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Wan P, Wang B, Yu W, Zhai LS, Qian B, Zhang F, Liu B, Wang J, Shao X, Shi Y, Jiang Q, Wang MF, Shao S, Wang Y. Right atrial wall inflammation detected by 18F-FDG PET/CT may be significantly associated with persistent atrial fibrillation: a prospective case-control study. BMC Cardiovasc Disord 2023; 23:587. [PMID: 38036990 PMCID: PMC10688480 DOI: 10.1186/s12872-023-03592-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
AIM Atrial fibrillation (AF) is a progressive disease from paroxysmal to persistent, and persistent AF (PerAF) had worse prognosis. AF has potential link with inflammation, but it is not clear whether PerAF or paroxysmal AF (ParAF) is more closely related to inflammation. On the basis of inhibiting myocardial physiological uptake, 18F-fluorodeoxyglucosepositron emission tomography/computed tomography (18F-FDG PET/CT) is an established imaging modality to detect cardiac inflammation. We aimed to decipher the association between AF and atrial inflammatory activity by 18F-FDG PET/CT. METHODS Thirty-five PerAF patients were compared to age and sex matched ParAF group with baseline 18F-FDG PET/CT scans prior to radiofrequency catheter ablation (RFCA) in the prospective case-control study. High-fat and low-carbohydrate diet and prolonged fast (HFLC+Fast) was applied to all AF patients before PET/CT. Then 22 AF patients with positive right atrial (RA) wall FDG uptake (HFLC+Fast) were randomly selected and underwent HFLC+Fast+heparin the next day. The CHA2DS2-VASc score was calculated to evaluate the risk of stroke. Clinical data, ECG, echocardiography, and atrial 18F-FDG uptake were compared. RESULTS PerAF patients had significantly higher probability of RA wall positive FDG uptake and higher SUVmax than ParAF group [91.4% VS. 28.6%, P < 0.001; SUVmax: 4.10(3.20-4.90) VS. 2.60(2.40-3.10), P < 0.001]. Multivariate logistic regression analyses demonstrated that RA wall SUVmax was the independent influencing factor of PerAF (OR = 1.80, 95%CI 1.02-3.18, P = 0.04). In 22 AF patients with RA wall positive FDG uptake (HFLC+Fast), the "HFLC+Fast+Heparin" method did not significantly change RA wall FDG uptake evaluated by either quantitative analysis or visual analysis. High CHA2DS2-VASc score group had higher RA wall 18F-FDG uptake [3.35 (2.70, 4.50) vs, 2.8 (2.4, 3.1) P = 0.01]. CONCLUSIONS RA wall FDG positive uptake was present mainly in PerAF. A higher RA wall 18F-FDG uptake was an independent influencing factor of PerAF. RA wall FDG uptake based on 18F-FDG PET/CT may indicate pathological inflammation. TRIAL REGISTRATION http://www.chictr.org.cn , ChiCTR2000038288.
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Affiliation(s)
- Peng Wan
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China
| | - Bing Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu Province, China
| | - Wenji Yu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu Province, China
| | - Li Shang Zhai
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China
| | - Bo Qian
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China
| | - Feifei Zhang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu Province, China
| | - Bao Liu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu Province, China
| | - Jianfeng Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu Province, China
| | - Xiaoliang Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu Province, China
| | - Yunmei Shi
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu Province, China
| | - Qi Jiang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China
| | - Meng Fei Wang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China
| | - Shan Shao
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China.
| | - Yuetao Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, Jiangsu Province, 213003, China.
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, Jiangsu Province, China.
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Gao Y, Guo Y, Hao W, Meng J, Miao Z, Hou A, Luan B. Correlation Analysis and Diagnostic Value of Serum Homocysteine, Cystatin C and Uric Acid Levels with the Severity of Coronary Artery Stenosis in Patients with Coronary Heart Disease. Int J Gen Med 2023; 16:2719-2731. [PMID: 37405124 PMCID: PMC10317548 DOI: 10.2147/ijgm.s411417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/22/2023] [Indexed: 07/06/2023] Open
Abstract
Background Coronary angiography (CAG) is an invasive examination with high risks and costs and various complications may occur. It is necessary to find a diagnostic method, non-invasiveness, inexpensive with low risk. This study aims to analyze the correlation between the levels of serum homocysteine (Hcy), cystatin C (Cys C) and uric acid (UA) and Gensini score in patients with coronary heart disease (CHD) and assess their diagnostic value for CHD. Methods A retrospective analysis was conducted on 1412 patients underwent CAG from October 2019 to December 2021, and we conducted this study from January to July 2022. A total of 765 patients with CHD confirmed by CAG were selected as the research group, while 647 patients revealed as non-obstructive stenosis by CAG as the control group. The serum Hcy, Cys C and UA levels were detected and the correlation between Gensini score and variables was analyzed. The receiver-operating characteristic (ROC) curve was performed to assess the diagnostic value of the Hcy, Cys C and UA for CHD. Results The serum Hcy, Cys C and UA levels in the research group were higher as compared with the control group (p<0.05). Spearman correlation and multivariate linear regression analysis showed that there was a significantly positive correlation between Gensini score and serum Hcy, Cys C and UA levels (p<0.05). The ROC curve analysis presented the combined Hcy and Cys C with UA having the highest specificity of diagnostic value for CHD (area under the curve (AUC)=0.768, 95% CI 0.706-0.823, specificity = 72.34%, sensitivity = 67.88%, Youden Index = 0.4022). Conclusion The serum Hcy, Cys C and UA levels in patients with CHD were significantly increased, positive correlation with Gensini score. The combined Hcy and Cys C with UA could be used to assess the severity of coronary artery stenosis and provide predictive and early intervention treatment values for CHD and a new way of diagnosing CHD, which is cheap, safe, effective and deserving of clinical application.
