358. Early Cardiac Marker of Mortality in COVID-19

Abstract Background Epicardial adipose tissue (EAT) is a highly inflammatory depot of fat, with high concentrations of IL-6 and macrophages, which can directly reach the myo-pericardium via the vasa vasorum or paracrine pathways. TNF-α and IL-6 diminish cardiac inotropic function, making EAT inflammation a potential cause of cardiac dysfunction. Methods A retrospective cohort study assessing EAT Thickness and Density from CT scans, without contrast, from adult patients during index admission for COVID-19 infection at Mount Sinai Medical Center from March 2020 to January 2021. A total of 1,644 patients were screened, of which 148 patients were included. Follow-up completed until death or discharge. The descriptive analysis was applied to the general population, parametric test of normality for comparisons between groups. Kaplan survival analysis was conducted after survival distribution was confirmed significant. It was followed by the assumption of normality by Q-Q Plot, prior to performing a multiple regression analysis in the vulnerable group using a K-Matrix input for cofounders. A log-rank test was conducted to determine differences in the survival distributions for the different ranges of EAT thickness. Results A total of 148 Participants were assigned to two groups based on epicardial adipose tissue in order to classify them as increased or decreased risk of cardiovascular risk: >5mm (n = 99), < 5mm (n = 49). The survival percentage was higher in the group with no EAT inflammation compared to the group with EAT inflammation (95.0% and 65%, respectively). Participants with EAT >5mm had a median day of hospital stay of 18 (95% CI, 16.86 to 29.92). The survival distributions for the two categories were statistically significantly different, χ2(2) = 6.9, p < 0.01. A Bonferroni correction was made with statistical significance accepted at the p < 0.025 level. There was a statistically significant difference in survival distributions for the EAT >5 mm vs EAT < 5 mm, χ2(1) =6.953, p = 0.008. EAT Thickness Survival Analysis 2020-2021 COVID-19 MSMC Scatter Plot Length of Stay by EAT Thickness Conclusion There was an association with increased EAT thickness and increased mortality. These findings suggest that EAT thickness can be used as a prognostic factor and as a risk factor for increased mortality in patients with COVID-19 Disclosures All Authors: No reported disclosures

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Survival Analysis of Hungarian Large White, Duroc and Pietrain Sows

Acta Agraria Debreceniensis ◽

10.34101/actaagrar/69/1784 ◽

2016 ◽

pp. 31-36

Author(s):

Ágnes Baginé Hunyadi ◽

Szilvia Kusza ◽

Péter Balogh

Keyword(s):

Survival Analysis ◽

Rank Test ◽

Large White ◽

Chi Square ◽

Survival Percentage ◽

Kaplan Meier ◽

Significant Difference ◽

Chi Square Test ◽

Single Factor Analysis ◽

The Individual

The aim of the present study was to perform lifetime performance analysis in three pig breeds; Hungarian Large White (n=295), Duroc (n=76) and Pietrain (n=91) on a commercial farm using analysis of survival sows. We took into consideration the age of sows at the time of their inclusion into breeding, their age at the time of culling, time spent in production, number of mating and parities, parity percentage, intervals between litters, number and mean of piglets born alive and born dead, number of raised piglet litters, number and mean of 21 days old piglets, the weight and mean of raised litter and raise percentage. We carried out the analysis by SPSS 22.0. Single factor analysis of variants, Kaplan-Meier analysis and Cox PH model were used. The determination of the significance of risk rates differences was done by Wald chi square test. Our results showed that the average culling age were 1056 (±33.52) days for the Hungarian Large White, 735 (±73.56) days for Duroc and 818 (±71.98) days for the Pietrain. The log rank test of the survival analysis indicated a significant difference between the three tested genotypes (χ2=16.981, P<0.001), which means that the survival percentage of the individual breeds varied significantly from one another. In comparison with the Hungarian Large White genotype the Duroc genotype has a 1.6 times higher (P<0.001) culling risk while that of the genotype Pietrain was 1.36 times higher (P<0.001). Our results can be used to compare the breeds kept under the same conditions and to compare the life span of one genotype under different farming conditions. Factors that increase survival and improve the profitability of pig farming can be determined by this method.

