Abstract 17402: Increased Epicardial Adipose Tissue Volume is Associated With Left Ventricular Diastolic Function in Patients With Zero Coronary Artery Calcium Score

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Hiroto Utsunomiya ◽  
Hideya Yamamoto ◽  
Atsushi Shimada ◽  
Toshiro Kitagawa ◽  
Takayuki Hidaka ◽  
...  

Background: Recent publications suggested that epicardial adipose tissue (EAT) contributes to the pathogenesis of coronary atherosclerosis. Although some studies showed the association between EAT accumulation and left ventricular (LV) diastolic dysfunction, these associations are not fully understood. Methods: We evaluated 153 patients without coronary artery disease who underwent coronary computed tomography (CT) angiography and Doppler echocardiography. We evaluated 153 patients (mean age of 60 years and 54% men) with zero coronary artery calcium score in coronary CT. Visceral adipose tissue (VAT) area was simultaneously measured by abdominal scans, and EAT volume was also calculated. These measurements were corrected by body surface area; VAT area index (VATAI), and EAT volume index (EATVI). The early diastolic mitral annular velocity at the septal (septal E’) and lateral (lateral E’) were measured using tissue Doppler echocardiography. Results: The mean values of BMI, VATAI, EATVI, and LVMI were 23.7 ± 3.8 kg/m 2 , 52.6 ± 26.4 cm 2 /m 2 , 71.3 ± 29.8 cm 3 /m 2 , and 83.3 ± 17.7 g/m 2 , respectively. The mean septal E’ and lateral E’ velocities were 7.2 ± 2.2 cm/s and 9.8 ± 2.9 cm/s, respectively. Each E’ velocity was negatively correlated with EATVI (septal, R = 0.276, p < 0.001; lateral, R = 0.342, p < 0.001) and VATAI (septal, R = 0.241, p = 0.03; lateral, R = 0.255, p = 0.002; Figure). In contrast, each E’ velocity was not correlated with LVMI (septal, R = 0.161, p = 0.03; lateral, R = 0.118, p = 0.14) and BMI (septal, R = 0.182, p = 0.03; lateral, R = 0.152, p = 0.06). To determine each E’ velocity, we performed stepwise multiple regression analyses where all clinical parameters were entered. Diastolic blood pressure (p = 0.014), statin use (p = 0.011), LVMI (p = 0.003), and EATVI (p = 0.004) were independently correlated with septal E’ velocity, and statin use (p = 0.024), LVMI (p = 0.011), and EATVI (p < 0.001) were independently correlated with lateral E’ velocity. Conclusion: An increase in EATVI was associated with the decrease of early diastolic mitral annular velocity along each side of the left ventricle in patients with coronary calcium score of zero. These findings indicate that EAT accumulation may cause LV diastolic dysfunction in the early phase of coronary artery disease.

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Khan ◽  
I Eskerud ◽  
T H Larsen ◽  
C A Berge ◽  
E R Pedersen ◽  
...  

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 (&lt;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 &gt;46.7 g/m2.7 in women and &gt;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&lt;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


PLoS ONE ◽  
2012 ◽  
Vol 7 (11) ◽  
pp. e48330 ◽  
Author(s):  
Christina Doesch ◽  
Tim Süselbeck ◽  
Dariusch Haghi ◽  
Florian Streitner ◽  
Stefan O. Schoenberg ◽  
...  

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
A El Etriby ◽  
A El sherbiny ◽  
R Remone ◽  
A Mamdouh

