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Soghomonian A, Gaborit B, Carbone F, Castinetti F, Dutour A. Editorial: Cardiac fat in metabolic and endocrine diseases. Front Endocrinol (Lausanne) 2023; 14:1271565. [PMID: 37727453 PMCID: PMC10506075 DOI: 10.3389/fendo.2023.1271565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/16/2023] [Indexed: 09/21/2023] Open
Affiliation(s)
- Astrid Soghomonian
- Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France
- Endocrinology, Metabolic Diseases and Nutrition Department, AP-HM, Marseille, France
| | - Bénédicte Gaborit
- Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France
- Endocrinology, Metabolic Diseases and Nutrition Department, AP-HM, Marseille, France
| | - Federico Carbone
- First Clinic of internal Medicine, Department of Internal Medicine, University of Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova – Italian Cardiovascular Network, Genova, Italy
| | - Frédéric Castinetti
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares Hypophysaires HYPO, AP-HM, Marseille, France
| | - Anne Dutour
- Aix-Marseille University, INSERM, INRAE, C2VN, Marseille, France
- Endocrinology, Metabolic Diseases and Nutrition Department, AP-HM, Marseille, France
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2
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Browning Epicardial Adipose Tissue: Friend or Foe? Cells 2022; 11:cells11060991. [PMID: 35326442 PMCID: PMC8947372 DOI: 10.3390/cells11060991] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 02/08/2023] Open
Abstract
The epicardial adipose tissue (EAT) is the visceral fat depot of the heart which is highly plastic and in direct contact with myocardium and coronary arteries. Because of its singular proximity with the myocardium, the adipokines and pro-inflammatory molecules secreted by this tissue may directly affect the metabolism of the heart and coronary arteries. Its accumulation, measured by recent new non-invasive imaging modalities, has been prospectively associated with the onset and progression of coronary artery disease (CAD) and atrial fibrillation in humans. Recent studies have shown that EAT exhibits beige fat-like features, and express uncoupling protein 1 (UCP-1) at both mRNA and protein levels. However, this thermogenic potential could be lost with age, obesity and CAD. Here we provide an overview of the physiological and pathophysiological relevance of EAT and further discuss whether its thermogenic properties may serve as a target for obesity therapeutic management with a specific focus on the role of immune cells in this beiging phenomenon.
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Daudé P, Ancel P, Confort Gouny S, Jacquier A, Kober F, Dutour A, Bernard M, Gaborit B, Rapacchi S. Deep-Learning Segmentation of Epicardial Adipose Tissue Using Four-Chamber Cardiac Magnetic Resonance Imaging. Diagnostics (Basel) 2022; 12:126. [PMID: 35054297 PMCID: PMC8774679 DOI: 10.3390/diagnostics12010126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/29/2021] [Accepted: 12/29/2021] [Indexed: 12/24/2022] Open
Abstract
In magnetic resonance imaging (MRI), epicardial adipose tissue (EAT) overload remains often overlooked due to tedious manual contouring in images. Automated four-chamber EAT area quantification was proposed, leveraging deep-learning segmentation using multi-frame fully convolutional networks (FCN). The investigation involved 100 subjects-comprising healthy, obese, and diabetic patients-who underwent 3T cardiac cine MRI, optimized U-Net and FCN (noted FCNB) were trained on three consecutive cine frames for segmentation of central frame using dice loss. Networks were trained using 4-fold cross-validation (n = 80) and evaluated on an independent dataset (n = 20). Segmentation performances were compared to inter-intra observer bias with dice (DSC) and relative surface error (RSE). Both systole and diastole four-chamber area were correlated with total EAT volume (r = 0.77 and 0.74 respectively). Networks' performances were equivalent to inter-observers' bias (EAT: DSCInter = 0.76, DSCU-Net = 0.77, DSCFCNB = 0.76). U-net outperformed (p < 0.0001) FCNB on all metrics. Eventually, proposed multi-frame U-Net provided automated EAT area quantification with a 14.2% precision for the clinically relevant upper three quarters of EAT area range, scaling patients' risk of EAT overload with 70% accuracy. Exploiting multi-frame U-Net in standard cine provided automated EAT quantification over a wide range of EAT quantities. The method is made available to the community through a FSLeyes plugin.
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Affiliation(s)
- Pierre Daudé
- Aix-Marseille Univ, CNRS, CRMBM, 13005 Marseille, France; (S.C.G.); (A.J.); (F.K.); (M.B.)
- APHM, Hôpital Universitaire Timone, CEMEREM, 13385 Marseille, France
| | - Patricia Ancel
- Department of Radiology, APHM, La Timone Hospital, 13005 Marseille, France;
- Aix-Marseille Univ, INSERM, INRAE, C2VN, 13005 Marseille, France; (A.D.); (B.G.)
| | - Sylviane Confort Gouny
- Aix-Marseille Univ, CNRS, CRMBM, 13005 Marseille, France; (S.C.G.); (A.J.); (F.K.); (M.B.)
- APHM, Hôpital Universitaire Timone, CEMEREM, 13385 Marseille, France
| | - Alexis Jacquier
- Aix-Marseille Univ, CNRS, CRMBM, 13005 Marseille, France; (S.C.G.); (A.J.); (F.K.); (M.B.)
- APHM, Hôpital Universitaire Timone, CEMEREM, 13385 Marseille, France
- Department of Radiology, APHM, La Timone Hospital, 13005 Marseille, France;
| | - Frank Kober
- Aix-Marseille Univ, CNRS, CRMBM, 13005 Marseille, France; (S.C.G.); (A.J.); (F.K.); (M.B.)
- APHM, Hôpital Universitaire Timone, CEMEREM, 13385 Marseille, France
| | - Anne Dutour
- Aix-Marseille Univ, INSERM, INRAE, C2VN, 13005 Marseille, France; (A.D.); (B.G.)
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Hôpital Nord, Chemin Des Bourrely, 13005 Marseille, France
| | - Monique Bernard
- Aix-Marseille Univ, CNRS, CRMBM, 13005 Marseille, France; (S.C.G.); (A.J.); (F.K.); (M.B.)