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Microbial Air Contamination in an Intensive Care Unit

International Journal of Public Health Science (IJPHS) ◽

10.11591/.v4i3.4725 ◽

2015 ◽

Vol 4 (3) ◽

pp. 145

Author(s):

Chih-Yi Chang ◽

Liang Tseng ◽

Lung-Shih Yang

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Medical Center ◽

Statistical Significance ◽

Incidence Density ◽

Air Contamination ◽

Care Services ◽

Air Sampler ◽

Significant Difference ◽

Central Taiwan

Unit layout affects every aspect of intensive care services, including patient safety. A previous study has shown that patients admitted to beds adjacent to the sink and to the door of a large bayroom had the highest number of positive blood cultures and the highest blood culture incidence density, respectively. The present study measures microbial air contamination in a medical intensive care unit of a medical center in central Taiwan. Of the 17 rooms, 8 rooms with distinct physical environmental characteristics were selected. Sampling tests were conducted between December 2013 and February 2014 with a microbial air sampler (MAS-100NT). TSA was used for bacteria collection and DG18 for fungi collection. The overall average bacterial and fungal concentrations were 83CFU/m3 and 69CFU/m3, respectively. The ranges were between 8-354 CFU/m3 and 0-1468 CFU/m3, respectively. A significant difference was found in the bacterial concentration (p=.005) between different room locations. The highest concentration was found in the rooms located at the front end of the circulation (99 CFU/m3), while the lowest was found in the rooms located at the rear end of the circulation (55CFU/m3). Differences in fungal concentrations for different room locations did not reach statistical significance. In addition, differences in bacterial and fungal concentrations for rooms with different sink locations did not reach statistical significance. Even though the microbial concentrations generally complied with standards, the results may help designers and hospital administrators develop a healthier environment for patients.

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The IC50 Assay Is Predictive of Molecular Response, and Indicative of Optimal Dose in De-Novo CML Patients.

Blood ◽

10.1182/blood.v112.11.1109.1109 ◽

2008 ◽

Vol 112 (11) ◽

pp. 1109-1109

Author(s):

Deborah L White ◽

Verity A Saunders ◽

Thea Kalebic ◽

Timothy P Hughes

Keyword(s):