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Affiliation(s)
- Yang Gao
- Department of Cardiology, the People’s Hospital of Liaoning Province, Shenyang, People’s Republic of China
| | - Yuguang Guo
- Department of Clinical Laboratory, the People’s Hospital of Liaoning Province, Shenyang, People’s Republic of China
| | - Wenjun Hao
- Department of Cardiology, the People’s Hospital of Liaoning Province, Shenyang, People’s Republic of China
| | - Jin Meng
- Department of Cardiology, the People’s Hospital of Liaoning Province, Shenyang, People’s Republic of China
| | - Zhilin Miao
- Department of Cardiology, the People’s Hospital of Liaoning Province, Shenyang, People’s Republic of China
| | - Aijie Hou
- Department of Cardiology, the People’s Hospital of Liaoning Province, Shenyang, People’s Republic of China
| | - Bo Luan
- Department of Cardiology, the People’s Hospital of Liaoning Province, Shenyang, People’s Republic of China
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Dou J, Thangaraj SV, Puttabyatappa M, Elangovan VR, Bakulski K, Padmanabhan V. Developmental programming: Adipose depot-specific regulation of non-coding RNAs and their relation to coding RNA expression in prenatal testosterone and prenatal bisphenol-A -treated female sheep. Mol Cell Endocrinol 2023; 564:111868. [PMID: 36708980 PMCID: PMC10069610 DOI: 10.1016/j.mce.2023.111868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/19/2023] [Accepted: 01/22/2023] [Indexed: 01/27/2023]
Abstract
Inappropriate developmental exposure to steroids is linked to metabolic disorders. Prenatal testosterone excess or bisphenol A (BPA, an environmental estrogen mimic) leads to insulin resistance and adipocyte disruptions in female lambs. Adipocytes are key regulators of insulin sensitivity. Metabolic tissue-specific differences in insulin sensitivity coupled with adipose depot-specific changes in key mRNAs, were previously observed with prenatal steroid exposure. We hypothesized that depot-specific changes in the non-coding RNA (ncRNA) - regulators of gene expression would account for the direction of changes seen in mRNAs. Non-coding RNA (lncRNA, miRNA, snoRNA, snRNA) from various adipose depots of prenatal testosterone and BPA-treated animals were sequenced. Adipose depot-specific changes in the ncRNA that are consistent with the depot-specific mRNA expression in terms of directionality of changes and functional implications in insulin resistance, adipocyte differentiation and cardiac hypertrophy were found. Importantly, the adipose depot-specific ncRNA changes were model-specific and mutually exclusive, suggestive of different regulatory entry points in this regulation.
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Affiliation(s)
- John Dou
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | | | | | | | - Kelly Bakulski
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA.
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Wang Q, Chi J, Wang C, Yang Y, Tian R, Chen X. Epicardial Adipose Tissue in Patients with Coronary Artery Disease: A Meta-Analysis. J Cardiovasc Dev Dis 2022; 9:jcdd9080253. [PMID: 36005417 PMCID: PMC9410067 DOI: 10.3390/jcdd9080253] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 12/14/2022] Open
Abstract
Objective: The aim of this study is to assess the association between epicardial adipose tissue (EAT) and coronary artery disease (CAD) via meta−analysis. Methods: Specific searches of online databases from January 2000 to May 2022 were conducted. All observational studies evaluating the association between EAT and CAD in PubMed, Web of Science, and the Cochrane Library databases were screened. A meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta−Analyses guidelines (PRISMA). In total, 21 studies encompassing 4975 subjects met the inclusion criteria, including 2377 diagnosed and assigned as the CAD group, while the other 2598 were assigned as the non−CAD group. Subjects in the CAD group were further divided into the severe stenosis group (stenosis ≥ 50%, n = 846) and the mild/moderate stenosis group (stenosis < 50%, n = 577). Results: Both the volume and thickness of EAT in the CAD group were larger compared to the non−CAD group (p < 0.00001). In a subgroup analysis within the CAD group, the severe stenosis group had a larger volume and thickness with respect to EAT when compared to the mild/moderate group (p < 0.001). Conclusions: The enlargement of EAT presented in CAD patients with an association with CAD severity. Although limited by different CAD types and measuring methods for EAT, as well as a smaller sample size, our results suggest that EAT is a novel predictor and a potential therapeutic target for CAD.