ABSTRACT The authors in that article addressed a very important and relevant issue. Background Epicardial adipose tissue (EAT) is a complex endocrine organ that plays an important role in the development of unfavorable metabolic and cardiovascular risk profile. EAT may express a variety of inflammatory mediators which may contribute to the pathogenesis of coronary artery disease (CAD). Aortic and mitral valve calcification may reflect generalized atherosclerosis in the elderly and may be a marker of high prevalence and severity of CAD. There is a direct correlation (extent, severity and the future CV events) between the coronary artery calcium and the CAD. Aim and Objectives To correlate peri-coronary epicardial adipose tissue and coronary artery calcification and valvular (aortic and mitral) calcification with the severity of the coronary artery disease. Patients and Methods The study recruited 200 patients with suspected coronary artery disease. The amount of EAT surrounding the left main and the three main coronary arteries was quantified in axial cuts with the most distinct layer of EAT. The amount of calcium in the aortic and mitral valve and the coronaries were quantified with multi-detector computed tomography MDCT using dedicated software for measuring calcium score that is based on Agatson score. Coronary artery disease severity was assessed in terms of number of vessels affected and the severity of coronary stenosis by multi-planner reformation technique. Results Based on the finding of the MDCT and according to the presence of calcification in the aortic or the mitral valves, and the significance of the coronary artery disease, patients were classified into two groups, group (I): 115 patients with normal coronaries or with non significant lesions in their coronaries, and group (II): 85 patients with significant coronary artery disease. The Mean ± SD (in millimeters) of EAT for the entire study cohort in various coronary artery locations were as follows: LM EAT 9.82 ± 2.67, proximal LAD EAT 10.06 ± 2.80, mid LAD EAT 9.15 ± 2.41, distal LAD EAT 6.46 ± 1.87, proximal LCX EAT 8.10 ± 1.90, distal LCX EAT 6.83 ± 1.79, proximal RCA EAT 10.23 ± 2.42, mid RCA EAT 9.26 ± 2.72, distal RCA EAT 7.25 ± 2.58. Statistically highly significant difference was observed between the two groups with regards to LM EAT, proximal, mid and distal LAD EAT, proximal and distal LCX EAT, proximal, mid and distal RCA EAT (8.38 ± 2.18 Vs 11.77 ± 1.94 P: 0.000, 8.49 ± 2.21 Vs 12.18 ± 2.00, 7.93 ± 1.77 Vs 10.81 ± 2.16, 5.45 ± 1.26 Vs 7.82 ± 1.68 P: 0.000, 7.08 ± 1.34 Vs 9.46 ± 1.67, 6.05 ± 1.50 Vs 7.89 ± 1.61 P: 0.000, 9.01 ± 1.94 Vs 11.88 ± 1.99, 8.07 ± 2.32 Vs 10.86 ± 2.39, 6.31 ± 2.26 Vs 8.51 ± 2.45 P: 0.000; respectively). Statistically highly significant difference was observed between the two groups with regards calcium score and the severity of CAD in the three major vessels (LAD, LCX and RCA) and the total calcium score in all vessels (35 (16 – 85.5) Vs 179.5 (59.5 – 243) P: 0.000, 20.5 (7 – 50.5) Vs 56 (33 – 95) P: 0.000, 31 (9 – 54) Vs 97 (54 – 199) P: 0.000, 12 (0 – 84) Vs 286 (106 – 511) P:0.000; respectively) while calcium score in the LM was not statistically significant with the severity of CAD (4 (3 – 26) Vs 12 (9 – 16) P: 0.360). As regards aortic valve calcification there was statistically highly significant difference between the two groups; P value 0.000, while mitral valve calcification was found to be not statistically significant between the two groups P: 0.272. Conclusion The present study demonstrated a significant correlation between the peri-coronary epicardial adipose tissue, coronary calcification and aortic valve calcification and the severity of the coronary artery disease.


2018 ◽  
Vol 08 (03) ◽  
pp. 155-158
Author(s):  
Sadaf Shaheen ◽  
Sahrish Mukhtar ◽  
Iffat Raza ◽  
Bashir Sheikh

Objectives: The aim of this study was to measure the Epicardial Adipose Tissue thickness through echocardiography in healthy adults and coronary artery disease patients and to make its association with age and gender. Methods: It was a case control study. A total of 315 samples including 159 cases of coronary artery disease and 156 asymptomatic individuals for coronary artery disease underwent echocardiography for Epicardial Adipose Tissue thickness measurement. Results: Mean Epicardial Adipose Tissue (EAT) in the study was found to be 15.45 ± 7.16 mm. Cases had significantly higher EAT 16.77 ±9.80mm as compared to controls 14.13 ± 4.52 mm (P=0.02). EAT thickness increased significantly with age (P=0.004). There was no significant difference of EAT (P=0.999) in both the genders. Conclusion: The mean EAT thickness is significantly higher in our study population as compared to previous studies. The mean EAT thickness was same in both males and females of our study. There was no significant difference in EAT of both genders.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Garcia Campos ◽  
V Alonso Vazquez ◽  
S Colunga Blanco ◽  
E Velasco Alonso ◽  
B Vega Hernandez ◽  
...  

