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Huang R, Li W, Xie Z, Zhuo K, Zhu J. Epicardial Adipose Tissue and Major Adverse Cardiovascular Events in Myocardial Infarction Patients with and without Diabetes. Acad Radiol 2024:S1076-6332(24)00208-3. [PMID: 38653598 DOI: 10.1016/j.acra.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/19/2024] [Accepted: 04/01/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Epicardial adipose tissue (EAT) accumulation plays a key role in the progression myocardial infarction (MI) and diabetes. Diabetic patients have elevated risk of major adverse cardiac events (MACEs) compared to non-diabetic patients. We aimed to investigate the prognostic value of EAT volume in MI patients with and without diabetes. METHODS This study included 458 MI patients who underwent cardiac computed tomography (CT) imaging and received successful stent implantation. EAT volume was quantified with cardiac CT imaging. Sub-study stratification of patients by diabetes status was further analyzed. Cox proportional hazards regression models were applied to evaluate the association between EAT volume and MACEs. RESULTS Diabetes was identified in 135 of the 458 patients (29.5%). EAT volume was significantly higher in diabetes than non-diabetes. During a median follow-up of 1154 days, MACEs occurred more frequently in patients with versus without diabetes. EAT volume was independent predictor of MACEs in all MI patients after adjustment for risk factors, and showed good predictive value in the evaluation of MACEs. Moreover, EAT volume was also significantly associated with MACEs after adjustment for risk factors in diabetes and non-diabetes in the subgroup analysis. CONCLUSION MI patients with diabetes had higher EAT volume and experienced higher rate of MACEs compared to non-diabetes. EAT volume is an independent risk of prognosis of MI, regardless of the diabetes status.
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Affiliation(s)
- Ruijue Huang
- Department of Basic Medicine, Hainan Vocational University of Science and Technology, Haikou 570100, China
| | - Wenjia Li
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610041, China
| | - Zhen Xie
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610041, China
| | - Kaimin Zhuo
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610041, China
| | - Jing Zhu
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610041, China.
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Krauz K, Kempiński M, Jańczak P, Momot K, Zarębiński M, Poprawa I, Wojciechowska M. The Role of Epicardial Adipose Tissue in Acute Coronary Syndromes, Post-Infarct Remodeling and Cardiac Regeneration. Int J Mol Sci 2024; 25:3583. [PMID: 38612394 PMCID: PMC11011833 DOI: 10.3390/ijms25073583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Epicardial adipose tissue (EAT) is a fat deposit surrounding the heart and located under the visceral layer of the pericardium. Due to its unique features, the contribution of EAT to the pathogenesis of cardiovascular and metabolic disorders is extensively studied. Especially, EAT can be associated with the onset and development of coronary artery disease, myocardial infarction and post-infarct heart failure which all are significant problems for public health. In this article, we focus on the mechanisms of how EAT impacts acute coronary syndromes. Particular emphasis was placed on the role of inflammation and adipokines secreted by EAT. Moreover, we present how EAT affects the remodeling of the heart following myocardial infarction. We further review the role of EAT as a source of stem cells for cardiac regeneration. In addition, we describe the imaging assessment of EAT, its prognostic value, and its correlation with the clinical characteristics of patients.
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Affiliation(s)
- Kamil Krauz
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Marcel Kempiński
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Paweł Jańczak
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Karol Momot
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Maciej Zarębiński
- Department of Invasive Cardiology, Independent Public Specialist Western Hospital John Paul II, Lazarski University, Daleka 11, 05-825 Grodzisk Mazowiecki, Poland; (M.Z.); (I.P.)
| | - Izabela Poprawa
- Department of Invasive Cardiology, Independent Public Specialist Western Hospital John Paul II, Lazarski University, Daleka 11, 05-825 Grodzisk Mazowiecki, Poland; (M.Z.); (I.P.)
