Increased Epicardial Fat Volume in HIV-Infected Men and Relationships to Body Composition and Metabolic Parameters.

Background: It has been reported that an increase in epicardial fat volume (EFV) has been associated with an increase in cardiovascular structural and functional abnormalities (CVSFA). Purpose: The purpose of this study is to assess whether a step-wise increase in EFV is associated with a proportional increase in CVSFA. Methods: We screened 2,756 asymptomatic subjects, ages 20-79, for CVD risk using the Early Cardiovascular Disease Risk Scoring System (ECVDRS), which consists of 10 tests; 7 are vascular and 3 are cardiac. The vascular tests are: large (C1) and small (C2) artery stiffness, blood pressure (BP) at rest and post-mild protocol exercise (PME), CIMT, abdominal aorta ultrasound, retinal photography, and microalbuminuria. The 3 cardiac tests are: Pro-BNP, ECG, and LV ultrasound. Additional tests are waist circumference, BMI, fasting blood sugar, lipid profile, and CRP. 596 out of the total subjects were asymptomatic, and out of these 220 (37%) underwent cardiac CT for coronary artery calcium scoring (CACS) and EFV determination using Siemens Somatom Definition Dual source CT scanner 64x2. 107 out of the 220 were females (48%). These females were divided into 5 groups based on their EFV: 24 with < 69cm 3 ; 33 between 70cm 3 and 94cm 3 ; 16 between 95cm 3 and 119cm 3 ; 20 between 120cm 3 and 144cm 3 ; and 14 >145cm 3 . Results: As noted in the table, a step-wise increase in EFV was associated with proportional increases in CVSFA, specifically CACS, resting BP, abnormal rise in BP-PME, CRP, and triglycerides. An increase in EFV was noticeably associated with an increase in resting blood BP by a 10mmHg difference between the group whose EFV < 120cm 3 and those whose EFV is > 120cm 3 . Conclusions: Based on our data, we feel that excess EFV appears to be the villain for most CVSFA. Accordingly, we urge all healthcare professionals that it is time to focus on early and accurate assessment of this significant risk marker, which is the culprit for many CVD risk factors. Early detect to protect.

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Abstract 5752: Epicardial Fat Assessed by Multi-Detector Computed Tomography (mdct) is a New Risk Factor of Coronary Artery Disease in Non-Obese Patients

Circulation ◽

10.1161/circ.118.suppl_18.s_995-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Tadateru Iwayama ◽

Joji Nitobe ◽

Mitsunori Ishino ◽

Harutoshi Tamura ◽

Tetsurou Shishido ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Epicardial Fat ◽

Coronary Risk Factors ◽

Coronary Risk ◽

Obese Patients ◽

Epicardial Fat Volume ◽

Artery Disease ◽

Fat Volume

Objective: An increment of abdominal visceral fat has been reported to be a coronary risk factor associated with metabolic syndrome. However, adipose tissue surrounding heart has not been fully determined as coronary risk factors. Accurate volumetric measurement of epicardial fat can be easily obtained by MDCT. We examined the relationship between epicardial fat volume and clinical parameters in patients with coronary artery disease (CAD). Method: We evaluated epicardial fat volume by 64 detector row CT scanner in CAD patients (obese, 13; non-obese, 11 patients) who underwent elective coronary artery bypass graft surgery and in non-CAD patients who showed normal coronary arteries on angiography (obese, 3; non-obese, 11 patients). Epicardial fat volume was obtained as the sum of fat areas on short axis images. Obese patients were defined as over 25 in body mass index (BMI). Result: Epicardial fat volume was significantly higher in patients with CAD than in those without CAD (40.6 ± 14.7 ml vs. 20.0 ± 14.7 ml, p < 0.05). Epicardial fat volume was not correlated to following coronary risk factors such as HbA1c, fasting plasma glucose, lipid and blood pressure except for BMI. Although there was no difference epicardial fat volume between in obese patients with CAD and in those without CAD (48.3 ± 27.9 ml vs. 41.2 ± 11.0 ml, NS), it was significantly higher in non-obese patients with CAD than in those without CAD (32.1 ± 9.2 ml vs. 14.2 ± 9.2 ml, p < 0.05). Conclusions: The quantity of epicardial fat using MDCT is related with the presence of CAD. Especially in non-obese patients, epicardial fat may affect directly progression of CAD independent of pathophysiological process of metabolic syndrome.

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