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Affiliation(s)
- Qingpeng Wang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jiangyang Chi
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Chen Wang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yun Yang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Rui Tian
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Xinzhong Chen
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Correspondence:
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Wang B, Xu Y, Wan P, Shao S, Zhang F, Shao X, Wang J, Wang Y. Right Atrial Fluorodeoxyglucose Uptake Is a Risk Factor for Stroke and Improves Prediction of Stroke Above the CHA2DS2-VASc Score in Patients With Atrial Fibrillation. Front Cardiovasc Med 2022; 9:862000. [PMID: 35872918 PMCID: PMC9304590 DOI: 10.3389/fcvm.2022.862000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAtrial fibrillation (AF) is a common arrhythmia, and its most severe and dreaded complication is stroke. The CHA2DS2-VASc score is currently recommended for stroke risk assessment in AF. We aimed to explore the relationship between atrial FDG uptake and stroke and whether atrial FDG uptake could provide incremental value above the CHA2DS2-VAS score to predict stroke in AF by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT).Materials and MethodsFrom September 2017 to December 2020, we retrospectively enrolled 230 patients (115 with AF and 115 without AF as the non-AF group, matched for the date of PET/CT examination and the basic characteristics of the patient) who underwent 18F-FDG PET/CT due to tumor screening or preoperative staging after prolonged fasting and followed up for at least 12 months from the date of PET/CT examination; the endpoint event is the occurrence of stroke. We visually and quantitatively analyzed 18F-FDG uptake in the right and left atria (RA/LA), right and left atrial appendage (RAA/LAA), right and left ventricle (RV/LV), and collected clinical features. In addition, according to the endpoint event (stroke), the enrolled population was divided into the stroke group and non-stroke group, and relevant clinical features and atrial FDG uptake indicators of the two groups were analyzed. Univariate and multivariate Cox regression analyzes were used to analyze the risk factors of stroke events. The Kaplan–Meier survival curve of atrial FDG uptake was drawn, and the log-rank method was used to compare the differences in the survival curves of the two groups. Receiver operating characteristic (ROC) curves were used to examine the discriminatory power of atrial FDG uptake in predicting stroke and determine whether the addition of atrial FDG uptake improves predictive value beyond the CHA2DS2-VASc score for stroke.ResultsIn the AF group, more than half of patients had RA FDG uptake and one-fifth had LA FDG uptake, while one patient had RA FDG uptake and two patients had LA FDG uptake in the non-AF group. In quantitative analysis, the maximum standardized uptake value (SUVmax) of the RA and LA in the AF group was significantly higher than that of the non-AF group (all P < 0.001). We followed up the patients for 28 ± 10 months, and finally, 31 patients had stroke. In the stroke group, atrial fibrillation, RA SUVmax, RAA SUVmax, LAA SUVmax, age ≥ 75 years, and left atrial dilation were significantly higher than those of the non-stroke group (all P < 0.05). Multivariate Cox regression analysis showed that high RA SUVmax (RA SUVmax ≥ 2.62) was an independent risk factor for stroke (HR = 4.264, 95% CI 1.368–13.293, P = 0.012). By using the log-rank test, patients with high RA SUVmax had a significantly higher incidence of stroke compared with patients with low RA SUVmax (P < 0.001). Addition of high RA SUVmax to the CHA2DS2-VASc score could predict stroke more effectively, with a larger AUC 0.790 (P < 0.001).ConclusionThis study found a significant correlation between atrial FDG uptake and AF, especially in RA. Meanwhile, RA FDG uptake is an independent risk factor for stroke, and patients with high RA SUVmax have a significantly higher risk of stroke. Moreover, RA FDG uptake improves prediction of stroke above the CHA2DS2-VASc score in patients with AF.