| | - Małgorzata Wojciechowska
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
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Gavara J, Merenciano-Gonzalez H, Llopis-Lorente J, Molina-Garcia T, Perez-Solé N, de Dios E, Marcos-Garces V, Monmeneu JV, Lopez-Lereu MP, Canoves J, Bonanad C, Moratal D, Núñez J, Bayés-Genis A, Sanchis J, Chorro FJ, Rios-Navarro C, Bodí V. Impact of Epicardial Adipose Tissue on Infarct Size and Left Ventricular Systolic Function in Patients with Anterior ST-Segment Elevation Myocardial Infarction. Diagnostics (Basel) 2024; 14:368. [PMID: 38396407 PMCID: PMC10888463 DOI: 10.3390/diagnostics14040368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/31/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024] Open
Abstract
We aimed to assess the correlation of cardiovascular magnetic resonance (CMR)-derived epicardial adipose tissue (EAT) with infarct size (IS) and residual systolic function in ST-segment elevation myocardial infarction (STEMI). We enrolled patients discharged for a first anterior reperfused STEMI submitted to undergo CMR. EAT, left ventricular (LV) ejection fraction (LVEF), and IS were quantified at the 1-week (n = 221) and at 6-month CMR (n = 167). At 1-week CMR, mean EAT was 31 ± 13 mL/m2. Patients with high EAT volume (n = 72) showed larger 1-week IS. After adjustment, EAT extent was independently related to 1-week IS. In patients with large IS at 1 week (>30% of LV mass, n = 88), those with high EAT showed more preserved 6-month LVEF. This association persisted after adjustment and in a 1:1 propensity score-matched patient subset. Overall, EAT decreased at 6 months. In patients with large IS, a greater reduction of EAT was associated with more preserved 6-month LVEF. In STEMI, a higher presence of EAT was associated with a larger IS. Nevertheless, in patients with large infarctions, high EAT and greater subsequent EAT reduction were linked to more preserved LVEF in the chronic phase. This dual and paradoxical effect of EAT fuels the need for further research in this field.
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Affiliation(s)
- Jose Gavara
- Center for Biomaterials and Tissue Engineering, Universitat Politècnica de València, 46022 Valencia, Spain; (J.G.); (D.M.)
| | - Hector Merenciano-Gonzalez
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
| | - Jordi Llopis-Lorente
- Centro de Investigación e Innovación en Bioingeniería (Ci2B), Universitat Politècnica de València, 46010 Valencia, Spain;
| | - Tamara Molina-Garcia
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
| | - Nerea Perez-Solé
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
| | - Elena de Dios
- Centro de Investigación Biomédica en Red—Cardiovascular (CIBER-CV), 28022 Madrid, Spain; (E.d.D.); (A.B.-G.)
| | - Víctor Marcos-Garces
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
| | - Jose V. Monmeneu
- Cardiovascular Magnetic Resonance Unit, ASCIRES Biomedical Group, 46004 Valencia, Spain; (J.V.M.); (M.P.L.-L.)
| | - Maria P. Lopez-Lereu
- Cardiovascular Magnetic Resonance Unit, ASCIRES Biomedical Group, 46004 Valencia, Spain; (J.V.M.); (M.P.L.-L.)
| | - Joaquim Canoves
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
| | - Clara Bonanad
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
| | - David Moratal
- Center for Biomaterials and Tissue Engineering, Universitat Politècnica de València, 46022 Valencia, Spain; (J.G.); (D.M.)
| | - Julio Núñez
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Centro de Investigación Biomédica en Red—Cardiovascular (CIBER-CV), 28022 Madrid, Spain; (E.d.D.); (A.B.-G.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Antoni Bayés-Genis
- Centro de Investigación Biomédica en Red—Cardiovascular (CIBER-CV), 28022 Madrid, Spain; (E.d.D.); (A.B.-G.)
