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Quarta S, Santarpino G, Carluccio MA, Calabriso N, Cardetta F, Siracusa L, Strano T, Palamà I, Leccese G, Visioli F, Massaro M. Cardiac fat adipocytes: An optimized protocol for isolation of ready-to-use mature adipocytes from human pericardial adipose tissue. J Mol Cell Cardiol 2024; 196:12-25. [PMID: 39214497 DOI: 10.1016/j.yjmcc.2024.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 08/23/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024]
Abstract
A better understanding of the pathophysiology of cardiac fat depots is crucial to describe their role in the development of cardiovascular diseases. To this end, we have developed a method to isolate mature fat cells from the pericardial adipose tissue (PAT), the most accessible cardiac fat depot during cardiac surgery. Using enzymatic isolation, we were able to successfully obtain mature fat cells together with the corresponding cells of the stromal vascular fraction (SVF). We subjected the PAT adipocytes to thorough morphological and molecular characterization, including detailed fatty acid profiling, and simultaneously investigated their reactivity to external stimuli. Our approach resulted in highly purified fat cells with sustained viability for up to 72 h after explantation. Remarkably, these adipocytes responded to multiple challenges, including pro-inflammatory and metabolic stimuli, indicating their potential to trigger a pro-inflammatory response and modulate endothelial cell behavior. Furthermore, we have created conditions to maintain whole PAT in culture and preserve their viability and reactivity to external stimuli. The efficiency of cell recovery combined with minimal dedifferentiation underscores the promise for future applications as a personalized tool for screening and assessing individual patient responses to drugs and supplements or nutraceuticals.
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Affiliation(s)
- Stefano Quarta
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 73100 Lecce, Italy.
| | - Giuseppe Santarpino
- Department of Clinical and Experimental Medicine, Magna Graecia University of Catanzaro, Italy; Department of Cardiac Surgery, Città di Lecce Hospital, GVM Care&Research, Lecce, Italy; Department of Cardiac Surgery, Paracelsus Medical University, Nuremberg, Germany.
| | | | - Nadia Calabriso
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 73100 Lecce, Italy.
| | - Francesco Cardetta
- Department of Cardiac Surgery, University "Campus Biomedico", Rome, Italy.
| | - Laura Siracusa
- Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Catania section, Via Paolo Gaifami 18, 95126 Catania, Italy.
| | - Tonia Strano
- Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Catania section, Via Paolo Gaifami 18, 95126 Catania, Italy.
| | - Ilaria Palamà
- Institute Nanotechnology Institute, CNR-NANOTEC, 73100 Lecce, Italy.
| | - Gabriella Leccese
- Institute Nanotechnology Institute, CNR-NANOTEC, 73100 Lecce, Italy.
| | | | - Marika Massaro
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 73100 Lecce, Italy.
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Yu P, Yang H, Qi X, Bai R, Zhang S, Gong J, Mei Y, Hu P. Gender differences in the ideal cutoffs of visceral fat area for predicting MAFLD in China. Lipids Health Dis 2022; 21:148. [PMID: 36585702 PMCID: PMC9805250 DOI: 10.1186/s12944-022-01763-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/23/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Since the discovery of metabolic-associated fatty liver disease (MAFLD) in 2020, no report on the connection between the visceral fat area (VFA) and MAFLD has been published in China, and the ideal cutoffs of VFA for predicting MAFLD has not been determined so far. Thus, the purpose of this research was to clarify the relationship between VFA and MAFLD and the ideal cutoffs of VFA to predict MAFLD in the Chinese population. METHODS Five thousand three hundred forty subjects were included in this research, with 30% randomly selected for the validation set (n = 1602) and 70% for the Training set (n = 3738). The association between VFA and MAFLD was determined by multiple logistic regression. ROC curves were used to evaluate the prediction effect of VFA on MAFLD. RESULTS Multiple logistic regression analysis revealed that the VFA ORs (95% CIs) were 1.25 (1.20, 1.29) for women and 1.15 (1.12, 1.17) for men. Meanwhile, the VFA quartile OR (95% CI) were 3.07 (1.64, 5.75), 7.22 (3.97, 13.14), 18.91 (10.30, 34.71) for women and 3.07 (1.64, 5.75), 7.22 (3.97, 13.14),18.91 (10.30, 34.71) for men in the Q2, Q3, and Q4 groups compared with Q1. The ROC curve showed the VFA, WC, WHR, and WHtR to predict MAFLD, the AUC value of VFA was the highest and the prediction effect was the best. The ideal cutoffs of VFA to predict MAFLD was 115.55 cm2 for women and 178.35 cm2 for men, and the AUC was 0.788 and 0.795, respectively. Finally, the AUC was 0.773 for women and 0.800 for men in the validation set. CONCLUSION VFA was an independent predictive factor for MAFLD, and the ideal cutoff of VFA to predict MAFLD was 115.55 cm2 in women and 178.35 cm2 in men.
