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Ma ZY, Duan H, Han D, He B, Xie XJ, Lu L, Jiang J, Li RH. Epicardial fat in patients with metabolic syndrome: A systematic review and meta-analysis. Eur J Radiol 2023; 167:111056. [PMID: 37666076 DOI: 10.1016/j.ejrad.2023.111056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE Abnormally increased epicardial fat appears to be associated with an additional risk of major adverse cardiovascular events (MACEs) in the context of metabolic syndrome (MetS). However, evidence on the relationship between epicardial fat volumes (EFVs), epicardial fat thickness (EFT) and MetS remains inconsistent. METHODS Specific searches of electronic databases from 1 January 2000 to 31 October 2022 were independently performed by two researchers. In this study, two quantification measures of epicardial fat were included: comparison of total computed tomography-based EFVs and EFT between two groups (individuals with and without MetS), estimating standardized mean difference (SMD) with corresponding 95 % confidence intervals (CIs) through a random-effects model analysis. The heterogeneity in the included studies was explored by meta-regression and subgroup analyses. RESULTS The EFVs were significantly increased in MetS subjects compared with non-MetS subjects (SMD: 1.07, 95 % CI: 0.69-1.45, p < 0.001), and the EFT was also significantly larger in MetS patients than in the Non-MetS (SMD: 1.12, 95 % CI: 0.84-1.41, p < 0.001). We compared the Caucasian and American subgroups with the Asian and African subgroups, and the EFT was greater in the former subgroups (SMD: 1.32, 95 % CI: 0.44-2.20, p < 0.001). When comparing the EFT among the age subgroups, there was a significant SMD between adolescents and adults or elderly individuals (SMD: 1.21, 95 % CI: 0.84-1.52, p < 0.001). CONCLUSIONS MetS patients tend to present greater EFT near the right ventricular free wall and greater total EFVs. Increased epicardial fat, an imaging biomarker, independently affects the onset of MetS.
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Affiliation(s)
- Zhong-Yan Ma
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Hui Duan
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China.
| | - Dan Han
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Bo He
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Xiao-Jie Xie
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Lin Lu
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Jie Jiang
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Rui-Hong Li
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
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Miller NE, Steptoe A. Pericardial Fat, Socioeconomic Status, and Biological Responses to Acute Mental Stress. Psychosom Med 2023; 85:280-288. [PMID: 36705572 PMCID: PMC10082067 DOI: 10.1097/psy.0000000000001169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/14/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Central adiposity is associated with impaired biological responses to mental stress, and socioeconomic status (SES) might moderate this relationship. However, evidence for associations between pericardial fat, a fat depot implicated in the pathogenesis of cardiovascular disease (CVD), with cardiovascular and inflammatory responses to mental stress is lacking, and moderation by SES is unknown. METHODS The sample was 473 healthy men and women (mean age = 62.8 years) from the Whitehall II study. Cardiovascular and inflammatory responses to laboratory-induced mental stress, consisting of a 5-minute Stroop task and 5-minute mirror tracing task, were assessed. Pericardial fat volume was measured using electron bean computed tomography and adjusted for body surface area. SES was defined by grade of employment within the British civil service (higher/intermediate/lower). RESULTS Pericardial fat was associated with lower heart rate variability, raised heart rate, plasma interleukin-6, fibrinogen, and C-reactive protein at baseline. Furthermore, greater pericardial fat was associated with lower systolic blood pressure reactivity to mental stress, independent of sociodemographics, smoking status, waist-to-hip ratio, and baseline systolic blood pressure. There were no interactions between pericardial fat and SES for any outcome. CONCLUSIONS Greater pericardial fat was associated with numerous cardiovascular and inflammatory factors implicated in CVD. It was also related to reduced systolic blood pressure reactivity to acute mental stress, independent of central adiposity and baseline systolic blood pressure. This association did not vary by SES. Reduced systolic blood pressure reactivity to mental stress might contribute to the association between greater pericardial fat and CVD.
