Quantification of epicardial fat with cardiac CT and association with cardiovascular risk factors and obstructive coronary disease

Abstract Introduction Recent studies advocate epicardial fat (EF) as a biologically active organ that influence coronary atherosclerosis development through endocrine and paracrine pathways. We aim to study the relations between EF, thoracic adipose tissue (TAT), cardiovascular risk factors (CRF) and obstructive coronary disease (OCD). Methods Retrospective analysis of patients (pts) referred to 64-multislice cardiac computed tomography (CT) in one center. The authors underwent a standardized protocol for quantification of EAT, TAT (subcutaneous and visceral), abdominal visceral fat, coronary calcium score and angiography. Results Total of 178 pts: male 99 (56%), mean age 65.9±12.9 years. Indications for performing CT were coronary disease (76%), valvular heart disease (15%), atrial fibrillation (6%) and congenital heart disease (2%). Regarding CRF, EF was only significant higher in patients with diabetes (115±60 vs 95±47, p=0.018), in male gender (114±60 vs 91±42, p=0.04) and was linear correlated with age (p=0.004). The authors also found that EF volume is significant higher in patients with typical angina (p=0.02) and with coronary atherosclerosis: non-obstructive (p=0.0049) and OCD (p=0.001) – Graphic 1. ROC analysis of EF (AUC 0.659, p=0.0039) and EF/TAT relation (AUC 0.704, p=0.003) allowed to estimate that EF>100 ml and EF/TAT >0.06 had a sensibility to predict OCD of 53% and 58%, respectively, and specificity of 66% and 60%. We did not find a correlation between EF, EF/TAT or TAT and coronary calcium score. Conclusion EF is higher in patients with diabetes and coronary atherosclerosis. EF and EF/TAT relation had moderate sensibility and specificity to predict OCD, irrespective of calcium score. EF and EF/TAT are promising atherosclerotic markers that could be routinely use in the near future. FUNDunding Acknowledgement Type of funding sources: None.

Download Full-text

The association of coronary calcium score and conventional cardiovascular risk factors in Type 2 diabetic subjects asymptomatic for coronary heart disease (The PREDICT Study)

Diabetic Medicine ◽

10.1111/j.1464-5491.2004.01409.x ◽

2004 ◽

Vol 21 (10) ◽

pp. 1129-1134 ◽

Cited By ~ 36

Author(s):

R. S. Elkeles ◽

M. D. Feher ◽

M. D. Flather ◽

I. F. Godsland ◽

F. Nugara ◽

...

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Calcium Score ◽

Coronary Calcium Score ◽

Predict Study ◽

Type 2 Diabetic

Download Full-text

Potential determinants of coronary calcium score in a population at intermediate cardiovascular risk

European Heart Journal ◽

10.1093/ehjci/ehaa946.2945 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C Brusq ◽

V Bongard ◽

E Berard ◽

D Taraszkiewicz ◽

J Ferrieres

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Multinomial Logistic Regression ◽

Calcium Score ◽

Coronary Calcium ◽

Coronary Calcium Score ◽

High Calcium ◽

History Of

Abstract Background Understanding determinants of coronary calcium score could lead to the development of new preventive actions for reducing cardiovascular risk. Our hypothesis is that major cardiovascular risk factors are linked with coronary calcium score, but the parameters associated with moderate or high scores could be different. Purpose The aim of our study was to explore the potential determinants of moderate and high elevation of coronary calcium score in a population of patients at intermediate cardiovascular risk. Methods We conducted a cross-sectional analysis, using data from a prospective cohort. Our study population was composed of people presenting with cardiovascular risk factors, who were referred by their attending physician for a complete assessment of their risk factors and for screening for silent cardiovascular disease. People in secondary prevention could also be referred. Coronary calcium score was assessed by cardiac CT scan. We used the following categories for classifying patients according to their coronary calcium score: low (0–100 AU (Agatston units)); moderate (101–300 AU) and high calcium score (greater than 300 AU). We performed a descriptive analysis and then we built a multinomial logistic regression model, using the low calcium score category as reference. Results Among the 1585 patients included in the database, we analyzed data from 1402 individuals who beneficiated from coronary calcium scoring. The sample included 714 (51%) men, and 144 (10%) people with a history of cardiovascular disease. Mean age was 59 yrs. Data from the multivariate analysis showed that age (OR=1.07; 95% CI [1.054–1.091] for 1-year increase), gender (OR=0.461; 95% CI [0.330–0.643] for women versus men) and smoking more than 20 cigarettes per day (OR=2.893; 95% CI [1.207–6.935]) were associated with a moderate calcium score. Variables associated with a high calcium score were: age (OR=1.097; 95% CI [1.076–1.119] for 1-year increase), gender (OR=0.221; 95% CI [0.151–0.323] for women vs men), treated dyslipidemia (OR=2.108; 95% CI [1.467–3.027]), treated hypertension (OR=2.199; 95% CI [1.523–3.175]), and history of cardiovascular disease (OR=4.138; 95% CI [2.510–6.823]). Conclusions In this study, well-known and modifiable cardiovascular risk factors are associated with calcium score. However, our results highlight that determinants of moderate and high scores may be different. While tobacco is associated with a higher risk of moderate calcium score, hypertension and dyslipidemia appear to be preferentially linked with the highest scores. It is thus appropriate that the 2019 ESC/EAS guidelines for dyslipidemias have classified patients with hypertension and dyslipidemia in the high risk category. Funding Acknowledgement Type of funding source: None