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Affiliation(s)
- Pingping Yu
- Department of Health Management, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huachao Yang
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoya Qi
- Department of Health Management, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ruixue Bai
- Department of Health Management, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shouqin Zhang
- Department of Health Management, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jianping Gong
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Mei
- Department of Health Management, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Peng Hu
- Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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3
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McInerney A, Tirado-Conte G, Rodes-Cabau J, Campelo-Parada F, Tafur Soto JD, Barbanti M, Muñoz-Garcia E, Arif M, Lopez D, Toggweiler S, Veiga G, Pylko A, Sevilla T, Compagnone M, Regueiro A, Serra V, Carnero M, Oteo JF, Rivero F, Barbosa Ribeiro H, Guimaraes L, Matta A, Giraldo Echavarria N, Valvo R, Moccetti F, Muñoz-Garcia AJ, Lopez-Pais J, Garcia Del Blanco B, Campanha Borges DC, Dumont E, Gonzalo N, Criscione E, Dabrowski M, Alfonso F, de la Torre Hernández JM, Cheema AN, Amat-Santos IJ, Saia F, Escaned J, Nombela-Franco L. Impact of Morbid Obesity and Obesity Phenotype on Outcomes After Transcatheter Aortic Valve Replacement. J Am Heart Assoc 2021; 10:e019051. [PMID: 34056919 PMCID: PMC8477858 DOI: 10.1161/jaha.120.019051] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background There is a paucity of outcome data on patients who are morbidly obese (MO) undergoing transcatheter aortic valve replacement. We aimed to determine their periprocedural and midterm outcomes and investigate the impact of obesity phenotype. Methods and Results Consecutive patients who are MO (body mass index, ≥40 kg/m2, or ≥35 kg/m2 with obesity-related comorbidities; n=910) with severe aortic stenosis who underwent transcatheter aortic valve replacement in 18 tertiary hospitals were compared with a nonobese cohort (body mass index, 18.5-29.9 kg/m2, n=2264). Propensity-score matching resulted in 770 pairs. Pre-transcatheter aortic valve replacement computed tomography scans were centrally analyzed to assess adipose tissue distribution; epicardial, abdominal visceral and subcutaneous fat. Major vascular complications were more common (6.6% versus 4.3%; P=0.043) and device success was less frequent (84.4% versus 88.1%; P=0.038) in the MO group. Freedom from all-cause and cardiovascular mortality were similar at 2 years (79.4 versus 80.6%, P=0.731; and 88.7 versus 87.4%, P=0.699; MO and nonobese, respectively). Multivariable analysis identified baseline glomerular filtration rate and nontransfemoral access as independent predictors of 2-year mortality in the MO group. An adverse MO phenotype with an abdominal visceral adipose tissue:subcutaneous adipose tissue ratio ≥1 (VAT:SAT) was associated with increased 2-year all-cause (hazard ratio [HR], 3.06; 95% CI, 1.20-7.77; P=0.019) and cardiovascular (hazard ratio, 4.11; 95% CI, 1.06-15.90; P=0.041) mortality, and readmissions (HR, 1.81; 95% CI, 1.07-3.07; P=0.027). After multivariable analysis, a (VAT:SAT) ratio ≥1 remained a strong predictor of 2-year mortality (hazard ratio, 2.78; P=0.035). Conclusions Transcatheter aortic valve replacement in patients who are MO has similar short- and midterm outcomes to nonobese patients, despite higher major vascular complications and lower device success. An abdominal VAT:SAT ratio ≥1 identifies an obesity phenotype at higher risk of adverse clinical outcomes.