- Cardiology Department and Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, 08193 Badalona, Spain
- Department of Medicine, Universitat Autonoma de Barcelona, 08193 Barcelona, Spain
| | - Juan Sanchis
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Centro de Investigación Biomédica en Red—Cardiovascular (CIBER-CV), 28022 Madrid, Spain; (E.d.D.); (A.B.-G.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Francisco J. Chorro
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Centro de Investigación Biomédica en Red—Cardiovascular (CIBER-CV), 28022 Madrid, Spain; (E.d.D.); (A.B.-G.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Cesar Rios-Navarro
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Department of Pathology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Vicente Bodí
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Centro de Investigación Biomédica en Red—Cardiovascular (CIBER-CV), 28022 Madrid, Spain; (E.d.D.); (A.B.-G.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
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Islas F, Gutiérrez E, Cachofeiro V, Martínez-Martínez E, Marín G, Olmos C, Carrión I, Gil S, Mahía P, Cobos MÁ, de Agustín A, Luaces M. Importance of cardiac imaging assessment of epicardial adipose tissue after a first episode of myocardial infarction. Front Cardiovasc Med 2022; 9:995367. [PMID: 36451918 PMCID: PMC9702512 DOI: 10.3389/fcvm.2022.995367] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/29/2022] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Over the past years, information about the crosstalk between the epicardial adipose tissue (EAT) and the cardiovascular system has emerged. Notably, in the context of acute myocardial infarction (AMI), EAT might have a potential role in the pathophysiology of ventricular structural changes and function, and the clinical evolution of patients. This study aims to assess the impact of EAT on morpho-functional changes in the left ventricle (LV) and the outcome of patients after an AMI. METHODS We studied prospectively admitted patients to our hospital with a first episode of AMI. All patients underwent percutaneous coronary intervention (PCI) during admission. Transthoracic echocardiography (TTE) was performed within 24-48 h after PCI, as well as blood samples to assess levels of galectin-3 (Gal-3). Cardiac magnetic resonance (CMR) was performed 5-7 days after PCI. Clinical follow-up was performed at 1 and 5 years after MI. RESULTS Mean age of our cohort (n = 41) was 57.5 ± 10 years, and 38 (93%) were male. Nine patients had normal BMI, 15 had overweight (BMI 25-30), and 17 were obese (BMI > 30). Twenty three patients (56%) had ≥ 4 mm thickness of EAT measured with echo. In these patients, baseline left ventricular ejection fraction (LVEF) after AMI was significantly lower, as well as global longitudinal strain. EAT thickness ≥ 4 m patients presented larger infarct size, higher extracellular volume, and higher T1 times than patients with EAT < 4 mm. As for Gal-3, the median was 16.5 ng/mL [12.7-25.2]. At five-year follow-up 5 patients had major cardiac events, and all of them had EAT ≥ 4 mm. CONCLUSIONS Patients with EAT >4 mm have worse LVEF and GLS, larger infarct size and longer T1 values after a MI, and higher levels of Gal-3. EAT >4 mm was an independent predictor of MACE at 5-year follow-up. EAT thickness is a feasible, noninvasive, low-cost parameter that might provide important information regarding the chronic inflammatory process in the myocardium after an infarction.
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Affiliation(s)
- Fabián Islas
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - Eva Gutiérrez
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - Victoria Cachofeiro
- Departamento de Fisiología, Facultad de Medicina, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, Madrid, Spain
- Ciber de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Ernesto Martínez-Martínez
- Departamento de Fisiología, Facultad de Medicina, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, Madrid, Spain
- Ciber de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Gema Marín
- Departamento de Fisiología, Facultad de Medicina, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, Madrid, Spain
| | - Carmen Olmos
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - Irene Carrión
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - Sandra Gil
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - Patricia Mahía
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - Miguel Ángel Cobos
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - Alberto de Agustín
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - María Luaces
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
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Ma Y, Ma Q, Wang X, Yu T, Dang Y, Shang J, Li G, Hou Y. Incremental Prognostic Value of Pericoronary Adipose Tissue Thickness Measured Using Cardiac Magnetic Resonance Imaging After Revascularization in Patients With ST-Elevation Myocardial Infarction. Front Cardiovasc Med 2022; 9:781402. [PMID: 35317286 PMCID: PMC8934413 DOI: 10.3389/fcvm.2022.781402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background and AimPericoronary adipose tissue (PCAT) reflects pericoronary inflammation and is associated with coronary artery disease. We aimed to identify the association between local PCTA thickness using cardiac magnetic resonance (CMR) and prognosis of patients with ST-elevation myocardial infarction (STEMI), and to investigate the incremental prognostic value of PCAT thickness in STEMI after reperfusion.MethodsA total of 245 patients with STEMI (mean age, 55.61 ± 10.52 years) who underwent CMR imaging within 1 week of percutaneous coronary intervention therapy and 35 matched controls (mean age, 53.89 ± 9.45 years) were enrolled. PCAT thickness indexed to body surface area at five locations, ventricular volume and function, infarct-related parameters, and global strain indices were evaluated using CMR. Associations between PCAT thickness index and 1-year major adverse cardiovascular events (MACE) after STEMI were calculated. The prognostic value of the standard model based on features of clinical and CMR and updated model including PACT thickness index were further assessed.ResultsPatients with MACE had a more significant increase in PCAT thickness index at superior interventricular groove (SIVGi) than patients without MACE. The SIVGi was significantly associated with left ventricular ejection fraction (LVEF), infarct size, and global deformation. SIVGi > 4.98 mm/m2 was an independent predictor of MACE (hazard ratio, 3.2; 95% CI: 1.6–6.38; p < 0.001). The updated model significantly improved the power of prediction and had better discrimination ability than that of the standard model for predicting 1-year MACE (areas under the ROC curve [AUC] = 0.8 [95% CI: 0.74–0.87] vs. AUC = 0.76 [95% CI: 0.68–0.83], p < 0.05; category-free net reclassification index [cfNRI] = 0.38 [95% CI: 0.1–0.53, p = 0.01]; integrated discrimination improvement [IDI] = 0.09 [95% CI: 0.01–0.18, p = 0.02]).ConclusionsThis study demonstrated SIVGi as an independent predictor conferred incremental value over standard model based on clinical and CMR factors in 1-year MACE predictions for STEMI.