- APHM, Hôpital Universitaire Timone, CEMEREM, 13385 Marseille, France
| | - Bénédicte Gaborit
- Aix-Marseille Univ, INSERM, INRAE, C2VN, 13005 Marseille, France; (A.D.); (B.G.)
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Hôpital Nord, Chemin Des Bourrely, 13005 Marseille, France
| | - Stanislas Rapacchi
- Aix-Marseille Univ, CNRS, CRMBM, 13005 Marseille, France; (S.C.G.); (A.J.); (F.K.); (M.B.)
- APHM, Hôpital Universitaire Timone, CEMEREM, 13385 Marseille, France
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Xie Z, Zhu J, Li W, Liu L, Zhuo K, Yang R, Hu F. Relationship of epicardial fat volume with coronary plaque characteristics, coronary artery calcification score, coronary stenosis, and CT-FFR for lesion-specific ischemia in patients with known or suspected coronary artery disease. Int J Cardiol 2021; 332:8-14. [PMID: 33775790 DOI: 10.1016/j.ijcard.2021.03.052] [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] [Received: 01/22/2021] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND We explored the association of epicardial fat volume (EFV) with coronary plaque characteristics, coronary artery calcification (CAC) score, coronary stenosis, lesion-specific ischemia in patients with known or suspected coronary artery disease (CAD). METHODS 88 controls and 221 patients were analyzed in the study. High-risk plaque was defined as existing≥2 features, including positive remodeling, low attenuation, napkin-ring sign and spotty calcification. EFV, CAC score was measured. The severity of coronary stenosis was quantified using Gensini score. CT-FFR was performed in three major coronary arteries, with a threshold of ≤0.8 considered the presence of ischemia. Univariate and multivariate regression was used to evaluate the association of EFV with CAD, palque characteristics, CAC score, Gensini score, and lesion-specific ischemia derived from CT-FFR. RESULTS Median EFV was 104.97 cm3 (85.47-136.09) in controls and 129.28cm3 (101.19-159.44) in patients (P < 0.001). Logistic regression analysis revealed a significant association of EFV with CAD even after adjusting for confounding factors (P < 0.05). At linear regression analysis, EFV was significantly correlated with high-risk plaque and lesion-specific ischemia, but not with non-calcified plaque, mixed plaque, calcified plaque, CAC score and Gensini score (P ≥ 0.05). CONCLUSION We found that EFV was associated with CAD, suggesting that it may be a promising marker of CAD. EFV was also correlated with high-risk plaque and lesion-specific ischemia, indicating that EAT was likely to be involved in myocardial ischemia and had the potential to definite patients' risk profile.
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Affiliation(s)
- Zhen Xie
- 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
| | - Wenjia Li
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610041, China
| | - Luzhou Liu
- 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
| | - Ru Yang
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610041, China
| | - Fubi Hu
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610041, China.
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Diverse Adiposity and Atrio-Ventricular Dysfunction across Obesity Phenotypes: Implication of Epicardial Fat Analysis. Diagnostics (Basel) 2021; 11:diagnostics11030408. [PMID: 33673715 PMCID: PMC7997462 DOI: 10.3390/diagnostics11030408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/18/2021] [Accepted: 02/24/2021] [Indexed: 12/18/2022] Open
Abstract
Obesity has been conceptualized as a highly heterogeneous condition. We aim to investigate chamber-specific effects of obesity on the heart and relevant outcomes. A total of 2944 symptom-free individuals (age: 47.5 ± 10.0 years), free of known cardiovascular diseases were classified into four categories based on body mass index (BMI) (as normal-weight (NW) vs. overweight/obese (O)) and metabolic status (metabolically-healthy (MH) vs. unhealthy (MU)). Epicardial adipose thickness (EAT) using echocardiography method. Speckle-tracking based atrio-ventricular (LA/LV) deformations including global longitudinal strain (GLS) and peak atrial longitudinal strain (PALS) were also analyzed. MUNW had higher cardiometabolic risks and more impaired diastolic and GLS/PALS than MHNW phenotype. Both MHO and MUO phenotypes exhibited worst atrial functions. Greater EAT was independently associated with worse GLS and PALS after correcting for various anthropometrics, LV mass and LA volume, respectively, with unfavorable LA effects from EAT being more pronounced in the NW phenotypes (both p interactions < 0.05). During a median follow-up period of 5.3 years, BMI/EAT improved the reclassification for atrial fibrillation (AF) incidence (p for net reclassification improvement < 0.05) mainly in the NW phenotypes (p interaction < 0.001). Categorization of clinical obesity phenotypes based on excessive visceral adiposity likely provides increment prognostic impacts on atrial dysfunction, particularly in non-obese phenotypes.
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Elias SO, Ajayi RE. Effect of sympathetic autonomic stress from the cold pressor test on left ventricular function in young healthy adults. Physiol Rep 2020; 7:e13985. [PMID: 30659769 PMCID: PMC6339552 DOI: 10.14814/phy2.13985] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/23/2018] [Accepted: 12/28/2018] [Indexed: 01/02/2023] Open
Abstract
There is a dearth of studies investigating the effect of sympathetic activation on left ventricular function. This study aimed to investigate the effect of sympathetic autonomic stress on left ventricular function in young healthy adults. Fifty‐six normotensive healthy participants (age 23.55 ± 3.82 years) took part in the study after giving informed consent. After obtaining baseline measurements, heart rate (HR), blood pressure (BP), peripheral saturation of oxygen (SpO2) and left ventricular function (assessed by means of ejection fraction (EF) obtained by transthoracic 2‐D echocardiography) were determined before and following sympathetic activation using cold pressor test (CPT). Exposure to CPT led to significant increase (P < 0.0001) in HR (70.4 ± 10.7 bpm to 91.6 ± 14.8 bpm), SBP (118 ± 8 mmHg to 138 ± 14 mmHg) and DBP (71 ± 7 mmHg to 91 ± 11 mmHg). Participants’ EDV (101.1 ± 15.8 ml to 104.2 ± 19.3 mL), ESV (38.7 ± 9.1 mL to 40.3 ± 11.6 mL), SpO2 (99.5 ± 0.79% to 99.5 ± 0.77%) and EF (61.9 ± 5.9% to 60.9 ± 6.4%) were only slightly changed (P > 0.05). However, cardiac output (4.3 ± 0.9 L/min to 5.4 ± 1.4 L/min) and cardiac index (3.7 ± 0.8 L/min per m2 to 4.5 ± 1.4 L/min per m2) increased significantly (P < 0.0001). We conclude that sympathetic stress induced by cold pressor test has marginal effect on ejection fraction and fractional shortening while increasing cardiac output and cardiac index in young healthy adults.