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Chang SH, Chu PH, Tsai CT, Kuo JY, Tsai JP, Hung TC, Hou CJY, Lai YH, Liu CY, Huang WM, Yun CH, Yeh HI, Hung CL. Both epicardial and peri-aortic adipose tissue blunt heart rate recovery beyond body fat mass. Front Cardiovasc Med 2022; 9:939515. [PMID: 36211580 PMCID: PMC9532623 DOI: 10.3389/fcvm.2022.939515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background Epicardial adipose tissue (EAT) as a marker of metabolic disorders has been shown to be closely associated with a variety of unfavorable cardiovascular events and cardiac arrhythmias. Data on regional-specific visceral adiposity outside the heart and its modulation on autonomic dysfunction, particularly heart rate recovery after exercise, remain obscure. Methods We studied 156 consecutive subjects (mean age: 49.3 ± 8.0 years) who underwent annual health surveys and completed treadmill tests. Multi-detector computed tomography-based visceral adiposity, including EAT and peri-aortic fat (PAF) tissue, was quantified using dedicated software (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA). We further correlated EAT and PAF with blood pressure and heart rate (HR) recovery information from an exercise treadmill test. Metabolic abnormalities were scored by anthropometrics in combination with biochemical data. Results Increased EAT and PAF were both associated with a smaller reduction in systolic blood pressure during the hyperventilation stage before exercise compared to supine status (β-coefficient (coef.): −0.19 and −0.23, respectively, both p < 0.05). Both visceral adipose tissue mediated an inverted relationship with heart rate recovery at 3 (EAT: β-coef.: −0.3; PAF: β-coef.: −0.36) and 6 min (EAT: β-coef.: −0.32; PAF: β-coef.: −0.34) after peak exercise, even after adjusting for baseline clinical variables and body fat composition (all p < 0.05). Conclusion Excessive visceral adiposity, whether proximal or distal to the heart, may modulate the autonomic response by lowering the rate of HR recovery from exercise after accounting for clinical metabolic index. Cardiac autonomic dysfunction may partly explain the increase in cardiovascular morbidity and mortality related to both visceral fats.
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Affiliation(s)
- Sheng-Hsiung Chang
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei City, Taiwan
| | - Po-Hua Chu
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Cheng-Ting Tsai
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei City, Taiwan
| | - Jen-Yuan Kuo
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei City, Taiwan
| | - Jui-Peng Tsai
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei City, Taiwan
| | - Ta-Chuan Hung
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei City, Taiwan
| | - Charles Jia-Yin Hou
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei City, Taiwan
| | - Yau-Hui Lai
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Hsinchu, Taiwan
| | - Chia-Yuan Liu
- Department of Gastroenterology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wei-Ming Huang
- Mackay Medicine, Nursing and Management College, New Taipei City, Taiwan
- Department of Gastroenterology, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chun-Ho Yun
- Mackay Medicine, Nursing and Management College, New Taipei City, Taiwan
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan
- *Correspondence: Chun-Ho Yun
| | - Hung-I Yeh
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei City, Taiwan
| | - Chung-Lieh Hung
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei City, Taiwan
- Chung-Lieh Hung
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Jo EA, Cho KI, Park JJ, Im DS, Choi JH, Kim BJ. Effects of High-Intensity Interval Training Versus Moderate-Intensity Continuous Training on Epicardial Fat Thickness and Endothelial Function in Hypertensive Metabolic Syndrome. Metab Syndr Relat Disord 2020; 18:96-102. [DOI: 10.1089/met.2018.0128] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Eun-Ah Jo
- Convergence Medicine & Exercise Science Research Institute, Kosin University College of Medicine, Busan, Korea
| | - Kyoung-Im Cho
- Convergence Medicine & Exercise Science Research Institute, Kosin University College of Medicine, Busan, Korea
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Jung-Jun Park
- Division of Sport Science, Pusan National University, Busan, Korea
| | - Do-Sun Im
- Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul, Korea
| | - Ji-Hyun Choi
- Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul, Korea
| | - Bong-Jun Kim
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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Jo EA, Wu SS, Han HR, Park JJ, Park S, Cho KI. Effects of exergaming in postmenopausal women with high cardiovascular risk: A randomized controlled trial. Clin Cardiol 2019; 43:363-370. [PMID: 31883278 PMCID: PMC7144488 DOI: 10.1002/clc.23324] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/05/2019] [Accepted: 12/11/2019] [Indexed: 12/21/2022] Open
Abstract
Objective Recently, exergames have been used an exercise modality as aerobic fitness activities. However, evidence of its effectiveness on cardiovascular (CV)‐related risk factors remain unclear. Hypothesis We evaluate the effects of exergaming on CV‐related risk factors compared with traditional aerobic exercise in high CV risk patients. Methods Sixty‐five postmenopausal women with high CV risk were randomized among exergame (n = 22), treadmill (n = 22), and control (n = 21) groups. The exergame group was engaged in the running‐based exergame using Exer Heart and the treadmill group walked or jogged on a treadmill. Cardiorespiratory fitness, flow‐mediated dilation, endothelial progenitor cells (EPCs), epicardial fat thickness, metabolic parameters, and anthropometric parameters were measured in patients before and 12 weeks after the training. Results Exergaming significantly improved VO2 peak (P < .001; different from control, P < .05), flow‐mediated dilation (P < .001; different from control, P < .05), EPCs (CD34/CD117+, P < .01). Treadmill exercise was effective at improving VO2 peak (P < .01; different from control, P < .05), flow‐mediated dilation (P < .05), EPCs (CD34/CD117+, P < .01; different from control P < .05). Epicardial fat thickness decreased after both exercise programs (exergame, P < .01; treadmill, P < .01; no different from control). Conclusion Exergaming showed similar effects to traditional aerobic exercise in improving cardiorespiratory fitness and endothelial function in postmenopausal women with high CV risk. These findings suggest that the exergames may serve as an alternative to conventional aerobic exercises for prevention and treatment in high CV risk patients.