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Affiliation(s)
- Bing Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China
| | - Yiduo Xu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China
| | - Peng Wan
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Shan Shao
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Feifei Zhang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China
| | - Xiaoliang Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China
| | - Jianfeng Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China
| | - Yuetao Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China
- *Correspondence: Yuetao Wang,
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Measurement of epicardial adipose tissue using non-contrast routine chest-CT: a consideration of threshold adjustment for fatty attenuation. BMC Med Imaging 2022; 22:114. [PMID: 35752770 PMCID: PMC9233319 DOI: 10.1186/s12880-022-00840-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/03/2022] [Indexed: 11/15/2022] Open
Abstract
Background Epicardial adipose tissue (EAT) is known as an important imaging indicator for cardiovascular risk stratification. The present study aimed to determine whether the EAT volume (EV) and mean EAT attenuation (mEA) measured by non-contrast routine chest CT (RCCT) could be more consistent with those measured by coronary CT angiography (CCTA) by adjusting the threshold of fatty attenuation. Methods In total, 83 subjects who simultaneously underwent CCTA and RCCT were enrolled. EV and mEA were quantified by CCTA using a threshold of (N30) (− 190 HU, − 30 HU) as a reference and measured by RCCT using thresholds of N30, N40 (− 190 HU, − 40 HU), and N45 (− 190 HU, − 45 HU). The correlation and agreement of EAT metrics between the two imaging modalities and differences between patients with coronary plaques (plaque ( +)) and without plaques (plaque ( −)) were analyzed. Results EV obtained from RCCT showed very strong correlation with the reference (r = 0.974, 0.976, 0.972 (N30, N40, N45), P < 0.001), whereas mEA showed a moderate correlation (r = 0.516, 0.500, 0.477 (N30, N40, N45), P < 0.001). Threshold adjustment was able to reduce the bias of EV, while increase the bias of mEA. Data obtained by CCTA and RCCT both demonstrated a significantly larger EV in the plaque ( +) group than in the plaque ( −) group (P < 0.05). A significant difference in mEA was shown only by RCCT using a threshold of N30 (plaque ( +) vs ( −): − 80.0 ± 4.4 HU vs − 78.0 ± 4.0 HU, P = 0.030). The mEA measured on RCCT using threshold of N40 and N45 showed no significant statistical difference between the two groups (P = 0.092 and 0.075), which was consistent with the result obtained on CCTA (P = 0.204). Conclusion Applying more negative threshold, the consistency of EV measurements between the two techniques improves and a consistent result can be obtained when comparing EF measurements between groups, although the bias of mEA increases. Threshold adjustment is necessary when measuring EF with non-contrast RCCT.
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Wang X, Tan Y, Liu D, Shen H, Deng Y, Tan Y, Wang L, Zhang Y, Ma X, Zeng X, Zhang J. Chemotherapy-associated steatohepatitis was concomitant with epicardial adipose tissue volume increasing in breast cancer patients who received neoadjuvant chemotherapy. Eur Radiol 2022; 32:4898-4908. [PMID: 35394181 DOI: 10.1007/s00330-022-08581-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/08/2022] [Accepted: 01/12/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To investigate the prevalence of chemotherapy-associated steatohepatitis, quantitate the epicardial adipose tissue (EAT) volume in breast cancer patients, and explore the mediating effect of liver fat content on EAT volume in breast cancer patients who received neoadjuvant chemotherapy (NAC). METHODS From October 2018 to April 2020, patients were retrospectively reviewed and divided into breast cancer non-NAC and NAC groups. The prevalence of chemotherapy-associated steatohepatitis was evaluated through quantitative MRI mDIXON-Quant examinations by using defined proton density fat fraction cutoffs of liver fat. The EAT volume was quantified on chest CT by semi-automatic volume analysis software. Bootstrap analysis was used in the breast cancer NAC group to test the significance of the mediating effect of liver fat content on EAT volume. RESULTS A total of 662 breast cancer patients (non-NAC group: 445 patients; NAC group: 217 patients) were included. The prevalence of chemotherapy-associated steatohepatitis in the NAC group was significantly higher than the prevalence of hepatic steatosis in the non-NAC group (42.8% vs. 33.3%, p < 0.001). EAT volume was measured in 561 of 662 breast cancer patients, and was significantly higher in the NAC group than in the non-NAC group (137.26 ± 53.48 mL vs. 125.14 ± 58.77 mL, p = 0.020). In the breast cancer NAC group, the indirect effect of liver fat content on EAT volume was 2.545 (p < 0.001), and the contribution rate to the effect was 69.1%. CONCLUSIONS EAT volume was significantly higher in the BC-NAC group than in the BC-non-NAC group. KEY POINTS • The prevalence of CASH was as high as 42.8% in BC patients. • NAC significantly increased the EAT volume in BC patients. • The liver fat content caused the change of EAT volume through mediating effect.