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Affiliation(s)
- Simiat O Elias
- Department of Physiology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Reina E Ajayi
- Department of Physiology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
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Barchuk M, Dutour A, Ancel P, Svilar L, Miksztowicz V, Lopez G, Rubio M, Schreier L, Nogueira JP, Valéro R, Béliard S, Martin JC, Berg G, Gaborit B. Untargeted Lipidomics Reveals a Specific Enrichment in Plasmalogens in Epicardial Adipose Tissue and a Specific Signature in Coronary Artery Disease. Arterioscler Thromb Vasc Biol 2020; 40:986-1000. [PMID: 32102570 DOI: 10.1161/atvbaha.120.313955] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Epicardial adipose tissue (EAT) is an active endocrine organ that could contribute to the pathophysiology of coronary artery disease (CAD) through the paracrine release of proatherogenic mediators. Numerous works have analyzed the inflammatory signature of EAT, but scarce informations on its lipidome are available. Our objective was first to study the differences between EAT and subcutaneous adipose tissue (SAT) lipidomes and second to identify the specific untargeted lipidomic signatures of EAT and SAT in CAD. Approach and Results: Subcutaneous and EAT untargeted lipidomic analysis was performed in 25 patients with CAD and 14 patients without CAD and compared with paired plasma lipidomic analysis of isolated VLDL (very low-density lipoprotein) and HDL (high-density lipoprotein). Lipidomics was performed on a C18 column hyphenated to a Q-Exactive plus mass spectrometer, using both positive and negative ionization mode. EAT and SAT had independent lipidomic profile, with 95 lipid species differentially expressed and phosphatidylethanolamine 18:1p/22:6 twenty-fold more expressed in EAT compared with SAT false discovery rate =3×10-4). Patients with CAD exhibited more ceramides (P=0.01), diglycerides (P=0.004; saturated and nonsaturated), monoglycerides (P=0.013) in their EAT than patients without CAD. Conversely, they had lesser unsaturated TG (triglycerides; P=0.02). No difference was observed in the 295 lipid species found in SAT between patients with and without CAD. Fifty-one lipid species were found in common between EAT and plasma lipoproteins. TG 18:0/18:0/18:1 was found positively correlated (r=0.45, P=0.019) in EAT and HDL and in EAT and VLDL (r=0.46, P=0.02). CONCLUSIONS CAD is associated with specific lipidomic signature of EAT, unlike SAT. Plasma lipoprotein lipidome only partially reflected EAT lipidome.
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Affiliation(s)
- Magali Barchuk
- From the Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Departamento de Bioquímica Clínica, Laboratorio de Lípidos y Aterosclerosis, Buenos Aires, Argentina (M.B., V.M., G.L., L.S., G.B.)
| | - Anne Dutour
- Aix-Marseille University, INSERM, INRAE, C2VN, France (A.D., P.A., L.S., R.V., S.B., J.C.M., B.G.).,Endocrinology, Metabolic Diseases and Nutrition Department, Assistance Publique Hôpitaux de Marseille, France (A.D., R.V., S.B., B.G.)
| | - Patricia Ancel
- Aix-Marseille University, INSERM, INRAE, C2VN, France (A.D., P.A., L.S., R.V., S.B., J.C.M., B.G.)
| | - Ljubica Svilar
- Aix-Marseille University, INSERM, INRAE, C2VN, France (A.D., P.A., L.S., R.V., S.B., J.C.M., B.G.).,CRIBIOM, Criblage Biologique Marseille, Faculté de Medecine de la Timone, France (L.S.)
| | - Veronica Miksztowicz
- From the Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Departamento de Bioquímica Clínica, Laboratorio de Lípidos y Aterosclerosis, Buenos Aires, Argentina (M.B., V.M., G.L., L.S., G.B.).,Universidad de Buenos Aires, CONICET, Facultad de Farmacia y Bioquímica, Argentina (V.M., G.B.)
| | - Graciela Lopez
- From the Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Departamento de Bioquímica Clínica, Laboratorio de Lípidos y Aterosclerosis, Buenos Aires, Argentina (M.B., V.M., G.L., L.S., G.B.)
| | - Miguel Rubio
- Universidad de Buenos Aires, Hospital de Clínicas "José de San Martín", División de Cirugía Cardiovascular, Argentina (M.R.)
| | - Laura Schreier
- From the Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Departamento de Bioquímica Clínica, Laboratorio de Lípidos y Aterosclerosis, Buenos Aires, Argentina (M.B., V.M., G.L., L.S., G.B.)
| | - Juan Patricio Nogueira
- Servicio de Docencia e Investigación, Hospital Central de Formosa, Facultad de Ciencias de la Salud, Universidad Nacional de Formosa, Argentina (J.P.N.)
| | - René Valéro
- Aix-Marseille University, INSERM, INRAE, C2VN, France (A.D., P.A., L.S., R.V., S.B., J.C.M., B.G.).,Endocrinology, Metabolic Diseases and Nutrition Department, Assistance Publique Hôpitaux de Marseille, France (A.D., R.V., S.B., B.G.)
| | - Sophie Béliard
- Aix-Marseille University, INSERM, INRAE, C2VN, France (A.D., P.A., L.S., R.V., S.B., J.C.M., B.G.).,Endocrinology, Metabolic Diseases and Nutrition Department, Assistance Publique Hôpitaux de Marseille, France (A.D., R.V., S.B., B.G.)
| | - Jean Charles Martin
- Aix-Marseille University, INSERM, INRAE, C2VN, France (A.D., P.A., L.S., R.V., S.B., J.C.M., B.G.)
| | - Gabriela Berg
- From the Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Departamento de Bioquímica Clínica, Laboratorio de Lípidos y Aterosclerosis, Buenos Aires, Argentina (M.B., V.M., G.L., L.S., G.B.).,Universidad de Buenos Aires, CONICET, Facultad de Farmacia y Bioquímica, Argentina (V.M., G.B.)
| | - Bénédicte Gaborit
- Aix-Marseille University, INSERM, INRAE, C2VN, France (A.D., P.A., L.S., R.V., S.B., J.C.M., B.G.).,Endocrinology, Metabolic Diseases and Nutrition Department, Assistance Publique Hôpitaux de Marseille, France (A.D., R.V., S.B., B.G.)