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Affiliation(s)
- Eun-Ah Jo
- Convergence Medicine & Exercise Science Research Institute, Kosin University College of Medicine, Busan, South Korea
| | - Shan-Shan Wu
- Division of Sport Science, Pusan National University, Busan, South Korea
| | - Hyung-Rae Han
- Division of Sport Science, Pusan National University, Busan, South Korea
| | - Jung-Jun Park
- Division of Sport Science, Pusan National University, Busan, South Korea
| | - Saejong Park
- Korea Institute of Sports Science, Seoul, South Korea
| | - Kyoung-Im Cho
- Convergence Medicine & Exercise Science Research Institute, Kosin University College of Medicine, Busan, South Korea.,Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
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Epicardial fat accumulation is an independent marker of impaired heart rate recovery in obese patients with obstructive sleep apnea. Clin Res Cardiol 2019; 108:1226-1233. [PMID: 30887111 DOI: 10.1007/s00392-019-01454-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 03/13/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sympathetic nervous system activation plays a pivotal role in obese patients with obstructive sleep apnea (OSA), contributing to increased cardiovascular risk. Epicardial adipose tissue (EAT) activates cardiac autonomic nervous system. Our main study objective was to investigate effects of these autonomic dysfunction factors on post-exercise heart rate recovery (HRR). METHODS 36 patients, referred for clinical assessment of obesity (BMI > 30 kg/m2), underwent overnight polysomnography, transthoracic echocardiography and cardiopulmonary exercise testing. RESULTS Compared to non-OSA patients, OSA patients were older and displayed reduced body weight-indexed peak VO2. Cardiac output at peak exercise was similar among groups. Peak exercise arterio-venous oxygen content difference D[a-v]O2 was lower in OSA patients. In univariate linear analysis, age, AHI, EAT thickness, peak VO2 and diabetes were associated with blunted HRR. Multiple linear regression analysis showed that increased EAT thickness, AHI and diabetes were independently associated with lower HRR. For identical AHI value and diabetes status, HRR significantly decreased by 61.7% for every 1 mm increase of EAT volume (p = 0.011). If HRR was treated as a categorical variable, EAT [odds ratio (OR) 1.78 (95% confidence interval [CI] 1.19-2.66); p = 0.005], and type 2 diabetes [OR 8.97 (95% CI 1.16-69.10); p = 0.035] were the only independent predictors of blunted HRR. CONCLUSIONS Aerobic capacity and peak exercise D[a-v]O2 are impaired in obese OSA patients, suggesting abnormal peripheral oxygen extraction. EAT thickness is an independent marker of post-exercise HRR, which is a noninvasive marker of autonomic nerve dysfunction accompanying poor cardiovascular prognosis in obese patients.
