Epicardial Adipose Tissue Volume Is Associated with High Risk Plaque Profiles in Suspect CAD Patients

NSTEMI Risk Prediction with the Combination of the Biomarkers Epicardial Adipose Tissue and Soluble Suppression of Tumorigenicity 2

BACKGROUND Epicardial adipose tissue (EAT) and soluble suppression of tumorigenicity 2 (sST2) are valuable markers of myocardial fibrosis, but the relationship between EAT and sST2 remains controversial. This study aimed to evaluate the role of combined EAT measurements and levels of sST2 and the risk of major adverse cardiovascular events (MACEs) in patients with diagnosis of non-ST-elevation myocardial infarction (NSTEMI). MATERIAL AND METHODS This was a single-center retrospective observational study. Patients diagnosed with NSTEMI from December 2019 to December 2022 were included. All patients completed the sST2 tests and computed tomography angiography during hospitalization. During the 12-month follow-up, MACEs were defined as all-cause death, reinfarction, and new congestive heart failure. RESULTS A total of 435 patients were enrolled in this study, of whom 59 patients (13.6%) developed MACEs. After adjusting for confounding factors, multivariate COX regression analysis showed that high EAT index (EATi) (HR=4.60; 95% CI 2.499-8.481; P<0.001) and high sST2 (HR=3.35; 95% CI 1.894-5.914; P<0.001) were the independent predictors of MACEs. According to Pearson correlation analysis, there was a positive correlation between EATi and sST2 (r=0.347, P<0.001). Kaplan-Meier analysis showed the patients with high sST2 or EATi had a significantly higher long-term risk of MACEs (both, log-rank P<0.001). After the addition of EATi and/or sST2, the predictive ability of the new model for MACEs was significantly improved (P<0.005). CONCLUSIONS EAT and sST2 are positively correlated in patients with NSTEMI. The combination of EAT and sST2 has a solid potential for predicting MACEs in patients with NSTEMI.

Correlation analysis between epicardial adipose tissue and acute coronary syndrome

To investigate the correlation between the density and volume of epicardial adipose tissue(EAT)and acute coronary syndrome (ACS). This study included 355 subjects (mean age: 60.65 ± 9.67 years; 54.65% male), comprising 175 patients with ACS and 180 without ACS. Propensity score matching was applied to balance the variables between the two groups, resulting in 96 successfully matched pairs. Clinical data, epicardial adipose tissue volume (EATV), and epicardial adipose tissue density (EATD) were compared. Independent factors influencing ACS were identified using logistic regression analysis, and the predictive ability of each variable was evaluated using receiver operating characteristic (ROC) curves. Systolic blood pressure, EATV, EATD, fasting blood glucose, triglycerides, and high-sensitivity C-reactive protein were significantly elevated in the ACS group compared with the non-ACS group (all p < 0.05). Spearman correlation analysis revealed a moderate positive correlation between EATV and BMI (r = 0.444, p < 0.001), while EATD showed a weak negative correlation with age (r = -0.177, p = 0.014) and a weak positive correlation with EATV (r = 0.239, p = 0.001). Univariable regression analysis demonstrated that both EATV (OR: 2.018, 95% CI: 1.334-3.052) and EATD (OR: 5.341, 95% CI: 3.293-8.663) were associated with ACS. After adjusting for other risk factors, logistic regression model confirmed that EATV (adjusted OR: 1.892, 95%CI: 1.211-2.955) and EATD (adjusted OR: 6.942, 95%CI: 3.875-12.437) were independent predictors of ACS (both p < 0.001), with EATD showing the highest predictive value (AUC = 0.859). This study identifies a close relationship between EAT and ACS, highlighting EATD and EATV as independent influencing factors for ACS. Among them, EATD demonstrated a stronger predictive value for ACS than both traditional risk factors and EATV.

Plasma proteomics implicate glutamic oxaloacetic transaminases as potential markers for acute myocardial infarction

AIM

To provide a novel perspective on the pathogenesis of acute myocardial infarction (AMI) patients with respect to glutamic oxaloacetic transaminase (GOT).