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Le Jemtel TH, Samson R, Ayinapudi K, Singh T, Oparil S. Epicardial Adipose Tissue and Cardiovascular Disease. Curr Hypertens Rep 2019; 21:36. [PMID: 30953236 DOI: 10.1007/s11906-019-0939-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Epicardial adipose tissue has been associated with the development/progression of cardiovascular disease. We appraise the strength of the association between epicardial adipose tissue and development/progression of cardiovascular diseases like coronary artery disease, atrial fibrillation, and heart failure with preserved ejection fraction. RECENT FINDINGS Cross-sectional clinical and translational correlative studies have established an association between epicardial adipose tissue and progression of coronary artery disease. Recent studies question this association and underline the need for longitudinal studies. Epicardial adipose tissue also plays a definite role in the pathobiology of atrial fibrillation and its recurrence after ablation. In contrast to an early paradigm, epicardial adipose tissue does not appear to play a key role in the pathogenesis of heart failure with preserved ejection fraction in obese patients. The association of epicardial adipose tissue with atrial fibrillation is robust. In contrast, the association of epicardial adipose tissue with coronary artery disease and heart failure with preserved ejection fraction is tenuous. Additional research, including longitudinal studies, is needed to confirm or refute these proposed associations.
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Affiliation(s)
- Thierry H Le Jemtel
- Section of Cardiology, Department of Medicine, Tulane University School of Medicine; Tulane University Heart and Vascular Institute, 1430 Tulane Avenue, SL-48, New Orleans, LA, 70112, USA.
| | - Rohan Samson
- Section of Cardiology, Department of Medicine, Tulane University School of Medicine; Tulane University Heart and Vascular Institute, 1430 Tulane Avenue, SL-48, New Orleans, LA, 70112, USA
| | - Karnika Ayinapudi
- Section of Cardiology, Department of Medicine, Tulane University School of Medicine; Tulane University Heart and Vascular Institute, 1430 Tulane Avenue, SL-48, New Orleans, LA, 70112, USA
| | - Twinkle Singh
- Section of Cardiology, Department of Medicine, Tulane University School of Medicine; Tulane University Heart and Vascular Institute, 1430 Tulane Avenue, SL-48, New Orleans, LA, 70112, USA
| | - Suzanne Oparil
- Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
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Lubert AM, Lu JC, Rocchini AP, Norris MD, Yu S, Agarwal PP, Ghadimi Mahani M, Dorfman AL. Relation of Increased Epicardial Fat After Fontan Palliation to Cardiac Output and Systemic Ventricular Ejection Fraction. Am J Cardiol 2018; 121:862-866. [PMID: 29433731 DOI: 10.1016/j.amjcard.2017.12.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/15/2017] [Accepted: 12/29/2017] [Indexed: 10/18/2022]
Abstract
Epicardial fat produces multiple proinflammatory cytokines and is associated with adverse cardiovascular events. Inflammation and resultant endothelial dysfunction may play a role in progressive myocardial dysfunction among adults with single ventricle physiology after Fontan palliation, but the potential impact of increased epicardial fat volume (EFV) has not been studied. This study sought to determine if there is greater EFV in Fontan patients compared with a group of repaired tetralogy of Fallot (rTOF) patients. We retrospectively measured EFV manually on cardiac magnetic resonance imaging in Fontan patients, ≥15 years, and 1:1 age, sex, and body mass index-matched patients with rTOF. EFV was indexed to body surface area. A random subset of studies was re-measured to assess intra- and interobserver reliability. Fontan patients (n = 63, median age 21.6 years, 51% male, mean body mass index 24.2 ± 5.6 kg/m2) had a larger indexed EFV compared with matched rTOF patients (75.3 ± 29.2 ml/m2 vs 60.0 ± 19.9 ml/m2, p = 0.001). In Fontan patients, indexed EFV was inversely correlated with ventricular ejection fraction (r = -0.26, p = 0.04) and cardiac index (r = -0.33, p = 0.01). Intra- and interobserver reliabilities of the indexed EFV measurements in both groups were excellent (intraclass correlation coefficient ranges from 0.93 to 0.97). In conclusion, indexed EFV is higher in Fontan patients compared with patients with rTOF and is associated with lower ventricular ejection fraction and cardiac index. Increased EFV could play a role in the failing Fontan circulation, but longitudinal studies are necessary to establish any causative role.
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Gaborit B, Sengenes C, Ancel P, Jacquier A, Dutour A. Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat? Compr Physiol 2017. [PMID: 28640452 DOI: 10.1002/cphy.c160034] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Epicardial adipose tissue (EAT) is a small but very biologically active ectopic fat depot that surrounds the heart. Given its rapid metabolism, thermogenic capacity, unique transcriptome, secretory profile, and simply measurability, epicardial fat has drawn increasing attention among researchers attempting to elucidate its putative role in health and cardiovascular diseases. The cellular crosstalk between epicardial adipocytes and cells of the vascular wall or myocytes is high and suggests a local role for this tissue. The balance between protective and proinflammatory/profibrotic cytokines, chemokines, and adipokines released by EAT seem to be a key element in atherogenesis and could represent a future therapeutic target. EAT amount has been found to predict clinical coronary outcomes. EAT can also modulate cardiac structure and function. Its amount has been associated with atrial fibrillation, coronary artery disease, and sleep apnea syndrome. Conversely, a beiging fat profile of EAT has been identified. In this review, we describe the current state of knowledge regarding the anatomy, physiology and pathophysiological role of EAT, and the factors more globally leading to ectopic fat development. We will also highlight the most recent findings on the origin of this ectopic tissue, and its association with cardiac diseases. © 2017 American Physiological Society. Compr Physiol 7:1051-1082, 2017.