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Affiliation(s)
- Angela McInerney
- Cardiovascular InstituteHospital Clínico San CarlosInstituto de Investigación Sanitaria San Carlos Madrid Spain
| | - Gabriela Tirado-Conte
- Cardiovascular InstituteHospital Clínico San CarlosInstituto de Investigación Sanitaria San Carlos Madrid Spain
| | - Josep Rodes-Cabau
- Quebec Heart and Lung InstituteLaval University Quebec City Quebec Canada
| | | | | | | | - Erika Muñoz-Garcia
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares Cardiology Department Hospital Universitario Virgen de la Victoria Málaga Spain
| | - Mobeena Arif
- Division of Cardiology St. Michael's HospitalToronto University Toronto Ontario Canada
| | - Diego Lopez
- Hospital Clínico Universitario de SantiagoCIBERCV Santiago Spain
| | | | - Gabriela Veiga
- Hospital Universitario Marques de Valdecilla IDIVAL Santander Spain
| | - Anna Pylko
- Department of Interventional Cardiology and Angiology National Institute of Cardiology Warsaw Poland
| | - Teresa Sevilla
- CIBERCVInstituto de Ciencias del CorazónHospital Clínico Universitario de Valladolid Valladolid Spain
| | - Miriam Compagnone
- Cardiology Unit Cardio-Thoracic-Vascular Department University Hospital of BolognaPoliclinico S, Orsola-Malpighi Bologna Italy
| | - Ander Regueiro
- Cardiology Department Cardiovascular Institute, Hospital ClínicUniversidad de BarcelonaInstitut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Spain
| | - Viçent Serra
- Hospital General Universitari Vall d'Hebron Barcelona Spain
| | - Manuel Carnero
- Cardiovascular InstituteHospital Clínico San CarlosInstituto de Investigación Sanitaria San Carlos Madrid Spain
| | - Juan F Oteo
- Department of Cardiology Hospital Universitario Puerta de Hierro Majadahonda Spain
| | - Fernando Rivero
- Cardiology Department Hospital Universitario de la PrincesaInstituto de Investigación Sanitaria Princesa (IIS-IP)Universidad Autónoma de Madrid, CIBER-CV Madrid Spain
| | | | - Leonardo Guimaraes
- Quebec Heart and Lung InstituteLaval University Quebec City Quebec Canada
| | - Anthony Matta
- Cardiology Department Rangueil University Hospital Toulouse France
| | | | - Roberto Valvo
- Ferrarotto Hospital University of Catania Catania Italy
| | | | - Antonio J Muñoz-Garcia
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares Cardiology Department Hospital Universitario Virgen de la Victoria Málaga Spain
| | | | | | | | - Eric Dumont
- Quebec Heart and Lung InstituteLaval University Quebec City Quebec Canada
| | - Nieves Gonzalo
- Cardiovascular InstituteHospital Clínico San CarlosInstituto de Investigación Sanitaria San Carlos Madrid Spain
| | | | - Maciej Dabrowski
- Department of Interventional Cardiology and Angiology National Institute of Cardiology Warsaw Poland
| | - Fernando Alfonso
- Cardiology Department Hospital Universitario de la PrincesaInstituto de Investigación Sanitaria Princesa (IIS-IP)Universidad Autónoma de Madrid, CIBER-CV Madrid Spain
| | | | - Asim N Cheema
- Division of Cardiology St. Michael's HospitalToronto University Toronto Ontario Canada
| | - Ignacio J Amat-Santos
- CIBERCVInstituto de Ciencias del CorazónHospital Clínico Universitario de Valladolid Valladolid Spain
| | - Francesco Saia
- Cardiology Unit Cardio-Thoracic-Vascular Department University Hospital of BolognaPoliclinico S, Orsola-Malpighi Bologna Italy
| | - Javier Escaned
- Cardiovascular InstituteHospital Clínico San CarlosInstituto de Investigación Sanitaria San Carlos Madrid Spain
| | - Luis Nombela-Franco
- Cardiovascular InstituteHospital Clínico San CarlosInstituto de Investigación Sanitaria San Carlos Madrid Spain
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Huang Y, Ge Y, Li F, Zhang C, Zhang Z, Xu N, Wang R, Wu S, Geng X, Quan Y, Ren H. Elucidating the relationship between nutrition indices and coronary artery calcification in patients undergoing maintenance hemodialysis. Ther Apher Dial 2021; 26:71-84. [PMID: 34038022 DOI: 10.1111/1744-9987.13693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/20/2021] [Accepted: 05/23/2021] [Indexed: 12/13/2022]
Abstract