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Affiliation(s)
- Yue Ma
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Quanmei Ma
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaonan Wang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tongtong Yu
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuxue Dang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jin Shang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Guangxiao Li
- Department of Medical Record Management Center, The First Hospital of China Medical University, Shenyang, China
| | - Yang Hou
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Yang Hou
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Rodríguez-Granillo GA, Cirio JJ, Ciardi C, Caballero ML, Fontana L, Pérez N, Ingino CA, Lylyk P. Epicardial and periaortic fat characteristics in ischemic stroke: Relationship with stroke etiology and calcification burden. Eur J Radiol 2021; 146:110102. [PMID: 34922116 DOI: 10.1016/j.ejrad.2021.110102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 11/24/2021] [Accepted: 12/08/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE We explored epicardial (EAT) and periaortic (PAT) adipose tissue characteristics in patients with acute ischemic stroke (AIS), and the relationship with stroke etiology, calcification burden, and inflammation. METHOD We included a retrospective cohort of consecutive patients admitted with AIS between 2015 and 2020 who underwent a chest computed tomography. We calculated volumes and attenuation of EAT and PAT, and coronary artery (CAC), and thoracic aortic (TAC) calcification. Admission's neutrophil/lymphocyte ratio (NLR) was recorded. Stroke severity was assessed using the National Institute of Health Stroke Scale (NIHSS), and patients were discriminated between cardioembolic (CE), non-CE, and embolic strokes of uncertain source (ESUS). RESULTS A total of 182 patients were included. EAT (non-CE 127.4 ± 47.1 cm3; CE 133.3 ± 56.7 cm3; ESUS 121.6 ± 63.5 cm3, p > 0.05) and PAT (non-CE 37.4 ± 18.6 cm3; CE 40.4 ± 17.2 cm3; ESUS 34.5 ± 14.1 cm3, p > 0.05) volumes were similar between stroke etiologies. Patients with CE stroke had higher PAT attenuation (PAT = non-CE -84.4 ± 7.0 HU; CE -78.1 ± 9.9 HU; ESUS -82.3 ± 9.3 HU, p < 0.001). Using multiple linear regression, albeit weak, we found a significant relationship between NLR and PAT attenuation [Beta 0.24; (95% CI 0.04-0.51), p < 0.05). Despite similar volume, PAT attenuation was higher (p < 0.01) among demised patients. CONCLUSION In this study, we identified higher periaortic fat attenuation, despite similar fat volume, in patients with CE stroke.
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Affiliation(s)
- Gaston A Rodríguez-Granillo
- Department of Cardiovascular Imaging, Instituto Medico ENERI, Clinica La Sagrada Familia, Buenos Aires, Argentina.