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Affiliation(s)
- Bénédicte Gaborit
- NORT, Aix Marseille Univ, INSERM, INRA, NORT, Marseille, France.,Endocrinology Metabolic Diseases, and Nutrition Department, Pole ENDO, APHM, Aix-Marseille Univ, Marseille, France
| | - Coralie Sengenes
- STROMALab, Université de Toulouse, EFS, ENVT, Inserm U1031, ERL CNRS 5311, CHU Rangueil, Toulouse, France
| | - Patricia Ancel
- NORT, Aix Marseille Univ, INSERM, INRA, NORT, Marseille, France
| | - Alexis Jacquier
- CNRS UMR 7339, Centre de Résonance Magnétique Biologique et Médicale (CRMBM), Marseille, France.,Radiology department, CHU La Timone, Marseille, France
| | - Anne Dutour
- NORT, Aix Marseille Univ, INSERM, INRA, NORT, Marseille, France.,Endocrinology Metabolic Diseases, and Nutrition Department, Pole ENDO, APHM, Aix-Marseille Univ, Marseille, France
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11
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Guglielmi V, Maresca L, Lanzillo C, Marinoni GM, D’Adamo M, Di Roma M, Preziosi P, Bellia A, Calò L, Sbraccia P. Relationship between Regional Fat Distribution and Hypertrophic Cardiomyopathy Phenotype. PLoS One 2016; 11:e0158892. [PMID: 27388274 PMCID: PMC4936675 DOI: 10.1371/journal.pone.0158892] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 06/23/2016] [Indexed: 01/27/2023] Open
Abstract
Background Hypertrophic cardiomyopathy (HCM), the most common genetic heart disease, is characterized by heterogeneous phenotypic expression. Body mass index has been associated with LV mass and heart failure symptoms in HCM. The aim of our study was to investigate whether regional (trunk, appendicular, epicardial) fat distribution and extent could be related to hypertrophy severity and pattern in HCM. Methods Cardiovascular magnetic resonance was performed in 32 subjects with echocardiography-based diagnosis of HCM (22M/10F, 57.2±12.6 years) characterized by predominant hypertrophy at the interventricular septum (IVS). Regional fat distribution was assessed by dual-energy X-ray absorptiometry. Results Gender differences were detected in maximum IVS thickness (M: 18.3±3.8 mm vs. F: 14.3±4 mm, p = 0.012), right ventricle (RV) systolic function (M: 61.3±6.7%; F: 67.5±6.3%, p = 0.048), indexed RV end-diastolic (M: 64.8±16.3 ml/m2; F: 50.7±15.5 ml/m2, p = 0.04) and end-systolic volumes (M: 24.3±8.3 ml/m2; F: 16.7±7.4 ml/m2, p = 0.04). After adjusting for age and gender, maximum IVS thickness was associated with truncal fat (Tr-FAT) (β = 0.43, p = 0.02), but not with either appendicular or epicardial fat. Epicardial fat resulted independently associated with NT-proBNP levels (β = 0.63, p = 0.04). Late Gadolinium Enhancement-positive subjects displayed greater maximum IVS thickness (p = 0.02), LV mass index (p = 0.015) and NT-proBNP levels (p = 0.04), but no associations with fat amount or distribution were observed. Conclusion Truncal, but not appendicular or epicardial fat amount, seems to be related with maximum IVS thickness, the hallmark feature in our cohort of HCM patients. Further prospective researches are needed to assess a potential causative effect of central adiposity on HCM phenotype.
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Affiliation(s)
- Valeria Guglielmi
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Luciano Maresca
- Diagnostic Imaging Department, Policlinico Casilino, Rome, Italy
| | | | | | - Monica D’Adamo
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Mauro Di Roma
- Diagnostic Imaging Department, Policlinico Casilino, Rome, Italy
| | - Paolo Preziosi
- Diagnostic Imaging Department, Policlinico Casilino, Rome, Italy
| | - Alfonso Bellia
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Leonardo Calò
- Cardiology Department, Policlinico Casilino, Rome, Italy
| | - Paolo Sbraccia
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
- * E-mail:
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12
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Selthofer-Relatić K, Bošnjak I. Myocardial fat as a part of cardiac visceral adipose tissue: physiological and pathophysiological view. J Endocrinol Invest 2015; 38:933-9. [PMID: 25770455 DOI: 10.1007/s40618-015-0258-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 02/08/2015] [Indexed: 01/07/2023]
Abstract
Thoracic fat includes extra-pericardial (outside the visceral pericardium) and intra-pericardial (inside the visceral pericardium) adipose tissue. It is called ectopic adipose tissue although it is a normal anatomical structure. Intra-pericardial adipose tissue, which is predominantly composed of epicardial and pericoronary adipose tissue, has a significant role in cardiovascular system function. It provides metabolic-mechanical support to the heart and blood vessels in physiological conditions, while it represents metabolic-cardiovascular risk in case of qualitative and quantitative structural changes in the tissue: it correlates with coronary atherosclerotic disease, left ventricular mass, left atrium enlargement and atrial fibrillation presence. In the last decade there has been mounting evidence of fat cells presence in the myocardium of healthy (non-diseased) persons as well as in persons with both cardiovascular and non-cardiovascular diseases. Thus, it is necessary to clarify the incidence, aetiology, physiological role of fat cells in the myocardium, as well as the clinical significance of pathological fatty infiltration of the myocardium.