METHODS

The plasma proteome of 20 patients with AMI were matched for age and sex and compared with 10 healthy individuals. We analyzed the mass spectrum data and compared the signal intensity of the corresponding peptides which related to their corresponding proteins. A sample-specific protein database was constructed and a quality control analysis was conducted to screen out the key regulatory proteins under specific experimental conditions. The data from 37 new AMI patients and 13 healthy adults were subjected to parallel reaction monitoring (PRM) to verify the target proteins found. Finally, the survival status of the key genes (> 1.5-fold) in the PPI were analyzed.

RESULTS

2589 and 2162 proteins were identified and quantified, respectively, and 143 differentially expressed proteins (DEPs) (≥1.5-fold) were found between the AMI and control groups. Of these 90 and 53 were significantly up-regulated and down-regulated, respectively. Gene ontology, KEGG enrichment, protein domain and cluster analysis as well as PPI networks of the DEPs revealed a central role of acute inflammatory response processes in patients with AMI. A cluster of proteins were found to be related to cysteine, methionine, arginine, proline, phenylalanine and propanoate metabolism as well as the cAMP signaling pathway. PPI network analysis showed CHI3L1, COPB2, GOT2, MB, CYCS, GOT1, CKM, SAA1 and PRKCD and RPS3 were in key positions, but only MB, CKM, GOT1, PRKCD, CYCS and GOT2 were found in a cluster. PRM verified the high levels of MB, CKM, GOT1 and GOT2 in 37 AMI patients but there was no statistical difference in the survival status for patients with either high or low expression levels of these proteins.

CONCLUSIONS

Our findings showed that acute inflammatory response processes play a central role in patients with AMI. Cysteine and methionine metabolism was also activated, in which GOT1 and GOT2 were key proteins. These pathways might be potential targets for diagnosis and novel therapies to improve the poor outcomes observed in patients with heart failure.

Pericardial fat volume and coronary risk factors as predictors of non-calcified coronary plaque presence among patients with coronary calcium score = 0

INTRODUCTION

There is scarce data linking pericardial fat volume (PFV) and classical coronary risk factors with non-calcified plaque presence among patients with CAC = 0 in the literature.

MATERIAL AND METHOD

A total of 811 patients with chest pain suggestive of angina underwent CT coronary angiography for the assessment of coronary artery disease were collected. Of these, 417 with CAC = 0 were included in the analysis.

RESULT

Patients with non-calcified plaque were older (54 ± 9 versus 50 ± 10, P = 0.01) and had a higher prevalence of diabetes mellitus (31% versus 17%, P = 0.02), high BMI (29.9 versus 28.3, P = 0.04), and increased PFV (123 cm3 versus 99 cm3, P < 0.01) compared to patients without plaque. In multivariate regression analysis, high BMI[OR(CI) = 1.1(1-1.3), P = 0.02] was an independent predictor of non-calcified coronary plaque presence among patients with CAC = 0 after adjustment to variables with P < 0.05 in the univariate analysis.

CONCLUSION

In patients with a CAC score of 0, advanced age, diabetes mellitus, increased PFV, and high BMI were all associated with the presence of non-calcified plaque. After multivariate adjustment, increased BMI remained a significant independent predictor for non-calcified plaque presence.

Retracted: Epicardial Adipose Tissue Volume Is Associated with High Risk Plaque Profiles in Suspect CAD Patients

[This retracts the article DOI: 10.1155/2021/6663948.].

Impacts of Non-alcoholic Fatty Liver Disease on Acute Coronary Syndrome: Evidence and Controversies

PURPOSE OF REVIEW

Acute coronary syndrome (ACS) and non-alcoholic fatty liver disease (NAFLD) are two clinically common disease entities that share numerous risk factors. This review aimed to discuss the impacts of NAFLD on ACS.

RECENT FINDINGS

In an era of improved control of traditional risk factors, the substantial burden of cardiometabolic abnormalities has caused widespread concern. NAFLD is considered the hepatic component of metabolic syndrome, which can exert an impact on human health beyond the liver. Accumulating studies have demonstrated that NAFLD is closely related to cardiovascular disease, especially coronary artery disease. Interestingly, although recent data have suggested an association between NAFLD and the incidence and outcomes of ACS, the results are not consistent. In this review, we comprehensively summarized evidence and controversies regarding whether NAFLD is a contributor to either the development of ACS or worse outcomes in patients with ACS. The potential pathophysiological and molecular mechanisms involved in the impacts of NAFLD on ACS were also elucidated.