Cardiovascular diseases (CVD) are common in maintenance hemodialysis (MHD) patients, and vascular calcification is associated with the incidence of CVD. Malnourished MHD patients are particularly prone to CVD events. Thus far, there is no clear explanation for the relationship of nutrition status with vascular calcification; therefore, we investigated the relationship between malnutrition and vascular calcification. One hundred thirty-one patients underwent laboratory testing, assessment of vascular calcification, modified quantitative subjective global assessment (MQSGA), bioelectrical impedance analysis (BIA), and anthropometric measurements. The patients were divided into two groups based on the presence or absence of coronary artery calcification (CAC), and nutritional statuses were compared between the two groups. The MQSGA score was higher in the CAC group (mean 10.9 ± 1.81) than in the no-CAC group (mean 10.2 ± 1.51); in addition, the mean phase angle (PA) value was significantly lower in the CAC group than in the no-CAC group. Stratification according to CAC score showed that age, Kt/V, incidence of valve calcification, incidence of abdominal aortic calcification, MQSGA score, and blood cell mass were related to the severity of CAC. In addition, quartile analysis revealed that MQSGA score and PA value were related to the incidence and severity of vascular calcification. Binary regression analysis showed that MQSGA score, age, hemoglobin level, and high-density lipoprotein level were independent risk factors for dialysis-related CAC. Patients on MHD who exhibited malnutrition were more likely to have vascular calcification, especially CAC. Namely, the higher the MQSGA score, the lower the PA, and the more likely the occurrence of CAC.
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Affiliation(s)
- Yingzi Huang
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yongchun Ge
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Furong Li
- Department of Nephrology, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chuanzhen Zhang
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zhaoyong Zhang
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Na Xu
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Rui Wang
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Shun Wu
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xin Geng
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yongqiang Quan
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Hongqi Ren
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China.,National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
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Venuraju SM, Lahiri A, Jeevarethinam A, Rakhit RD, Shah PK, Nilsson J. Association of Epicardial Fat Volume With the Extent of Coronary Atherosclerosis and Cardiovascular Adverse Events in Asymptomatic Patients With Diabetes. Angiology 2021; 72:442-450. [PMID: 33467865 DOI: 10.1177/0003319720984607] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Epicardial adipose tissue has a paracrine effect, enhancing coronary artery atherosclerotic plaque development. This study evaluated epicardial fat volume (EFV), adipokines, coronary atherosclerosis, and adverse cardiovascular events in a cohort of asymptomatic patients with type 2 diabetes mellitus (T2DM). Epicardial fat volume was calculated using data from computed tomography coronary angiograms. Adipokines and inflammatory cytokines were also assayed and correlated with EFV. Epicardial fat volume was also assessed as a predictor of coronary artery calcium (CAC) score, number of coronary artery plaques, and significant plaque (>50% luminal stenosis). Data from the EFV analysis were available for 221 (85.7%) participants. Median EFV was 97.4 cm3, mean body mass index was 28.1 kg/m2, and mean duration of T2DM was 13 years. Statistically significant, but weak, correlations were observed between several adipokines, inflammatory cytokines, and EFV. Epicardial fat volume was a significant univariate (P = .01), but not multivariate, predictor of the number of coronary plaques, but not of CAC score or significant plaque. After a mean follow-up of 22.8 months, 12 adverse cardiovascular events were reported, exclusively in participants with EFV >97.4 cm3. Epicardial fat volume has limited utility as a marker of coronary artery plaque in patients with T2DM and is weakly correlated with adipokine expression.