Download Full-text

Coronary Calcium Score May Replace Cardiovascular Risk Factors as Primary Risk Stratification Tool Before Kidney Transplantation

Transplantation Journal ◽

10.1097/tp.0000000000000992 ◽

2016 ◽

Vol 100 (10) ◽

pp. 2177-2187 ◽

Cited By ~ 7

Author(s):

Simon Winther ◽

Morten Bøttcher ◽

Hanne S. Jørgensen ◽

Kirsten Bouchelouche ◽

Lars C. Gormsen ◽

...

Keyword(s):

Risk Factors ◽

Kidney Transplantation ◽

Cardiovascular Risk ◽

Risk Stratification ◽

Cardiovascular Risk Factors ◽

Calcium Score ◽

Coronary Calcium ◽

Coronary Calcium Score ◽

Risk Stratification Tool

Download Full-text

SUN-300 Improvement in Cardiovascular Risk Factors in Long Term Follow up of Hypopituitary Septagenarian and Octagenarian Patients

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.814 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Isabella Naves Rosa ◽

Alexandre Anderson S M Soares ◽

Luciana Ansaneli Naves

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Calcium Score ◽

Coronary Calcium Score ◽

Framingham Score ◽

Long Term Follow Up ◽

Pituitary Macroadenomas

Abstract Background: Hypopituitarism in the elderly population is an underdiagnosed condition and may increase co-morbidities in glucose metabolism, dyslipidemia and cardiovascular risk factors. Pituitary macroadenomas are benign tumors, which prevalence is unknown in aged people, and is frequently associated to impairment in pituitary function. Objective: The aim of this study is to identify cardiovascular risk factors in hypopituitary septagenarians and octagenarians by diagnosis and after long term follow up of pituitary dysfunction. Methods: This is a retrospective observational study and the patients were recruited and selected from a service registry in a tertiary medical center. We included patients aged from 70-99 years with the diagnosis of pituitary macroadenomas, evaluated hormonal and biochemical parameters, cardiovascular risk scores were calculated by diagnosis and compared after long term follow up. All patients signed informed consent. Results: Thirty five patients were included, 21 patients aged 70-75 years (72.61 yo), 7 patients 76-80 years (77.28yo), 7 patients 81-99 years (89.28 yo). All tumors were macroadenomas, 40% of them Non Functioning Pituitary Macroadenomas, mean maximal diameter 3.4 cm (2.9-.4.3), 40% of them submitted to surgery, 14% adjuvant radiotherapy, 20% presented previous apoplexy. Co-morbidities were frequent by diagnosis, 85.71% presented Hypertension, 37.14% Diabetes, 62.8% Hypercholesterolemia and 45.71% Hypertriglyceridemia. Hypopituitarism was present in 71.42%, GH deficiency in 37.14%, hypogonadism in 60%, central hypothyroidism in 54.28%, adrenal insufficiency in 31.42%, 51.42 % presented more than two combined deficiencies. Analysis of cardiovascular risk prediction in total cohort showed, 57.14% of patients presented reduction of Framingham Score and 45.71% in Coronary Calcium Score, during mean time follow up of 13.09 years (3-32 years after diagnosis). According to ages, Framingham score and Coronary Calcium Score reduced respectively in 66% and 33.3% (70-75 yo), 57.15% and 85.71% (76-80 yo) and 42.85% and 28.57% (81-99 yo), during long term follow up. Discussion and Conclusion: In this study, most of hypopituitary aged patients presented reduction of cardiovascular risk factors during long term treatment and follow up, despite replacement with corticosteroids and gonadal steroids. Considering the importance of early diagnosis and the lack of data observed in the medical literature, larger scale studies should be performed with the objective to assess of the risk benefit ratio of hormonal replacement in metabolic control in septagenarian and octogenarian patients.

Download Full-text