De Novo ◽

Statistical Significance ◽

Continuous Variable ◽

Rank Test ◽

P Value ◽

Molecular Response ◽

Optimization Strategy ◽

Log Reduction ◽

Significant Difference ◽

The Impact

Abstract We have previously demonstrated significant interpatient variability in the IC50imatinib, a measure of the intrinsic sensitivity of a patient to imatinib induced kinase inhibition. Furthermore, this measure is predictive of the achievement of major molecular response (MMR > 3 log reduction in BCR-ABL) in de-novo CML patients treated with imatinib (n=60)1. In an expanded patient pool (n=116) we now perform an evaluation of the IC50 as a predictor of response, and address the IC50imatinib as a guide to dose selection. Samples were obtained with informed consent from de novo CML patients enrolled to either the TIDEL (600mg imatinib) or TOPS (randomised 400mg vs 800mg imatinib) trials. Blood was collected pre therapy, and the IC50 was performed as previously1. Outcome data was assessed using Kaplan Meier Analysis and the log rank test was used to assess statistical significance. In our previous analysis the IC50imatinib was divided about the median value for the cohort (0.6μM) into low and high IC50, with a significantly greater proportion of patients with low IC50imatinib achieving MMR by 12 months. In this expanded patient pool, we confirm this finding (<median of 0.7μM for this patient group) (low IC50 65% of patients achieve MMR by 12 mo vs high IC50 39% of patients p=0.014) Dividing the IC50’s into quartiles we now demonstrate that the IC50imatinib is a continuous variable with a greater proportion of patients in the lower quartile achieving MMR than those in the higher (Table 1 Total). Addressing the issue of dose we demonstrate that no patients with IC50>0.95uM achieve MMR on 400mg, and that this is statistically significantly when compared to all other groups. At 600mg while there is no overall significant difference there is a statistically relevant difference between groups 1, 2 and 4 as indicated. In contrast, at 800 mg the effect of IC50imatinib is overcome. MMR by 12 months Total 400mg 600mg 800mg p value Group1 <0.5μM 67% (27) 83% (12)* 50% (8)* 86% (7) 0.470 Group 2 >0.5<0.7μM 63% (30) 67% (6)* 53% (17)* 71% (7) 0.337 Group 3 >0.7<0.95μM 45% (31) 40%(5)* 30% (10) 56% (16) 0.139 Group 4>0.95μM 32% (28) 0% (7)* 22% (9)* 58% (12) 0.016 P value 0.042 0.018 0.108 0.778 Table 1: Dividing the patients into quartile based on the IC50 imatinib and assessing the Impact of dose on the achievement of MMR by 12 month. *p value <0.05 between groups (n). The failure to achieve a Complete Cytogenetic Response by 12 months is considered a suboptimal response. Assessing the molecular equivalent (≥2 log reduction in BCR-ABL) we demonstrate that a significantly greater proportion of patients with IC50imatinib>0.7μM fail to achieve a 2 log reduction when treated with 400mg (IC50 <0.7μM 11%: >0.7μM 33% p=0.034), and 600mg (IC50 <0.7μM 12%: >0.7μM 22% p=0.036). However, there is no significant difference in the 800mg patient cohort (IC50 <0.7μM 7%: >0.7μM 14% p=0.79). This analysis confirms that the IC50imatinib, is predictive of imatinib response. Patients with an IC50imatinib <0.7μM are likely to respond well to doses of 400mg imatinib, as suggested by evaluation of statistically relevant outcome benefit. In contrast patients with higher IC50imatinib (>0.7μM) may benefit from higher dosing regimens (p=0.012). Thus, the accurate assessment of IC50imatinib could support dose optimization strategy for patients with a suboptimal response.

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Radiotherapy planning study comparing volumetric modulated arc therapy (VMAT) with intensity modulated radiotherapy (IMRT) in the treatment of bladder and pelvic lymph nodes.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.5_suppl.320 ◽

2012 ◽

Vol 30 (5_suppl) ◽

pp. 320-320

Author(s):

Victoria Harris ◽

Karole Warren-Oseni ◽

Robert Anthony Huddart

Keyword(s):

Low Dose ◽

Treatment Time ◽

Statistical Significance ◽

Volumetric Modulated Arc Therapy ◽

Radiotherapy Planning ◽

Rank Test ◽

Attractive Alternative ◽

Planning Study ◽

Significant Difference ◽

3D Crt

320 Background: VMAT is increasingly used as an alternative to IMRT and has been shown to reduce treatment time and monitor units delivered. We report a radiotherapy (RT) planning study of bladder and pelvic lymph node (LN) RT comparing dosimetric outcomes of VMAT and IMRT techniques. Methods: 8 patients with/at high risk of LN+ bladder cancer were treated with bladder/pelvic LN IMRT. 4 clinical target volumes (CTVs) were defined: Whole bladder (CTV1), Pelvic LN (CTV2), Involved Bladder (CTV3) and Involved LNs (CTV4). Margins were applied to create 4 corresponding PTVs. IMRT plans were compared with VMAT plans in order to assess planning target volume (PTV) and organ at risk (OAR) coverage. The same PTV/OAR volumes and doses were used for each technique. Results: The mean dose statistics were compared for each dosimetric parameter for both techniques. The Wilcoxon signed-rank test was used to compare techniques with statistical significance assumed as p<0.05. Both techniques met prescription goals for PTV coverage. Comparison of conformity indices revealed no significant difference between techniques. VMAT achieved significantly better homogeneity in coverage of PTV2, although this finding was not replicated in the other PTVs (Table). Homogeneity index (HI) was defined as HI = 100x(D2-D98)/ Dp, where Dp = prescribed dose. VMAT resulted in significantly larger volumes of bowel (4.7%) and rectum (4.8%) receiving low dose radiation (15 Gy) than IMRT, although there was no significant difference seen at higher dose levels. Comparison with 3D conformal radiotherapy (3D-CRT) showed that both techniques resulted in a large reduction in bowel irradiation to 45Gy (IMRT = 123cc, VMAT = 145cc and 3D-CRT = 218cc). Conclusions: VMAT offers an attractive alternative to IMRT with similar conformality. Whilst increased low dose RT to OARs was seen with VMAT, it is of doubtful significance relative to the higher doses received by these structures. [Table: see text]