Abstract Background Epicardial adipose tissue (EPI) and pericardial adipose tissue (PERI) measured using echocardiography or magnetic resonance imaging have shown to be markers of metabolic syndrome and begin to be regarded as predictors of coronary artery disease. EPI is also thought to have paracrine effects on coronary vessels and, therefore, might be more intimately linked to ischemic heart disease. Purpose We aim to study if EPI related to PERI thickness is a predictor of ischemic etiology of left ventricular (LV) systolic dysfunction among ambulatory patients. Methods We retrospectively evaluated 56 consecutive patients followed on a heart failure clinic. A cardiologist, blind to the clinical records and systolic dysfunction etiology, reviewed the echocardiographic images and measured EPI and PERI thickness on right ventricle free wall (parasternal long axis view). Cardiovascular risk factors, body mass inex (BMI), LV dimensions by echo, LV systolic dysfunction etiology (investigated by other means such as angiography or magnetic resonance) were analyzed. Results Echocardiographic image quality allowed for analyzing 55 patients (80% male, 62% hypertension, 51% diabetes, 44% dyslipidemia, BMI 28,9 ± 4,0, age 66 ± 14 years). Mean EPI thickness was 3,4 ± 2,0 mm and PERI was 5,6 ± 3,4 mm. LV ejection fraction 33 ± 10% and LV end diastolic volume 157 ± 48ml. Supplementary investigations showed an ischemic etiology of LV systolic dysfunction in 45% of patients. We found that patients with EPI thickness equal or greater than PERI were more likely to have an ischemic etiology (univariate analysis: OR 9,8 p = 0,002; adjusted for BMI and diabetes: OR 5,8 p = 0,032). Conclusions Epicardial adipose tissue thickness equal or greater than pericardial adipose tissue, parameter easily obtained using transthoracic echocardiography, may predict ischemic etiology of LV systolic dysfunction in a cohort of ambulatory patients . Future research will be necessary to confirm this finding and its possible value in every-day clinical practice as marker of coronary artery disease. ALL ISCHEMIC NON ISCHEMIC p Epicardial Adipose Tissue 3,4 ± 2,0 3,7 ± 1,6 3,1 ± 2,2 0,53 Pericardial Adipose Tissue 5,6 ± 3,4 4,6 ± 3,0 6,4 ± 3,5 0,09 Ratio EPI/PERI 0,82 ± 0,66 1,16 ± 0,83 0,55 ± 0,28 0,000 Table Adipose tissue thickness measured on paraesternal long axis (mm): mean ± SD.


Open Medicine ◽  
2011 ◽  
Vol 6 (3) ◽  
pp. 251-262 ◽  
Author(s):  
Alina Silaghi ◽  
Raluca Pais ◽  
Ana Valea ◽  
Aurel Mironiuc ◽  
Horatiu Silaghi

AbstractEpicardial adipose tissue (EAT) is metabolically active tissue that accumulates around the coronary arteries. Epicardial fat is a rich source of free fatty acids and may contribute to local inflammatory load by increased synthesis of inflammatory cytokines. Direct passage of bioactive molecules into the coronary arteries due to close contact with the vascular wall and the lack of fascia may contribute to the pathogenesis of coronary artery disease. Direct correlation between visceral fat and EAT defines the latter as an indirect marker of intra-abdominal visceral adiposity. EAT is related to anthropometric and clinical features of the metabolic syndrome (MS) and to hepatic transaminases as markers of steatohepatitis. An increase in EAT thickness is related to an increase in left ventricular mass and is correlated with atrial enlargement and impairment in diastolic filling in obesity. Echocardiographic study of EAT is an easy and reliable imaging indicator of visceral adiposity and cardiovascular risk. EAT is an independent factor strongly correlated with significant coronary stenosis. A level of EAT above an established average value can be considered a predictive marker of cardiovascular risk. We review the most recent studies proving the specific active role of EAT in the development of cardiac disease.


2013 ◽  
Vol 80 (4) ◽  
Author(s):  
Samuele Baldasseroni ◽  
Alessandra Pratesi ◽  
Francesco Orso ◽  
Claudia Di Serio ◽  
Alice Foschini ◽  
...  

Background. Epicardial adipose tissue (EAT) is a visceral fat that fulfills two important functions: lipid-storage and secretion of adipokines with pro-inflammatory and pro-atherogenic properties. It has been suggested that EAT may affect the pathogenesis of atherosclerosis and the clinical course of coronary artery disease (CAD). In patients with obesity, diabetes and metabolic syndrome, the epicardial adipose tissue is enlarged. Little is known about the role of EAT in left ventricular dysfunction. Aim of this study was to evaluate the ability of insulin resistance to predict EAT thickness in patients with significant CAD and systolic dysfunction. Methods. We enrolled 114 subjects diagnosed with CAD by angiography. The majority underwent revascularization after an acute coronary syndrome. Patients were considered affected by significant left ventricular dysfunction when EF was


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 469-P
Author(s):  
MILOS MRAZ ◽  
ANNA CINKAJZLOVA ◽  
ZDENA LACINOVÁ ◽  
JANA KLOUCKOVA ◽  
HELENA KRATOCHVILOVA ◽  
...  

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