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Affiliation(s)
- K Selthofer-Relatić
- Department for Cardiovascular Medicine, University Hospital Centre Osijek, Osijek, Croatia,
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13
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Gaborit B, Venteclef N, Ancel P, Pelloux V, Gariboldi V, Leprince P, Amour J, Hatem SN, Jouve E, Dutour A, Clément K. Human epicardial adipose tissue has a specific transcriptomic signature depending on its anatomical peri-atrial, peri-ventricular, or peri-coronary location. Cardiovasc Res 2015; 108:62-73. [PMID: 26239655 DOI: 10.1093/cvr/cvv208] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 07/23/2015] [Indexed: 11/14/2022] Open
Abstract
AIMS Human epicardial adipose tissue (EAT) is a visceral and perivascular fat that has been shown to act locally on myocardium, atria, and coronary arteries. Its abundance has been linked to coronary artery disease (CAD) and atrial fibrillation. However, its physiological function remains highly debated. The aim of this study was to determine a specific EAT transcriptomic signature, depending on its anatomical peri-atrial (PA), peri-ventricular (PV), or peri-coronary location. METHODS AND RESULTS Samples of EAT and thoracic subcutaneous fat, obtained from 41 patients paired for cardiovascular risk factors, CAD, and atrial fibrillation were analysed using a pangenomic approach. We found 2728 significantly up-regulated genes in the EAT vs. subcutaneous fat with 400 genes being common between PA, PV, and peri-coronary EAT. These common genes were related to extracellular matrix remodelling, inflammation, infection, and thrombosis pathways. Omentin (ITLN1) was the most up-regulated gene and secreted adipokine in EAT (fold-change >12, P < 0.0001). Among EAT-enriched genes, we observed different patterns depending on adipose tissue location. A beige expression phenotype was found in EAT but PV EAT highly expressed uncoupled protein 1 (P = 0.01). Genes overexpressed in peri-coronary EAT were implicated in proliferation, O-N glycan biosynthesis, and sphingolipid metabolism. PA EAT displayed an atypical pattern with genes implicated in cardiac muscle contraction and intracellular calcium signalling pathway. CONCLUSION This study opens new perspectives in understanding the physiology of human EAT and its local interaction with neighbouring structures.
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Affiliation(s)
- Bénédicte Gaborit
- Institute of Cardiometabolism and Nutrition, ICAN, Heart and Nutrition Department, Assistance-Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris F-75013, France Sorbonne Universities, University Pierre et Marie Curie-Paris 6, UMRS 1166, Paris F-75006, France INSERM, Nutriomics (team6 and Team3), UMR_S U1166, Paris F-75013, France Aix-Marseille Université, Faculté de Médecine, Department 'Nutrition, Obésité et Risque Thrombotique', INSERM, UMR 1062, INRA 1260, 13385 Marseille, France
| | - Nicolas Venteclef
- Institute of Cardiometabolism and Nutrition, ICAN, Heart and Nutrition Department, Assistance-Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris F-75013, France Sorbonne Universities, University Pierre et Marie Curie-Paris 6, UMRS 1166, Paris F-75006, France INSERM, UMRS_S1138, Paris F-75006, France
| | - Patricia Ancel
- Institute of Cardiometabolism and Nutrition, ICAN, Heart and Nutrition Department, Assistance-Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris F-75013, France Sorbonne Universities, University Pierre et Marie Curie-Paris 6, UMRS 1166, Paris F-75006, France INSERM, Nutriomics (team6 and Team3), UMR_S U1166, Paris F-75013, France Aix-Marseille Université, Faculté de Médecine, Department 'Nutrition, Obésité et Risque Thrombotique', INSERM, UMR 1062, INRA 1260, 13385 Marseille, France
| | - Véronique Pelloux
- Institute of Cardiometabolism and Nutrition, ICAN, Heart and Nutrition Department, Assistance-Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris F-75013, France Sorbonne Universities, University Pierre et Marie Curie-Paris 6, UMRS 1166, Paris F-75006, France INSERM, Nutriomics (team6 and Team3), UMR_S U1166, Paris F-75013, France
| | - Vlad Gariboldi
- Assistance-Publique Hôpitaux de Marseille, Cardiac Surgery, La Timone Hospital,13005 Marseille, France
| | - Pascal Leprince
- Institute of Cardiometabolism and Nutrition, ICAN, Heart and Nutrition Department, Assistance-Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris F-75013, France Sorbonne Universities, University Pierre et Marie Curie-Paris 6, UMRS 1166, Paris F-75006, France Assistance-Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Heart Department, 73013 Paris, France
| | - Julien Amour
- Institute of Cardiometabolism and Nutrition, ICAN, Heart and Nutrition Department, Assistance-Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris F-75013, France Sorbonne Universities, University Pierre et Marie Curie-Paris 6, UMRS 1166, Paris F-75006, France Assistance-Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Heart Department, 73013 Paris, France
| | - Stéphane N Hatem
- Institute of Cardiometabolism and Nutrition, ICAN, Heart and Nutrition Department, Assistance-Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris F-75013, France Sorbonne Universities, University Pierre et Marie Curie-Paris 6, UMRS 1166, Paris F-75006, France INSERM, Nutriomics (team6 and Team3), UMR_S U1166, Paris F-75013, France Assistance-Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Heart Department, 73013 Paris, France
| | - Elisabeth Jouve
- Assistance-Publique Hôpitaux de Marseille, Medical Evaluation Department, CIC-CPCET, 13005 Marseille, France
| | - Anne Dutour
- Aix-Marseille Université, Faculté de Médecine, Department 'Nutrition, Obésité et Risque Thrombotique', INSERM, UMR 1062, INRA 1260, 13385 Marseille, France
| | - Karine Clément
- Institute of Cardiometabolism and Nutrition, ICAN, Heart and Nutrition Department, Assistance-Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris F-75013, France Sorbonne Universities, University Pierre et Marie Curie-Paris 6, UMRS 1166, Paris F-75006, France INSERM, Nutriomics (team6 and Team3), UMR_S U1166, Paris F-75013, France
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14
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Bakkum MJ, Danad I, Romijn MAJ, Stuijfzand WJA, Leonora RM, Tulevski II, Somsen GA, Lammertsma AA, van Kuijk C, van Rossum AC, Raijmakers PG, Knaapen P. The impact of obesity on the relationship between epicardial adipose tissue, left ventricular mass and coronary microvascular function. Eur J Nucl Med Mol Imaging 2015; 42:1562-73. [PMID: 26054890 PMCID: PMC4521095 DOI: 10.1007/s00259-015-3087-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 05/11/2015] [Indexed: 12/14/2022]
Abstract
Purpose Epicardial adipose tissue (EAT) has been linked to coronary artery disease (CAD) and coronary microvascular dysfunction. However, its injurious effect may also impact the underlying myocardium. This study aimed to determine the impact of obesity on the quantitative relationship between left ventricular mass (LVM), EAT and coronary microvascular function. Methods A total of 208 (94 men, 45 %) patients evaluated for CAD but free of coronary obstructions underwent quantitative [15O]H2O hybrid positron emission tomography (PET)/CT imaging. Coronary microvascular resistance (CMVR) was calculated as the ratio of mean arterial pressure to hyperaemic myocardial blood flow. Results Obese patients [body mass index (BMI) > 25, n = 133, 64 % of total] had more EAT (125.3 ± 47.6 vs 93.5 ± 42.1 cc, p < 0.001), a higher LVM (130.1 ± 30.4 vs 114.2 ± 29.3 g, p < 0.001) and an increased CMVR (26.6 ± 9.1 vs 22.3 ± 8.6 mmHg×ml−1×min−1×g−1, p < 0.01) as compared to nonobese patients. Male gender (β = 40.7, p < 0.001), BMI (β = 1.61, p < 0.001), smoking (β = 6.29, p = 0.03) and EAT volume (β = 0.10, p < 0.01) were identified as independent predictors of LVM. When grouped according to BMI status, EAT was only independently associated with LVM in nonobese patients. LVM, hypercholesterolaemia and coronary artery calcium score were independent predictors of CMVR. Conclusion EAT volume is associated with LVM independently of BMI and might therefore be a better predictor of cardiovascular risk than BMI. However, EAT volume was not related to coronary microvascular function after adjustments for LVM and traditional risk factors. Electronic supplementary material The online version of this article (doi:10.1007/s00259-015-3087-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M. J. Bakkum