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Association of Epicardial Adipose Tissue with Essential Hypertension: A Meta-Analysis

10.21203/rs.3.rs-684093/v1 ◽

2021 ◽

Author(s):

Xinyu Zou ◽

Yingrui Li ◽

Qiang She ◽

Bin Liu

Keyword(s):

Cardiovascular Disease ◽

Adipose Tissue ◽

Essential Hypertension ◽

Odds Ratio ◽

Observational Studies ◽

Epicardial Adipose Tissue ◽

Meta Analysis ◽

Hypertensive Patients ◽

New Information ◽

Significant Difference

Abstract Background and aims: Increased epicardial adipose tissue (EAT) has been proposed as a risk factor for essential hypertension (EH). The aim of this study was to investigate the association of EAT with EH.Methods and results: PubMed, EMBASE, and Cochrane databases were systematically reviewed to identify relevant studies assessing the association of EAT thickness (EAT-t) and volume (EAT-v) with EH. There were 39 observational studies and 8,983 subjects included in the meta-analysis. The analysis indicated that hypertensive patients had a higher mean of EAT-t (SMD=0.64, 95% CI: 0.44-0.83, p<0.001) and EAT-v (SMD: 0.69, 95% CI:0.34-0.1.05, p<0.001) than normotensive individuals. Accordingly, we calculated pooled odds ratio (OR) and 95% confidence intervals (CI) for the association of EAT with EH, and the results showed that EAT-t (OR: 1.59, 95% CI: 1.09–2.33, P<0.001) and EAT-v (OR: 1.82, 95% CI: 1.33–2.19, P<0.001) were associated with essential hypertension. Additionally, higher mean of EAT-t (SMD=0.85, 95% CI=0.49-0.1.21, p<0.001) and EAT-v (SMD=0.83, 95% CI=0.31-1.34, p=0.002) were found in non-dipper hypertensive patients than those in dipper patients, but we didn’t find significant difference in EAT-t among patients with different grades of hypertension. We also investigated the association of EAT with complications in hypertensive patients, and the results showed that EAT was increased in patients with arteriosclerotic cardiovascular disease (ASCVD) or cardiac hypertrophy and dysfunction than those without. Conclusions: The increase in EAT was associated with the occurrence and complications of EH. The findings provide new information regarding the occurrence and complications of EH.

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Pancreatic Cancer Stem Cells May Define Tumor Stroma Characteristics and Recurrence Patterns in Pancreatic Ductal Adenocarcinoma

10.21203/rs.3.rs-49165/v2 ◽

2020 ◽

Author(s):

Gokce Askan ◽

Ibrahim Halil Sahin ◽

Joanne F. Chou ◽

Aslihan Yavas ◽

Marinela Capanu ◽

...

Keyword(s):