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Affiliation(s)
- Xiaoxia Wang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, No.181 Hanyu Road, Shapingba District, Chongqing, 400030, People's Republic of China
| | - Yuchuan Tan
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, No.181 Hanyu Road, Shapingba District, Chongqing, 400030, People's Republic of China
| | - Daihong Liu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, No.181 Hanyu Road, Shapingba District, Chongqing, 400030, People's Republic of China
| | - Hesong Shen
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, No.181 Hanyu Road, Shapingba District, Chongqing, 400030, People's Republic of China
| | - Yongchun Deng
- Department of Breast Cancer Center, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, 400030, People's Republic of China
| | - Yong Tan
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, No.181 Hanyu Road, Shapingba District, Chongqing, 400030, People's Republic of China
| | - Lei Wang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, No.181 Hanyu Road, Shapingba District, Chongqing, 400030, People's Republic of China
| | - Yipeng Zhang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, No.181 Hanyu Road, Shapingba District, Chongqing, 400030, People's Republic of China
| | - Xin Ma
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, No.181 Hanyu Road, Shapingba District, Chongqing, 400030, People's Republic of China
| | - Xiaohua Zeng
- Department of Breast Cancer Center, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, 400030, People's Republic of China.
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, No.181 Hanyu Road, Shapingba District, Chongqing, 400030, People's Republic of China.
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D'Marco L, Puchades MJ, Panizo N, Romero-Parra M, Gandía L, Giménez-Civera E, Pérez-Bernat E, Gonzalez-Rico M, Gorriz JL. Cardiorenal Fat: A Cardiovascular Risk Factor With Implications in Chronic Kidney Disease. Front Med (Lausanne) 2021; 8:640814. [PMID: 34113631 PMCID: PMC8185173 DOI: 10.3389/fmed.2021.640814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 04/29/2021] [Indexed: 12/14/2022] Open
Abstract
There is a growing interest in the potential role of adipose tissues in cardiac and renal pathophysiology, and determining the mechanisms by which fat compartments around the heart and kidneys influence cardiovascular disease is of clinical importance in both general and high-risk populations. Epicardial fat and perirenal fat have been associated with adverse outcomes in chronic kidney disease (CKD) patients. Epicardial fat is a rich source of free fatty acids and is capable of secreting inflammatory and pro-atherogenic cytokines that promote atherosclerosis through a local paracrine effect. Recent evidence has demonstrated that perirenal fat has a closer correlation with kidney diseases than other visceral fat deposits in obesity or metabolic disturbances. Moreover, perirenal fat has been reported as an independent risk factor for CKD progression and even associated with cardiorenal dysfunction. Accordingly, these forms of organ-specific fat deposits may act as a connecter between vascular and cardiorenal disease. This review explores the possible links between epicardial and perirenal fat and its significant role as a modulator of cardiorenal dysfunction in CKD patients.
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Affiliation(s)
- Luis D'Marco
- Nephrology Department, Hospital Clínico Universitario, Institute of Health Research (INCLIVA), Valencia, Spain
| | - María Jesús Puchades
- Nephrology Department, Hospital Clínico Universitario, Institute of Health Research (INCLIVA), Valencia, Spain.,Universidad de Valencia, Medicine School, Valencia, Spain
| | - Nayara Panizo
- Nephrology Department, Hospital Clínico Universitario, Institute of Health Research (INCLIVA), Valencia, Spain
| | - María Romero-Parra
- Nephrology Department, Hospital Clínico Universitario, Institute of Health Research (INCLIVA), Valencia, Spain
| | - Lorena Gandía
- Nephrology Department, Hospital Clínico Universitario, Institute of Health Research (INCLIVA), Valencia, Spain
| | - Elena Giménez-Civera
- Nephrology Department, Hospital Clínico Universitario, Institute of Health Research (INCLIVA), Valencia, Spain
| | - Elisa Pérez-Bernat
- Nephrology Department, Hospital Clínico Universitario, Institute of Health Research (INCLIVA), Valencia, Spain
| | - Miguel Gonzalez-Rico
- Nephrology Department, Hospital Clínico Universitario, Institute of Health Research (INCLIVA), Valencia, Spain
| | - José Luis Gorriz
- Nephrology Department, Hospital Clínico Universitario, Institute of Health Research (INCLIVA), Valencia, Spain.,Universidad de Valencia, Medicine School, Valencia, Spain
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9
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Saco-Ledo G, Valenzuela PL, Castillo-García A, Arenas J, León-Sanz M, Ruilope LM, Lucia A. Physical exercise and epicardial adipose tissue: A systematic review and meta-analysis of randomized controlled trials. Obes Rev 2021; 22:e13103. [PMID: 32692478 DOI: 10.1111/obr.13103] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/04/2020] [Accepted: 07/04/2020] [Indexed: 01/06/2023]
Abstract
We performed a meta-analysis of the effects of exercise on epicardial adipose tissue (EAT). A systematic search was conducted in PubMed and Scopus (since inception to 1 February 2020) of randomized controlled trials assessing the effects of exercise interventions alone (with no concomitant weight loss intervention) on EAT. The standardized mean difference (Hedges' g) and 95% confidence interval between interventions were computed using a random effects model. Ten studies (including 521 participants who had, on average, overweight/obesity) met all inclusion criteria. Interventions were supervised and lasted 2 to 16 weeks (≥3 sessions·per week). Exercise significantly reduced EAT (g = 0.82 [0.57-1.07]) irrespective of the duration of the intervention or the EAT imaging assessment method. Exercise benefits were separately confirmed for endurance (six studies, n = 287; g = 0.83 [0.52-1.15]) but not for resistance exercise training (due to insufficient data for quantitative synthesis). It was not possible to compare the effect of high-intensity interval training (HIIT) versus moderate-intensity continuous training (two studies, one reporting higher benefits with HIIT and the other no differences). Physical exercise interventions-particularly endurance training, with further evidence needed for other exercise modalities-appear as an effective strategy for reducing EAT in individuals with overweight/obesity, which supports their implementation for cardiovascular risk reduction.
