men, the relationship between Syndrome X and LVH was significant when LVM was adjusted for height 2.7 (OR 3.0, 95% CI: 1.4-6.7) but not when adjusted for BSA (OR 1.2, 95% CI: 0.4-3.5). Conclusions:Both the prevalence of LVH and the relationship between LVH and Syndrome X are dependent on the method used to adjust LVM. When LVM is adjusted for height 2.7 , LVH is more prevalent and the relationship with Syndrome X is stronger than when adjusted for BSA. Regardless of adjustment method, the relationship between Syndrome X and LVH is much stronger in women than men. The LVM adjustment method employed is important to take into account both in epidemiological studies and clinical practice.

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