Local Recurrence ◽

Pancreatic Ductal Adenocarcinoma ◽

Statistical Significance ◽

Specific Antigen ◽

Tumor Stroma ◽

Ductal Adenocarcinoma ◽

Rank Test ◽

Stem Cell Markers ◽

Significant Difference ◽

The Impact

Abstract Background: Herein, we investigate the relationship between pancreatic stem cell markers (PCSC markers), CD44, and epithelial-specific antigen (ESA), tumor stroma, and the impact on recurrence outcomes in pancreatic ductal adenocarcinoma (PDAC) patients.Methods: PDAC patients who underwent surgical resection between 01/2012 -06/2014 were identified. CD44 and ESA expression was assessed by immunohistochemistry. Stroma was classified as loose, moderate, and dense based on fibroblast content. Overall survival (OS) and relapse-free survival (RFS) were estimated using the Kaplan-Meier method and compared between subgroups by log-rank test. The association between PCSC markers and stroma type was assessed by Fisher`s exact test. Results: N= 93 PDAC patients were identified. The number of PDAC patients with dense, moderate density, and loose stroma was 11 (12%), 51 (54%), and 31 (33%) respectively. PDAC with CD44+/ESA- had highest rate of loose stroma (63%) followed by PDAC CD44+/ESA+ (50%), PDAC CD44-/ESA+ (35%), CD44-/ESA- (9%) (p=0.0033). No local recurrence was observed in patients with dense stroma and 9 had distant recurrence. The highest rate of cumulative local recurrence observed in patients with loose stroma. No statistically significant difference in RFS and OS were observed among subgroups (P=0.089). Conclusions: These data indicate PCSCs may have an important role in stroma differentiation in PDAC. Although not reaching statistical significance, we observed more local recurrences in patients with loose stroma, and no local recurrence was seen in patients with dense stroma suggesting tumor stroma may influence the recurrence pattern in PDAC patients.

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CT-derived characterization of pericoronary, paracardial and epicardial adipose tissue and its association with myocardial ischemia as assessed by adenosine stress CMR perfusion imaging

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeab090.008 ◽

2021 ◽

Vol 22 (Supplement_2) ◽

Author(s):

M Goeller ◽

H Duncker ◽

D Dey ◽

M Moshage ◽

D Bittner ◽

...

Keyword(s):

Adipose Tissue ◽

Myocardial Ischemia ◽

Perfusion Imaging ◽

Epicardial Adipose Tissue ◽

Adenosine Stress ◽

Single Centre ◽

Ct Attenuation ◽

Significant Difference ◽

Single Centre Study ◽

Stress Cmr

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Kaltenbach scholarship of the german heart foundation Background Increased attenuation of pericoronary adipose tissue (PCAT) around the right coronary artery (RCA) is a new imaging biomarker to detect coronary inflammation derived from routine coronary CT angiography (CTA) and has been shown to be associated with cardiac mortality. Increased volume of epicardial adipose tissue (EAT) has been reported be associated with myocardial ischemia. Purpose We aimed to investigate for the first time a potential association between CTA-derived PCAT measures and myocardial ischemia as assessed by adenosine stress CMR perfusion imaging. Methods In this single-centre study 109 stable individuals (mean age of 62 ± 11 years, 77% males) with coronary artery disease underwent CTA followed by adenosine stress CMR perfusion imaging to detect myocardial ischemia. PCAT CT attenuation (HU) and PCAT volume (cm³) was measured around the RCA (10 to 50 mm from RCA ostium), the proximal 40 mm of the left anterior descending artery (LAD) and the circumflex artery (LCX) using semi-automated software. Per patient PCAT CT attenuation was calculated as followed: (PCAT attenuation of RCA + LAD + LCX)/3). Non-contrast CT data sets were used for coronary calcium scoring and the quantification of EAT (located between the myocardial surface and the pericardium) and paracardial adipose tissue (PAT; intrathoracic and outside of the pericardium). Results Between patients with evidence of significant myocardial ischemia as assessed by adenosine stress CMR (n = 35) and patients without myocardial ischemia (n = 74) there was no significant difference in the PCAT CT attenuation of RCA (-85.3 vs. -85.7 HU, p = 0.87), LAD (-84.8 vs. -85.7 HU, p = 0.66) and LCX (-82.8 vs. -83.2 HU, p = 0.79) as well as in the per patient PCAT CT attenuation (-84.2 vs. -84.9 HU, p = 0.76). Neither did patients with myocardial ischemia within the RCA territory show increased RCA PCAT CT attenuation (-87.7 vs. -85.3 HU, p = 0.40); nor was such a relationship found for the territory of the LAD (-80.6 vs. 85.8 HU, p = 0.11) or LCX (-83.1 vs. -83.0 HU, p = 0.99). The CT attenuation of EAT (-77.9 vs. -78.7 HU, p = 0.65) and PAT (-89.9 vs. -90.0 HU, p = 0.93) did not differ significantly between patients with myocardial ischemia compared to patients without myocardial ischemia. Between patients with myocardial ischemia and patients without myocardial ischemia there was no significant difference in the volumes of EAT (118.1 vs. 110.6 cm³, p = 0.55), PAT (279.5 vs. 240.9 cm³, p = 0.20) and the per patient PCAT volume (1021.9 vs. 1015.5 cm³, p = 0.90). In logistic regression analysis the volume and CT attenuation of the different intrathoracic fat compartments PCAT, EAT and PAT were not independently associated with the presence of myocardial ischemia (n.s.). Conclusions In this single-centre study CTA-derived quantified CT attenuation and volume of PCAT, EAT and PAT were not associated with myocardial ischemia as assessed by adenosine stress CMR perfusion imaging.