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Affiliation(s)
- Gonzalo Saco-Ledo
- Bioenergy and Motion Analysis Laboratory, National Research Center on Human Evolution (CENIEH), Burgos, Spain
| | | | | | - Joaquín Arenas
- Research Institute of the Hospital Universitario 12 de Octubre ('imas12'), Madrid, Spain
| | - Miguel León-Sanz
- Research Institute of the Hospital Universitario 12 de Octubre ('imas12'), Madrid, Spain.,Clinical Nutrition Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Luis M Ruilope
- Research Institute of the Hospital Universitario 12 de Octubre ('imas12'), Madrid, Spain.,Hypertension Unit and Cardiorenal Translational Laboratory, Hospital 12 de Octubre, Madrid, Spain
| | - Alejandro Lucia
- Research Institute of the Hospital Universitario 12 de Octubre ('imas12'), Madrid, Spain.,Faculty of Sport Sciences, European University of Madrid, Madrid, Spain
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10
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Gać P, Czerwińska K, Poręba M, Macek P, Mazur G, Poręba R. Environmental Tobacco Smoke Exposure Estimated Using the SHSES Scale and Epicardial Adipose Tissue Thickness in Hypertensive Patients. Cardiovasc Toxicol 2020; 21:79-87. [PMID: 32809142 PMCID: PMC7790793 DOI: 10.1007/s12012-020-09598-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/11/2020] [Indexed: 02/08/2023]
Abstract
The aim of the study was to assess the relationship between environmental tobacco smoke exposure (ETS) and epicardial adipose tissue thickness (EATT) in hypertensive patients. A total of 96 patients with essential hypertension were recruited for this study. The group consisted of 48 females and 48 males with the mean age of 69.32 ± 9.54 years. ETS was assessed with The Secondhand Smoke Exposure Scale (SHSES). EATT was assessed in 128-slice dual source coronary computed tomography angiography. In accordance to SHSES scale patients were divided into subgroups: subgroup A-no ETS exposure (SHSES = 0 points, n = 48), subgroup B-low ETS exposure (SHSES = 1-3 points, n = 11), subgroup C-medium ETS exposure (SHSES = 4-7 points, n = 20) and subgroup D-high ETS exposure (SHSES = 8-11 points, n = 17). Within the study group the mean EATT was 5.75 ± 1.85 mm and the mean SHSES score was 3.05 ± 3.74. EATT was statistically significantly higher in subgroup D than in subgroups A and B (A: 5.28 ± 1.64 mm, B: 5.04 ± 2.64 mm, D: 7.04 ± 2.64 mm, pA-D and pB-D < 0.05). There was a positive linear correlation between the exposure to ETS expressed by the SHSES scale and EATT (r = 0.44, p < 0.05). Regression analysis showed that higher SHSES score, higher BMI, and higher systolic and diastolic blood pressure are independent risk factors for higher EATT values. Contrary, the use of ACE inhibitors and β-blockers appeared to be independent protecting factor against higher EATT values. There is an unfavorable positive relationship between ETS exposure estimated using the SHSES scale and EATT in hypertensive patients.