- />Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - I. Danad
- />Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - M. A. J. Romijn
- />Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - W. J. A. Stuijfzand
- />Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - R. M. Leonora
- />Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - I. I. Tulevski
- />Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
| | - G. A. Somsen
- />Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
| | - A. A. Lammertsma
- />Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - C. van Kuijk
- />Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - A. C. van Rossum
- />Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - P. G. Raijmakers
- />Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - P. Knaapen
- />Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
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15
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Niemann M, Alkadhi H, Gotschy A, Kozerke S, Manka R. [Epicardial fat: Imaging and implications for diseases of the cardiovascular system]. Herz 2014; 40 Suppl 3:282-90. [PMID: 25178875 DOI: 10.1007/s00059-014-4146-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 07/24/2014] [Accepted: 07/31/2014] [Indexed: 10/24/2022]
Abstract
Since the discovery of the obese (ob) gene product leptin, fat has been considered an endocrine organ. Especially epicardial fat has gained increasing attention in recent years. The epicardial fat plays a major role in fat metabolism; however, harmful properties have also been reported. Echocardiography, computed tomography and cardiac magnetic resonance imaging are the non-invasive tools used to measure epicardial fat volume. This review briefly introduces the basic physiological and pathophysiological considerations concerning epicardial fat. The main issue of this review is the presentation of non-invasive measurement techniques of epicardial fat using various imaging modalities and a literature overview of associations between epicardial fat and common cardiovascular diseases.
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Affiliation(s)
- M Niemann
- Institut für Biomedizinische Technik, Universität und ETH Zürich, Gloriastr. 35, CH-8092, Zürich, Schweiz,
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16
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Valenta I, Dilsizian V, Quercioli A, Jüngling FD, Ambrosio G, Wahl R, Schindler TH. Impact of obesity and bariatric surgery on metabolism and coronary circulatory function. Curr Cardiol Rep 2014; 16:433. [PMID: 24281976 DOI: 10.1007/s11886-013-0433-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Increases in intra-abdominal visceral adipose tissue have been widely appreciated as a risk factor for metabolic disorders such as dyslipidemia, hypertension, insulin resistance, and type 2 diabetes, whereas this is not the case for peripheral or subcutaneous obesity. While the underlying mechanisms that contribute to these differences in adipose tissue activity remain uncertain, increases in visceral fat commonly induce metabolic dysregulation, in part because of increased venous effluent of fatty acids and/or adipokines/cytokines to the liver. Increased body weight, paralleled by an increase in plasma markers of the insulin-resistance syndrome and chronic inflammation, is independently associated with coronary circulatory dysfunction. Recent data suggest that plasma proteins originating from the adipose tissue, such as endocannabinoids (EC), leptin, and adiponectin (termed adipocytes) play a central role in the regulation and control of coronary circulatory function in obesity. Positron emission tomography (PET) in concert with tracer kinetic modeling is a well established technique for quantifying regional myocardial blood flow at rest and in response to various forms of vasomotor stress. Myocardial flow reserve assessed by PET provides a noninvasive surrogate of coronary circulatory function. PET also enables the monitoring and characterization of coronary circulatory function in response to gastric bypass-induced weight loss in initially morbidly obese individuals, to medication and/or behavioral interventions related to weight, diet, and physical activity. Whether the observed improvement in coronary circulatory dysfunction via weight loss may translate to diminution in cardiovascular events awaits clinical confirmation.
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Affiliation(s)
- Ines Valenta
- Department of Radiology, Johns Hopkins University, Division of Nuclear Medicine, Baltimore, MD, USA
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17
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Effect of type 2 diabetes mellitus on epicardial adipose tissue volume and coronary vasomotor function. Am J Cardiol 2014; 113:90-7. [PMID: 24169015 DOI: 10.1016/j.amjcard.2013.09.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 09/24/2013] [Accepted: 09/24/2013] [Indexed: 12/27/2022]
Abstract
Patients with coronary artery disease and/or type 2 diabetes mellitus (DM) generally exhibit more epicardial adipose tissue (EAT) than healthy controls. Recently, it has been proposed that EAT affects vascular function and structure by secreting proinflammatory and vasoactive substances, thereby potentially contributing to the development of cardiovascular disease. In the present study, the interrelation of EAT, coronary vasomotor function, and coronary artery calcium was investigated in patients with and without DM, who were evaluated for coronary artery disease. Myocardial blood flow (MBF) was assessed at rest and during adenosine-induced hyperemia using [(15)O]-water positron emission tomography combined with computed tomography to quantify coronary artery calcium and EAT in 199 patients (46 with DM). In this cohort (mean age 58 ± 10 years), the patients with DM had a greater body mass index, heart rate, and systolic blood pressure at rest (all p <0.05). Coronary artery calcium and the EAT volumes were comparable between those with and without DM. Both patient groups showed comparable MBF at rest and coronary vascular resistance. A lower hyperemic MBF and coronary flow reserve (CFR) and greater hyperemic coronary vascular resistance (all p <0.05) was observed in the patients with DM. A pooled analysis showed a positive association of EAT volume with hyperemic coronary vascular resistance but not with the MBF at rest, hyperemic MBF, or coronary vascular resistance at rest. In the group analysis, the EAT volume was inversely associated with hyperemic MBF (r = -0.16, p = 0.05) and CFR (r = -0.17, p = 0.04) and positively with hyperemic coronary vascular resistance (r = 0.26, p = 0.002) only in patients without DM. Multivariate regression analysis, adjusted for age, gender, and body mass index, showed an independent association between the EAT volume and hyperemic MBF (β = -0.16, p = 0.02), CFR (β = -0.16, p = 0.04), and hyperemic coronary vascular resistance (β = 0.25, p <0.001) in the non-DM group. In conclusion, these results suggest a role for EAT in myocardial microvascular dysfunction; however, once DM has developed, other factors might be more dominant in contributing to impaired myocardial microvascular dysfunction.