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Quantification of Epicardial Fat using 3D Cine Dixon MRI

10.21203/rs.3.rs-26979/v1 ◽

2020 ◽

Author(s):

Markus Henningsson ◽

Martin Brundin ◽

Tobias Scheffel ◽

Carl Edin ◽

Federica Viola ◽

...

Keyword(s):

Adipose Tissue ◽

Measurement Error ◽

Single Phase ◽

Image Quality Assessment ◽

Epicardial Adipose Tissue ◽

Interquartile Range ◽

Epicardial Fat ◽

Observer Variability ◽

Inter Observer Variability ◽

Significant Difference

Abstract Background There is an increased interest in quantifying and characterizing epicardial fat which has been linked to various cardiovascular diseases such as coronary artery disease and atrial fibrillation. Recently, three-dimensional single-phase Dixon techniques has been used to depict the heart and to quantify the surrounding fat. The purpose of this study was to investigate the merits of a new high-resolution cine 3D Dixon technique for quantification of epicardial adipose tissue and compare it to single-phase 3D Dixon in patients with cardiovascular disease.Methods Fifteen patients referred for clinical CMR examination of known or suspected heart disease were scanned on a 1.5T scanner using single-phase Dixon and cine Dixon. Epicardial fat was segmented by three readers and intra- and inter-observer variability was calculated per slice. Cine Dixon segmentation was performed in the same cardiac phase as single-phase Dixon. Subjective image quality assessment of water and fat images were performed by three readers using a 4-point Likert scale (1 = severe; 2 = significant; 3 = mild; 4 = no blurring of cardiac structures).Results Intra-observer variability was excellent for cine Dixon images (ICC = 0.96), and higher than single-phase Dixon (ICC = 0.92). Inter-observer variability was good for cine Dixon (ICC = 0.76) and moderate for single-phase Dixon (ICC = 0.63). The intra-observer measurement error (mean ± standard deviation) per slice for cine was − 0.02 ± 0.51 ml (-0.08 ± 0.4%), and for single-phase 0.39 ± 0.72 ml (0.18 ± 0.41%). Inter-observer measurement error for cine was 0.46 ± 0.98 ml (0.11 ± 0.46%) and for single-phase 0.42 ± 1.53 ml (0.17 ± 0.47%). Visual scoring of the water image yielded median of 2 (interquartile range = [Q3-Q1] 2–2) for cine and median of 3 (interquartile range = 3 − 2) for single-phase (P < 0.05) while no significant difference was found for the fat images, both techniques yielding a median of 3 and interquartile range of 3 − 2.Conclusion Cine Dixon can be used to quantify epicardial fat with lower intra- and inter-observer variability compared to standard single-phase Dixon. The time-resolved information provided by the cine acquisition appears to support the delineation of the epicardial adipose tissue depot.

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Visceral Adiposity Associates With Malnutrition Risk Determined by Royal Free Hospital-Nutritional Prioritizing Tool in Cirrhosis

Frontiers in Nutrition ◽

10.3389/fnut.2021.766350 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xiaoyu Wang ◽

Yifan Li ◽

Mingyu Sun ◽

Gaoyue Guo ◽

Wanting Yang ◽

...