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Affiliation(s)
- Shreenidhi M Venuraju
- Institute of Cardiovascular Science, 4919University College London, United Kingdom
- 40531British Cardiac Research Trust, London, United Kingdom
- Bedford Hospital, Bedford, United Kingdom
| | - Avijit Lahiri
- 40531British Cardiac Research Trust, London, United Kingdom
- Cardiac Imaging and Research Centre, Wellington Hospital, London, United Kingdom
- Imperial College School of Medicine, Imperial College London, United Kingdom
- Healthcare Science, Middlesex University, London, United Kingdom
| | - Anand Jeevarethinam
- Institute of Cardiovascular Science, 4919University College London, United Kingdom
- 40531British Cardiac Research Trust, London, United Kingdom
- Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - Roby D Rakhit
- Institute of Cardiovascular Science, 4919University College London, United Kingdom
- Department of Cardiology, Royal Free Hospital, London, United Kingdom
| | | | - Jan Nilsson
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Lund University, Sweden
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Abrahim M. The Pleating Effect Explains the Cardioauricular Connection. J Oral Maxillofac Surg 2020; 79:273. [PMID: 33166520 DOI: 10.1016/j.joms.2020.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 11/27/2022]
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Abstract
A new cardiometabolic-based chronic disease (CMBCD) model is presented that provides a basis for early and sustainable, evidence-based therapeutic targeting to promote cardiometabolic health and mitigate the development and ravages of cardiovascular disease. In the first part of this JACC State-of-the-Art Review, a framework is presented for CMBCD, focusing on 3 primary drivers (genetics, environment, and behavior) and 2 metabolic drivers (adiposity and dysglycemia) with applications to 3 cardiovascular endpoints (coronary heart disease, heart failure, and atrial fibrillation). Specific mechanistic pathways are presented configuring early primary drivers with subsequent adiposity, insulin resistance, β-cell dysfunction, and metabolic syndrome, leading to cardiovascular disease. The context for building this CMBCD model is to expose actionable targets for prevention to achieve optimal cardiovascular outcomes. The tactical implementation of this CMBCD model is the subject of second part of this JACC State-of-the-Art Review.
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Cardiometabolic-Based Chronic Disease, Adiposity and Dysglycemia Drivers: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 75:525-538. [PMID: 32029136 DOI: 10.1016/j.jacc.2019.11.044] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/06/2019] [Accepted: 11/17/2019] [Indexed: 02/07/2023]
Abstract
A new cardiometabolic-based chronic disease (CMBCD) model is presented that provides a basis for early and sustainable, evidence-based therapeutic targeting to promote cardiometabolic health and mitigate the development and ravages of cardiovascular disease. In the first part of this JACC State-of-the-Art Review, a framework is presented for CMBCD, focusing on 3 primary drivers (genetics, environment, and behavior) and 2 metabolic drivers (adiposity and dysglycemia) with applications to 3 cardiovascular endpoints (coronary heart disease, heart failure, and atrial fibrillation). Specific mechanistic pathways are presented configuring early primary drivers with subsequent adiposity, insulin resistance, β-cell dysfunction, and metabolic syndrome, leading to cardiovascular disease. The context for building this CMBCD model is to expose actionable targets for prevention to achieve optimal cardiovascular outcomes. The tactical implementation of this CMBCD model is the subject of second part of this JACC State-of-the-Art Review.