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Affiliation(s)
- Paweł Gać
- Department of Hygiene, Wroclaw Medical University, Mikulicza-Radeckiego 7, 50-368, Wrocław, Poland. .,Centre of Diagnostic Imaging, 4th Military Hospital, Weigla 5, 50-981, Wrocław, Poland.
| | - Karolina Czerwińska
- Department of Hygiene, Wroclaw Medical University, Mikulicza-Radeckiego 7, 50-368, Wrocław, Poland
| | - Małgorzata Poręba
- Department of Pathophysiology, Wroclaw Medical University, Marcinkowskiego 1, 50-368, Wrocław, Poland
| | - Piotr Macek
- Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Borowska 213, 50-556, Wrocław, Poland
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Borowska 213, 50-556, Wrocław, Poland
| | - Rafał Poręba
- Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Borowska 213, 50-556, Wrocław, Poland
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11
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Kleinaki Z, Agouridis AP, Zafeiri M, Xanthos T, Tsioutis C. Epicardial adipose tissue deposition in patients with diabetes and renal impairment: Analysis of the literature. World J Diabetes 2020; 11:33-41. [PMID: 32064034 PMCID: PMC6969709 DOI: 10.4239/wjd.v11.i2.33] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/11/2019] [Accepted: 12/15/2019] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus (DM) is defined as a chronic disease of disordered metabolism with an ongoing increase in prevalence and incidence rates. Renal disease in patients with diabetes is associated with increased morbidity and premature mortality, particularly attributed to their very high cardiovascular risk. Since this group of patients frequently lacks specific symptomatology prior to the adverse events, a screening tool for the identification of high-risk patients is necessary. The epicardial adipose tissue (EAT) is a biologically active organ having properties similar to visceral adipose tissue and has been associated with metabolic diseases and coronary artery disease. Superior to conventional cardiovascular risk factors and anthropometric measures, including body mass index and waist circumference, the EAT can early predict the development of coronary artery disease. Assessment of EAT can be performed by two-dimensional echocardiography, magnetic resonance imaging or computer tomography. However, its role and significance in patients with DM and nephropathy has not been thoroughly evaluated. The aim of the current editorial is to evaluate all available evidence regarding EAT in patients with DM and renal impairment. Systematic search of the literature revealed that patients with DM and nephropathy have increased EAT measurements, uncontrolled underlying disease, high body mass index and raised cardiovascular risk markers. Acknowledging the practical implications of this test, EAT assessment could serve as a novel and non-invasive biomarker to identify high-risk patients for cardiovascular adverse events.
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Affiliation(s)
- Zoi Kleinaki
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus
| | - Aris P Agouridis
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus
| | - Maria Zafeiri
- Diabetes and Obesity Center, Konstantopouleio Hospital, Athens 14233, Greece
| | - Theodoros Xanthos
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus
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12
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D’Marco L, Puchades MJ, Gorriz JL, Romero-Parra M, Lima-Martínez M, Soto C, Bermúdez V, Raggi P. Epicardial Adipose Tissue, Adiponectin and Leptin: A Potential Source of Cardiovascular Risk in Chronic Kidney Disease. Int J Mol Sci 2020; 21:ijms21030978. [PMID: 32024124 PMCID: PMC7037723 DOI: 10.3390/ijms21030978] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/21/2020] [Accepted: 01/29/2020] [Indexed: 12/18/2022] Open
Abstract
The importance of cardiometabolic factors in the inception and progression of atherosclerotic cardiovascular disease is increasingly being recognized. Beyond diabetes mellitus and metabolic syndrome, other factors may be responsible in patients with chronic kidney disease (CKD) for the high prevalence of cardiovascular disease, which is estimated to be 5- to 20-fold higher than in the general population. Although undefined uremic toxins are often blamed for part of the increased risk, visceral adipose tissue, and in particular epicardial adipose tissue (EAT), have been the focus of intense research in the past two decades. In fact, several lines of evidence suggest their involvement in atherosclerosis development and its complications. EAT may promote atherosclerosis through paracrine and endocrine pathways exerted via the secretion of adipocytokines such as adiponectin and leptin. In this article we review the current knowledge of the impact of EAT on cardiovascular outcomes in the general population and in patients with CKD. Special reference will be made to adiponectin and leptin as possible mediators of the increased cardiovascular risk linked with EAT.