Keyword(s):

Adipose Tissue ◽

Subcutaneous Adipose Tissue ◽

Statistical Significance ◽

Visceral Adiposity ◽

Royal Free Hospital ◽

Significant Difference ◽

Total Adipose Tissue ◽

Male Patients ◽

Visceral Adipose ◽

Subcutaneous Adipose

Mounting evidence has suggested the clinical significance of body composition abnormalities in the context of cirrhosis. Herein, we aimed to investigate the association between visceral adiposity and malnutrition risk in 176 hospitalized patients with cirrhosis. The adiposity parameters were obtained by computed tomography (CT) as follows: total adipose tissue index (TATI), visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), and visceral to subcutaneous adipose tissue area ratio (VSR). Malnutrition risk was screened using Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT). Visceral adiposity was determined given a higher VSR based on our previously established cutoffs. Multivariate analysis implicated that male gender (OR = 2.884, 95% CI: 1.360–6.115, p = 0.006), BMI (OR = 0.879, 95% CI: 0.812–0.951, P = 0.001), albumin (OR = 0.934, 95% CI: 0.882–0.989, P = 0.019), and visceral adiposity (OR = 3.413, 95% CI: 1.344–8.670, P = 0.010) were independent risk factors of malnutrition risk. No significant difference was observed regarding TATI, SATI, and VATI among patients with low or moderate and high risk of malnutrition. In contrast, the proportion of male patients embracing visceral adiposity was higher in high malnutrition risk group compared with that in low or moderate group (47.27 vs. 17.86%, p = 0.009). Moreover, this disparity was of borderline statistical significance in women (19.05 vs. 5.88%, p = 0.061). Assessing adipose tissue distribution might potentiate the estimation of malnutrition risk in cirrhotics. It is pivotal to recognize visceral adiposity and develop targeted therapeutic strategies.

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Quantification of epicardial fat using 3D cine Dixon MRI

10.21203/rs.3.rs-26979/v2 ◽

2020 ◽

Author(s):

Markus Henningsson ◽

Martin Brundin ◽

Tobias Scheffel ◽

Carl Edin ◽

Federica Viola ◽

...

Keyword(s):

Adipose Tissue ◽

Measurement Error ◽

Single Phase ◽

Image Quality Assessment ◽

Epicardial Adipose Tissue ◽

Interquartile Range ◽

Epicardial Fat ◽

Observer Variability ◽

Inter Observer Variability ◽

Significant Difference

Abstract Background: There is an increased interest in quantifying and characterizing epicardial fat which has been linked to various cardiovascular diseases such as coronary artery disease and atrial fibrillation. Recently, three-dimensional single-phase Dixon techniques have been used to depict the heart and to quantify the surrounding fat. The purpose of this study was to investigate the merits of a new high-resolution cine 3D Dixon technique for quantification of epicardial adipose tissue and compare it to single-phase 3D Dixon in patients with cardiovascular disease. Methods: Fifteen patients referred for clinical CMR examination of known or suspected heart disease were scanned on a 1.5T scanner using single-phase Dixon and cine Dixon. Epicardial fat was segmented by three readers and intra- and inter-observer variability was calculated per slice. Cine Dixon segmentation was performed in the same cardiac phase as single-phase Dixon. Subjective image quality assessment of water and fat images were performed by three readers using a 4-point Likert scale (1=severe; 2=significant; 3=mild; 4=no blurring of cardiac structures).Results: Intra-observer variability was excellent for cine Dixon images (ICC=0.96), and higher than single-phase Dixon (ICC=0.92). Inter-observer variability was good for cine Dixon (ICC=0.76) and moderate for single-phase Dixon (ICC=0.63). The intra-observer measurement error (mean ± standard deviation) per slice for cine was -0.02±0.51 ml (-0.08±0.4%), and for single-phase 0.39±0.72 ml (0.18±0.41%). Inter-observer measurement error for cine was 0.46±0.98 ml (0.11±0.46%) and for single-phase 0.42±1.53 ml (0.17±0.47%). Visual scoring of the water image yielded median of 2 (interquartile range = [Q3-Q1] 2-2) for cine and median of 3 (interquartile range = 3-2) for single-phase (P < 0.05) while no significant difference was found for the fat images, both techniques yielding a median of 3 and interquartile range of 3-2. Conclusion: Cine Dixon can be used to quantify epicardial fat with lower intra- and inter-observer variability compared to standard single-phase Dixon. The time-resolved information provided by the cine acquisition appears to support the delineation of the epicardial adipose tissue depot.

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