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9
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Si Y, Cui Z, Liu J, Ding Z, Han C, Wang R, Liu T, Sun L. Pericardial adipose tissue is an independent risk factor of coronary artery disease and is associated with risk factors of coronary artery disease. J Int Med Res 2020; 48:300060520926737. [PMID: 32493096 PMCID: PMC7273777 DOI: 10.1177/0300060520926737] [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] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective Pericardial adipose tissue volume (PATV) is related to the mechanism of coronary artery disease (CAD), but its association with CAD risk factors is not clear. This study aimed to investigate the relationships between PATV and its associated factors. Methods A total of 682 inpatients were consecutively enrolled in this study. Patients were divided into the high PATV group (PATV ≥174.5 cm3; n = 506) and low PATV group (PATV < 174.5 cm3; n = 176). Multiple linear regression analysis was conducted to evaluate the related factors of PATV. Multivariable logistic regression was used to analyze the risk factors of CAD. Results Left ventricular fat volume, right ventricular fat volume, body mass index, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were significant and independent risk factors of enlargement of PATV. Increased PATV was identified as an independent risk factor of CAD, and increased pulse pressure was also independently and positively correlated with CAD. Conclusions PATV is significantly correlated with the classic risk factors of CAD. Pulse pressure is also correlated with PATV. PATV is an independent risk factor of CAD, and pericardial adipose tissue may alternatively be used in non-invasive diagnostic examination of CAD.
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Affiliation(s)
- Yueqiao Si
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Zhixin Cui
- Department of Radiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Jingyi Liu
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Zhenjiang Ding
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Chao Han
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Ruijuan Wang
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Tong Liu
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Lixian Sun
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
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Rodriguez-Granillo GA, Nieman K, Carrascosa P, Campisi R, Ambrose JA. Anatomic or functional testing in stable patients with suspected CAD: contemporary role of cardiac CT in the ISCHEMIA trial era. Int J Cardiovasc Imaging 2020; 36:1351-1362. [PMID: 32180079 DOI: 10.1007/s10554-020-01815-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 03/07/2020] [Indexed: 11/30/2022]
Abstract
One of the foundations of the management of patients with suspected coronary artery disease (CAD) is to avoid unnecessary invasive coronary angiography (ICA) referrals. However, the diagnostic yield of ICA following abnormal conventional stress testing is low. The ability of ischemia testing to predict subsequent myocardial infarction and death is currently being challenged, and more than half of cardiac events among stable patients with suspected CAD occur in those with normal functional tests. The optimal management of patients with stable CAD remains controversial and ischemia-driven interventions, though improving anginal symptoms, have failed to reduce the risk of hard cardiovascular events. In this context, there is an ongoing debate whether the initial diagnostic test among patients with stable suspected CAD should be a functional test or coronary computed tomography angiography. Aside from considering the specific characteristics of individual patients and local availability and conditions, the choice of the initial test relates to whether the objective concerns its role as gatekeeper for ICA, prognosis, or treatment decision-making. Therefore, the aim of this review is to provide a contemporary overview of these issues and discuss the emerging role of CCTA as the upfront imaging tool for most patients with suspected CAD.