Vigorous-intensity exercise as a modulator of cardiac adipose tissue in women with obesity: a cross-sectional and randomized pilot study

Cardiac adipose tissue (CAT) has become an important target for the reduction of disease risk. Supervised exercise programs have shown potential to "significantly" reduce CAT; however, the impact of different exercise modalities is not clear, and the relationships between CAT, physical activity (PA) levels and fitness (PFit) remain unknown. Therefore, the purpose of this study was to analyze the relationships between CAT, PA and PFit, and to explore the effects of different exercise modalities in a group of women with obesity. A total of 26 women (age: 23.41 ± 5.78 years-old) were enrolled in the cross-sectional study. PA, cardiorespiratory fitness, muscular strength, body composition and CAT were evaluated. The pilot intervention included 16 women randomized to a control (CON, n=5), high intensity interval training (HIIT, n = 5) and high-intensity circuit training (HICT, n=6) groups. Statistical analysis showed negative correlations between CAT and vigorous PA (VPA) (r s=-0.41, p=0.037); and between percent body fat (%BF), fat mass (FM), and all PA levels (r s=-0.41- -0.68, p<0.05); while muscle mass was positively associated with moderate-to-vigorous PA, and upper-body lean mass with all PA levels (r s =0.40-0.53, p<0.05). The HICT intervention showed significant improvements (p<0.05) in %BF, FM, fat free mass, and whole-body and lower extremities lean mass and strength after three weeks; however, only leg strength and upper extremities' FM improved significantly compared to CON and HICT. In conclusion, although all types of PA showed a positive influence on body fat content, only VPA significantly impacted on CAT volume. Moreover, three weeks of HICT induced positive changes in PFit in women with obesity. Further research is needed to explore VPA levels and high-intensity exercise interventions for short- and long-term CAT management.

Macrophage polarization markers in subcutaneous, pericardial, and epicardial adipose tissue are altered in patients with coronary heart disease

Background

Epicardial and pericardial adipose tissue (EAT and PAT) surround and protect the heart, with EAT directly sharing the microcirculation with the myocardium, possibly presenting a distinct macrophage phenotype that might affect the inflammatory environment in coronary heart disease (CHD). This study aims to investigate the expression of genes in different AT compartments driving the polarization of AT macrophages toward an anti-inflammatory (L-Galectin 9; CD206) or pro-inflammatory (NOS2) phenotype.

Methods

EAT, PAT, and subcutaneous (SAT) biopsies were collected from 52 CHD patients undergoing coronary artery bypass grafting, and from 22 CTRLs undergoing aortic valve replacement. L-Galectin9 (L-Gal9), CD206, and NOS2 AT gene expression and circulating levels were analyzed through RT-PCR and ELISA, respectively.

Results

L-Gal9, CD206, and NOS2 gene expression was similar in all AT compartments in CHD and CTRLs, as were also L-Gal9 and CD206 circulating levels, while NOS2 serum levels were higher in CHD (p = 0.012 vs. CTRLs). In CTRLs, NOS2 expression was lower in EAT vs. SAT (p = 0.007), while in CHD patients CD206 expression was lower in both SAT and EAT as compared to PAT (p = 0.003, p = 0.006, respectively), suggestive of a possible macrophage reprogramming toward a pro-inflammatory phenotype in EAT. In CHD patients, NOS2 expression in SAT correlated to that in PAT and EAT (p = 0.007, both), CD206 expression correlated positively to L-Gal9 (p < 0.001) only in EAT, and CD206 expression associated with that of macrophage identifying markers in all AT compartments (p < 0.001, all). In CHD patients, subjects with LDL-C above 1.8 mmol/L showed significantly higher NOS2 expression in PAT and EAT as compared to subjects with LDL-C levels below (p < 0.05), possibly reflecting increased cardiac AT pro-inflammatory activation. In SAT and PAT, CD206 expression associated with BMI in both CHD and CTRLs (p < 0.05, all), and with L-Gal9 in EAT, however only in CTRLs (p = 0.002).

Conclusion

CHD seems to be accompanied by an altered cardiac, and especially epicardial AT macrophage polarization. This may represent an important pathophysiological mechanism and a promising field of therapy targeting the excessive AT inflammation, in need of further investigation.