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18
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Dey D, Nakazato R, Li D, Berman DS. Epicardial and thoracic fat - Noninvasive measurement and clinical implications. Cardiovasc Diagn Ther 2013; 2:85-93. [PMID: 24282702 DOI: 10.3978/j.issn.2223-3652.2012.04.03] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Accepted: 04/28/2012] [Indexed: 12/13/2022]
Abstract
Epicardial fat, the local visceral fat depot enclosed by the visceral pericardial sac, surrounds the coronary arteries for most of their course, and may contribute to the development of coronary atherosclerosis through local production of inflammatory cytokines. Several studies which measured epicardial fat volume noninvasively have shown a relationship of increased epicardial fat volume with coronary artery disease, with the presence and progression of coronary plaque, major adverse cardiovascular events, myocardial ischemia and atrial fibrillation. Quantitative measurement of epicardial fat volume from noninvasive imaging modalities such as CT and MRI are feasible, and may play a clinical role in cardiovascular risk assessment. The evidence to date warrants larger studies with follow-up to further investigate the role of epicardial fat as an imaging marker with prognostic importance.
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Affiliation(s)
- Damini Dey
- Department of Biomedical Sciences and Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; ; Departments of Imaging and Medicine, Cedars-Sinai Medical Center, and Cedars-Sinai Heart Institute, Los Angeles, CA, USA
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19
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Measurements of pericardial adipose tissue using contrast enhanced cardiac multidetector computed tomography—comparison with cardiac magnetic resonance imaging. Int J Cardiovasc Imaging 2013; 29:1401-7. [DOI: 10.1007/s10554-013-0218-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Accepted: 04/06/2013] [Indexed: 10/26/2022]
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20
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Can MM, Can E, Ozveren O, Okuyan E, Ayca B, Dinckal MH. Epicardial fat tissue thickness in preeclamptic and normal pregnancies. ISRN OBSTETRICS AND GYNECOLOGY 2012; 2012:389539. [PMID: 23119176 PMCID: PMC3478736 DOI: 10.5402/2012/389539] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 09/12/2012] [Indexed: 01/20/2023]
Abstract
Background. Epicardial fat tissue, another form of visceral adiposity, has been proposed as a new cardiometabolic risk factor, and the possible association of epicardial fat with hypertension has been shown in some recent studies. Although epicardial fat thickness (EFT) is associated with hypertension, the relationship between preeclampsia and EFT is still unknown. The purpose of this paper is to investigate the association between the echocardiographic EFT and the severity of preeclampsia in pregnant women. Methods. Forty women with preeclampsia were recruited and thirty-five normal pregnant women were matched for both maternal age and gestastional age served as control. The materials were collected immediately after delivery of the fetus, before placenta expulsion and before clamping of the umblical cord in patients and controls whom were in fasting state. Total cholesterol, high-density lipoprotein cholesterol (HDL), and triglyceride levels (TG) and low-density-lipoprotein cholesterol (LDL), and homeostatic model assessment of insulin resistance (HOMA-IR) levels were assessed. EFT was measured by using transthoracic echocardiography. Results. Among the preeclamptic women, 12 were diagnosed with severe preeclampsia and 28 mild preeclampsia. There were no statistically significant differences between patients with preeclampsia and normal pregnancy except when they are divided according to systolic and diastolic blood pressure, proteinuria levels, and parity and EFT levels. Among women with preeclampsia (n = 40), 30% had severe disease. Women with mild and severe preeclampsia had significiantly higher blood pressures at delivery and earlier gestational ages in comparison to control subjects. Although TG, VLDL and LDL, HDL, and HOMA-IR levels (P > 0.05) were comparable between preeclampsia and normal pregnancies, EFT levels were significiantly higher in patients with preeclampsia. Moreover, in subgroup analysis, patients with severe preeclampsia had higher EFT levels (P < 0.05) in comparison with mild preeclampsia. Conclusions. EFT levels measured at delivery were increased in patients with preeclampsia, and patients with increased levels of EFT levels had a substantially higher probability of the disease severity in comparison to those with mild preeclampsia and controls.
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Affiliation(s)
- Mehmet Mustafa Can
- Cardiology Department, Bagcılar Research and Education Hospital, Istanbul, Turkey
| | - Esra Can
- Gynecology and Obstetrics Department, Malatya Akcadag State Hospital, Istanbul, Turkey
| | - Olcay Ozveren
- Cardilogy Department, Yeditepe University, Istanbul, Turkey
| | - Ertugrul Okuyan
- Cardiology Department, Bagcılar Research and Education Hospital, Istanbul, Turkey
| | - Burak Ayca
- Cardiology Department, Bagcılar Research and Education Hospital, Istanbul, Turkey
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21
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de Roos A. Reversibility of Intrathoracic Lipotoxicity in Obesity After Bariatric Surgery. J Am Coll Cardiol 2012; 60:1390-2. [DOI: 10.1016/j.jacc.2012.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Accepted: 07/10/2012] [Indexed: 10/27/2022]
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