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Affiliation(s)
- Gaston A Rodriguez-Granillo
- Department of Cardiovascular Imaging, Instituto Medico Eneri, Clinica La Sagrada Familia, Av. Libertador 6647 (C1428ARJ), Buenos Aires, Argentina. .,Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET), Buenos Aires, Argentina.
| | - Koen Nieman
- Stanford University School of Medicine, Cardiovascular Institute, Stanford, CA, USA
| | - Patricia Carrascosa
- Department of Cardiovascular Imaging, Diagnostico Maipu, Buenos Aires, Argentina
| | - Roxana Campisi
- Department of Nuclear Medicine, Diagnostico Maipu, Buenos Aires, Argentina
| | - John A Ambrose
- Division of Cardiology, Department of Internal Medicine, University of California San Francisco-Fresno, Fresno, USA
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Ajmera VH, Cachay E, Ramers C, Vodkin I, Bassirian S, Singh S, Mangla N, Bettencourt R, Aldous JL, Park D, Lee D, Blanchard J, Mamidipalli A, Boehringer A, Aslam S, Leinhard OD, Richards L, Sirlin C, Loomba R. MRI Assessment of Treatment Response in HIV-associated NAFLD: A Randomized Trial of a Stearoyl-Coenzyme-A-Desaturase-1 Inhibitor (ARRIVE Trial). Hepatology 2019; 70:1531-1545. [PMID: 31013363 PMCID: PMC7164416 DOI: 10.1002/hep.30674] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/01/2019] [Indexed: 12/12/2022]
Abstract
Aramchol, an oral stearoyl-coenzyme-A-desaturase-1 inhibitor, has been shown to reduce hepatic fat content in patients with primary nonalcoholic fatty liver disease (NAFLD); however, its effect in patients with human immunodeficiency virus (HIV)-associated NAFLD is unknown. The aramchol for HIV-associated NAFLD and lipodystrophy (ARRIVE) trial was a double-blind, randomized, investigator-initiated, placebo-controlled trial to test the efficacy of 12 weeks of treatment with aramchol versus placebo in HIV-associated NAFLD. Fifty patients with HIV-associated NAFLD, defined by magnetic resonance imaging (MRI)-proton density fat fraction (PDFF) ≥5%, were randomized to receive either aramchol 600 mg daily (n = 25) or placebo (n = 25) for 12 weeks. The primary endpoint was a change in hepatic fat as measured by MRI-PDFF in colocalized regions of interest. Secondary endpoints included changes in liver stiffness using magnetic resonance elastography (MRE) and vibration-controlled transient elastography (VCTE), and exploratory endpoints included changes in total-body fat and muscle depots on dual-energy X-ray absorptiometry (DXA), whole-body MRI, and cardiac MRI. The mean (± standard deviation) of age and body mass index were 48.2 ± 10.3 years and 30.7 ± 4.6 kg/m2 , respectively. There was no difference in the reduction in mean MRI-PDFF between the aramchol group at -1.3% (baseline MRI-PDFF 15.6% versus end-of-treatment MRI-PDFF 14.4%, P = 0.24) and the placebo group at -1.4% (baseline MRI-PDFF 13.3% versus end-of-treatment MRI-PDFF 11.9%, P = 0.26). There was no difference in the relative decline in mean MRI-PDFF between the aramchol and placebo groups (6.8% versus 1.1%, P = 0.68). There were no differences in MRE-derived and VCTE-derived liver stiffness and whole-body (fat and muscle) composition analysis by MRI or DXA. Compared to baseline, end-of-treatment aminotransferases were lower in the aramchol group but not in the placebo arm. There were no significant adverse events. Conclusion: Aramchol, over a 12-week period, did not reduce hepatic fat or change body fat and muscle composition by using MRI-based assessment in patients with HIV-associated NAFLD (clinicaltrials.gov ID:NCT02684591).