| | - Juan J Cirio
- Stroke Unit, Instituto Medico ENERI, Clinica La Sagrada Familia, Buenos Aires, Argentina
| | - Celina Ciardi
- Stroke Unit, Instituto Medico ENERI, Clinica La Sagrada Familia, Buenos Aires, Argentina
| | - Maria Laura Caballero
- Stroke Unit, Instituto Medico ENERI, Clinica La Sagrada Familia, Buenos Aires, Argentina
| | - Lucia Fontana
- Department of Cardiovascular Imaging, Instituto Medico ENERI, Clinica La Sagrada Familia, Buenos Aires, Argentina
| | - Nicolás Pérez
- Department of Interventional Neuroradiology, Instituto Medico ENERI, Clinica La Sagrada Familia, Buenos Aires, Argentina
| | - Carlos A Ingino
- Department of Cardiology, Instituto Medico ENERI, Clinica La Sagrada Familia, Buenos Aires, Argentina
| | - Pedro Lylyk
- Department of Interventional Neuroradiology, Instituto Medico ENERI, Clinica La Sagrada Familia, Buenos Aires, Argentina
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Yamaguchi M, Yonetsu T, Hoshino M, Sugiyama T, Kanaji Y, Yasui Y, Nogami K, Ueno H, Nagamine T, Misawa T, Hada M, Sumino Y, Hamaya R, Usui E, Murai T, Lee T, Sasano T, Kakuta T. Clinical Significance of Increased Computed Tomography Attenuation of Periaortic Adipose Tissue in Patients With Abdominal Aortic Aneurysms. Circ J 2021; 85:2172-2180. [PMID: 33896902 DOI: 10.1253/circj.cj-20-1014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Recent imaging studies reported an association between vascular inflammation and progression of abdominal aortic aneurysm (AAA). This study investigated the clinical significance of periaortic adipose tissue inflammation derived from multidetector computed tomography angiography (MDCTA).Methods and Results:Patients with asymptomatic AAA (n=77) who underwent an index and >6 months follow-up MDCTA examinations were retrospectively investigated. MDCTA analysis included AAA diameter and the periaortic adipose tissue attenuation index (PAAI). The PAAI was defined as the mean CT attenuation value within a predefined range from -190 to -30 Hounsfield units of adipose tissue surrounding the AAA. The growth rate of the AAA was calculated as the change in diameter. AAA progression (AP) was defined as an AAA growth rate ≥5 mm/year. Univariate and multivariate logistic regression analysis were performed to determine the predictors of AP. AP was observed in 19 patients (24.7%), the median baseline AAA diameter was 38.9 mm (interquartile range [IQR] 32.7-42.9 mm), and the median growth rate was 3.1 mm/year (IQR 1.5-4.9 mm/year). Baseline AAA diameter (odds ratio [OR] 1.16; 95% confidence interval [CI] 1.05-1.28; P=0.001) and PAAI (OR 1.12; 95% CI 1.05-1.20; P=0.004) were independent predictors of AP. CONCLUSIONS PAAI was an independent and significant predictor of AP, supporting the notion that local adipose tissue inflammation may contribute to aortic remodeling.
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Affiliation(s)
- Masao Yamaguchi
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Taishi Yonetsu
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Masahiro Hoshino
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Tomoyo Sugiyama
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Yoshihisa Kanaji
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Yumi Yasui
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Kai Nogami
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Hiroki Ueno
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | | | - Toru Misawa
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Masahiro Hada
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Yohei Sumino
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Rikuta Hamaya
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Eisuke Usui
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Tadashi Murai
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | - Tetsumin Lee
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Tetsuo Sasano
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Tsunekazu Kakuta
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
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Tanaka K, Fukuda D, Sata M. Roles of Epicardial Adipose Tissue in the Pathogenesis of Coronary Atherosclerosis - An Update on Recent Findings. Circ J 2020; 85:2-8. [PMID: 33268604 DOI: 10.1253/circj.cj-20-0935] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Adipose tissue serves not only as an energy store or a mechanical cushion, but also as an endocrine organ. Recent evidence revealed that perivascular adipose tissue is involved in vascular homeostasis and pathophysiology of adjacent arteries by producing various adipokines. Epicardial adipose tissue (EAT) is located between the surface of the heart and the visceral layer of the pericardium and surrounds the coronary arteries. Many clinical studies suggest that an increase in EAT volume is associated with coronary artery disease. It has been reported that exercise and some antidiabetic drugs can reduce EAT volume. In this review, we outline recent findings on the roles of EAT in the pathogenesis of coronary atherosclerosis.
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Affiliation(s)
- Kimie Tanaka
- Division for Health Service Promotion, The University of Tokyo
| | - Daiju Fukuda
- Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences.,Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
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