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Affiliation(s)
- Luis D’Marco
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, University of Valencia, 46010 Valencia, Spain; (L.D.); (M.J.P.); (J.L.G.); (M.R.-P.)
| | - Maria Jesús Puchades
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, University of Valencia, 46010 Valencia, Spain; (L.D.); (M.J.P.); (J.L.G.); (M.R.-P.)
| | - Jose Luis Gorriz
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, University of Valencia, 46010 Valencia, Spain; (L.D.); (M.J.P.); (J.L.G.); (M.R.-P.)
| | - Maria Romero-Parra
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, University of Valencia, 46010 Valencia, Spain; (L.D.); (M.J.P.); (J.L.G.); (M.R.-P.)
| | - Marcos Lima-Martínez
- Physiologic Sciences Department, School of Health Sciences, Universidad de Oriente, Bolívar 5110, Venezuela;
| | - Carlos Soto
- Nephrology Department, Consorci Sanitari del Alt Penedes-Garraf, 08800 Barcelona, Spain;
| | - Valmore Bermúdez
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 080005, Colombia;
| | - Paolo Raggi
- Mazankowski Alberta Heart Institute, School of Medicine, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Correspondence: ; Tel.: +1-780-407-8006; Fax: +1-780-407-6452
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13
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Epicardial Adipose Tissue and Renal Disease. J Clin Med 2019; 8:jcm8030299. [PMID: 30832377 PMCID: PMC6463003 DOI: 10.3390/jcm8030299] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 02/19/2019] [Accepted: 02/25/2019] [Indexed: 01/09/2023] Open
Abstract
Epicardial adipose tissue (EAT) is derived from splanchnic mesoderm, localized anatomically between the myocardium and pericardial visceral layer, and surrounds the coronary arteries. Being a metabolically active organ, EAT secretes numerous cytokines, which moderate cardiovascular morphology and function. Through its paracrine and vasocrine secretions, EAT may play a prominent role in modulating cardiac function. EAT protects the heart in normal physiological conditions by secreting a variety of adipokines with anti-atherosclerotic properties, and in contrast, secretes inflammatory molecules in pathologic conditions that may play a dynamic role in the pathogenesis of cardiovascular diseases by promoting atherosclerosis. Considerable research has been focused on comparing the anatomical and biochemical features of EAT in healthy people, and a variety of disease conditions such as cardiovascular diseases and renal diseases. The global cardiovascular morbidity and mortality in renal disease are high, and there is a paucity of concrete evidence and societal guidelines to detect early cardiovascular disease (CVD) in this group of patients. Here we performed a clinical review on the existing evidence and knowledge on EAT in patients with renal disease, to evaluate its application as a reliable, early, noninvasive biomarker and indicator for CVD, and to assess its significance in cardiovascular risk stratification.
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14
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Kozan M, Ozan ZT, Demir V, Ede H. The relation of novel cardiovascular risk parameters in patients with familial Mediterranean fever. JRSM Cardiovasc Dis 2019; 8:2048004018823856. [PMID: 30643639 PMCID: PMC6322093 DOI: 10.1177/2048004018823856] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/27/2018] [Accepted: 09/26/2018] [Indexed: 11/17/2022] Open
Abstract
Objective In this study, we aimed at correlating the thickness of epicardial adipose tissue and levels of Vitamin D with cardiac risk in patients with familial Mediterranean fever. Methods Sixty-five patients with familial Mediterranean fever and 38 healthy controls with matching age and sex were included in the study. The patients with a history of familial Mediterranean fever attacks within the previous two weeks or with any history of inflammatory or cardiovascular disease were excluded. Data regarding age, gender, weight, height, waist circumference, body mass index (calculated as weight/height2), pulse wave velocity, serum Vitamin D levels from fasting blood samples, and Homeostatic Model Assessment for insulin resistance were obtained for the patients and controls. The epicardial adipose tissue was visualized as an echo-free space between the outer surface of myocardium and visceral pericardium using two-dimensional echocardiography, and the thickness of epicardial adipose tissue was measured in parasternal long-axis view at the end of diastole. Results The patients with familial Mediterranean fever had significantly higher levels of C-reactive protein, epicardial adipose tissue, and pulse wave velocity (p < 0.001, <0.05, <0.005, respectively) as compared with the control group. However, the serum Vitamin D levels in the two groups were observed to be similar (p = 0.486). Weak but significant positive correlations were observed between epicardial adipose tissue thickness and C-reactive protein (r = 0.302, p < 0.005), epicardial adipose tissue thickness and pulse wave velocity (r = 0.263, p < 0.01), and C-reactive protein and pulse wave velocity (r = 0.235, p < 0.05). Conclusion Thickness of epicardial adipose tissue and pulse wave velocity were observed to increase in patients with familial Mediterranean fever.
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Affiliation(s)
- Mustafa Kozan
- Department of Internal Medicine, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Zeynep Tugba Ozan
- Department of Internal Medicine, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Vahit Demir
- Department of Cardiology, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Hüseyin Ede
- Department of Cardiology, Faculty of Medicine, Bozok University, Yozgat, Turkey
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15
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Berg G, Miksztowicz V, Morales C, Barchuk M. Epicardial Adipose Tissue in Cardiovascular Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1127:131-143. [DOI: 10.1007/978-3-030-11488-6_9] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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