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Affiliation(s)
- Veeral H. Ajmera
- NAFLD Research Center, Department of Medicine, La Jolla, California,Division of Gastroenterology, Department of Medicine, La Jolla, California
| | - Edward Cachay
- Division of Infectious Diseases, Owen Clinic, University of California San Diego, San Diego, California
| | | | - Irine Vodkin
- Division of Gastroenterology, Department of Medicine, La Jolla, California
| | - Shirin Bassirian
- NAFLD Research Center, Department of Medicine, La Jolla, California
| | - Seema Singh
- NAFLD Research Center, Department of Medicine, La Jolla, California
| | - Neeraj Mangla
- NAFLD Research Center, Department of Medicine, La Jolla, California
| | | | | | | | - Daniel Lee
- Division of Infectious Diseases, Owen Clinic, University of California San Diego, San Diego, California
| | - Jennifer Blanchard
- Division of Infectious Diseases, Owen Clinic, University of California San Diego, San Diego, California
| | - Adrija Mamidipalli
- Liver Imaging Group, University of California, San Diego, La Jolla, California
| | - Andrew Boehringer
- Liver Imaging Group, University of California, San Diego, La Jolla, California
| | - Saima Aslam
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego California
| | - Olof Dahlqvist Leinhard
- AMRA Medical AB, Linkoping Sweden,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Lisa Richards
- NAFLD Research Center, Department of Medicine, La Jolla, California
| | - Claude Sirlin
- Liver Imaging Group, University of California, San Diego, La Jolla, California
| | - Rohit Loomba
- NAFLD Research Center, Department of Medicine, La Jolla, California,Division of Gastroenterology, Department of Medicine, La Jolla, California,Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California
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Tanaka T, Kishi S, Ninomiya K, Tomii D, Koseki K, Sato Y, Okuno T, Sato K, Koike H, Yahagi K, Komiyama K, Aoki J, Tanabe K. Impact of abdominal fat distribution, visceral fat, and subcutaneous fat on coronary plaque scores assessed by 320-row computed tomography coronary angiography. Atherosclerosis 2019; 287:155-161. [DOI: 10.1016/j.atherosclerosis.2019.06.910] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/11/2019] [Accepted: 06/21/2019] [Indexed: 11/28/2022]
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13
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Prognostic Value of Vascular Calcifications and Regional Fat Depots Derived From Conventional Chest Computed Tomography. J Thorac Imaging 2019; 34:33-40. [DOI: 10.1097/rti.0000000000000370] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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14
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Atherosclerotic plaque burden evaluated from neck to groin: effect of gender and cardiovascular risk factors. Int J Cardiovasc Imaging 2018; 35:907-915. [PMID: 30547317 DOI: 10.1007/s10554-018-1512-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 12/02/2018] [Indexed: 10/27/2022]
Abstract
We explored the impact of gender and cardiovascular risk factors (RF) in the distribution and burden of coronary and extra-coronary atherosclerotic plaques among patients undergoing ECG-gated thoracoabdominal computed tomography angiography (CTA) from the supra-aortic trunks to the femoral arteries. We included a consecutive cohort of patients who underwent ECG-gated thoracoabdominal aortic CTA from the supra-aortic trunks to the pubic symphysis. We evaluated the number of coronary segments with plaques [segment-involvement score (SIS)]; and the extra-coronary atherosclerotic plaque burden, comprising the aorta and supra-aortic trunks, iliofemoral arteries, and visceral arteries (extra-coronary SS). A total of 3400 vascular segments were evaluated in 100 patients (mean age 67.0 ± 12.6 years, 66% male). Seventy-two (72%) patients had evidence of atherosclerosis in the coronary tree (coronary SIS ≥ 1), of which 32% was extensive (coronary SIS > 5). Males had a significantly higher prevalence of coronary SIS ≥ 1 [53 (80%), vs. 19 (56%), p = 0.018], and coronary SIS > 5 [24 (36%) vs. 8 (24%), p = 0.035] than females. Extra-coronary SS was similar between genders (males 10.2 ± 5.8 vs. females 9.7 ± 5.4, p = 0.70), irrespective of the location along the different vascular beds. The number of coronary RF was significantly related to the coronary SIS (p = 0.038), and hypertension and diabetes were consistently related to coronary and extra-coronary plaque burden. In the present study involving analysis of multiple vascular beds from the supra-aortic trunks to the femoral arteries, we identified significant sex-related differences in coronary plaque burden, whereas extra-coronary plaque burden was similar between genders irrespective of the vascular bed assessed.
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