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Kim DS, Ok EJ, Choi BH, Joo NS. The Cutoff Pericardial Adipose Tissue Volume Associated with Metabolic Syndrome. Korean J Fam Med 2018; 39:284-289. [PMID: 29983041 PMCID: PMC6166121 DOI: 10.4082/kjfm.17.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 10/12/2017] [Indexed: 11/04/2022] Open
Abstract
Background Metabolic syndrome (MS) is a well-known risk factor of cardiovascular diseases that is focused on central obesity. Recent studies have reported the association between pericardial adipose tissue (PAT) volume and MS. However, no studies have demonstrated the cutoff PAT volume that represents the best association with MS. Methods The data of 374 subjects were analyzed cross-sectionally to compare PAT, measured on coronary multidetector computed tomography, and various metabolic parameters according to MS. After PAT volumes were divided into tertiles, various metabolic parameters were compared among tertiles; furthermore, the odds ratio for developing MS was calculated. Finally, we demonstrated the cutoff PAT volume that represented the best association with MS by using the receiver-operating characteristic curve. Results We found that 27.5% of the subjects had MS, and the mean PAT volume was 123.9 cm3. PAT showed a significant positive correlation with body mass index, waist circumference, and levels of glucose, triglyceride, high-sensitivity C-reactive protein, uric acid, and homocysteine, but a negative correlation with high-density lipoprotein cholesterol. Furthermore, after dividing into tertiles, PAT volume was also significantly associated with various metabolic parameters. The odds ratio for having MS was 4.19 (95% confidence interval, 2.27–7.74) in the top tertile of PAT volumes after adjusting for age, sex, and smoking. The cutoff PAT volume that represented the best association with MS was 142.2 cm3. Conclusion PAT was significantly associated with MS and various metabolic parameters. The cutoff PAT volume of 142.2 cm3 showed the best association with MS.
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Affiliation(s)
- Dong Sun Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Eun Jeong Ok
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Beom Hee Choi
- CHA Anti-aging Institute, CHA University, Seoul, Korea
| | - Nam-Seok Joo
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
- Corresponding Author: Nam-Seok Joo https://orcid.org/0000-0001-5895-1800 Tel: +82-31-219-5324, Fax: +82-31-219-5218, E-mail:
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Miyazawa I, Ohkubo T, Kadowaki S, Fujiyoshi A, Hisamatsu T, Kadota A, Arima H, Budoff M, Murata K, Miura K, Maegawa H, Ueshima H. Change in Pericardial Fat Volume and Cardiovascular Risk Factors in a General Population of Japanese Men. Circ J 2018; 82:2542-2548. [PMID: 30047503 DOI: 10.1253/circj.cj-18-0153] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Pericardial fat volume (PFV), defined as the volume of ectopic fat in and around the heart, is associated with the atherosclerotic process in coronary arteries. The magnitude of change in PFV over time and the factors affecting this change in a general population, however, have not been investigated. Methods and Results: Cardiac computed tomography (CT) was carried out at baseline and at follow-up in 623 Japanese men aged 40-79 years without a history of cardiovascular disease who were selected randomly in Kusatsu (Shiga, Japan). PFV was measured on cardiac CT in a qualified laboratory. Age, heart rate, triglycerides, and obesity measurements (weight, body mass index, and waist circumference) were significantly and positively associated with PFV at baseline. Over an average interval of 4.7 years, median PFV increased significantly from 64.1 cm3 (IQR, 47.2-90.0 cm3) to 73.6 cm3 (IQR, 53.3-98.1 cm3; P<0.001). Current smoking and heart rate were significantly and independently associated with changes in PFV (B=3.336, P<0.001 and B=6.409, P=0.003, respectively). CONCLUSIONS PFV increased significantly over time in a population-based observational study of Japanese men. PFV change was significantly and independently associated with smoking status and heart rate, suggesting that quitting smoking might help reduce PFV, which could be expected to decrease the risk of coronary artery disease.
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Affiliation(s)
| | - Takayoshi Ohkubo
- Department of Public Health, Shiga University of Medical Science.,Department of Hygiene and Public Health, Teikyo University School of Medicine
| | - Sayaka Kadowaki
- Department of Public Health, Shiga University of Medical Science
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science
| | - Takashi Hisamatsu
- Department of Public Health, Shiga University of Medical Science.,Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Hisatomi Arima
- Department of Public Health, Shiga University of Medical Science.,Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University
| | - Matthew Budoff
- Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles
| | - Kiyoshi Murata
- Department of Radiology, Shiga University of Medical Science
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | | | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
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Cho KI, Lee YS, Kim BK, Kim BJ, Kim KS. Epicardial Fat Thickness is Correlated with Vagal Hyperactivity in Patients with Neurally-Mediated Syncope. J Cardiovasc Ultrasound 2017; 25:57-62. [PMID: 28770033 PMCID: PMC5526886 DOI: 10.4250/jcu.2017.25.2.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 06/04/2017] [Accepted: 06/05/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Epicardial fat tissue has unique endocrine and paracrine functions that affect the cardiac autonomic system. The head-up tilt test (HUTT) is a simple non-invasive measurement that assesses autonomic nervous system dysfunction. We investigated the association between epicardial fat thickness (EFT) and autonomic neural tone, such as vagal tone. METHODS A total of 797 consecutive patients (mean age 46.5 years, male: 45.7%) who underwent HUTT and echocardiography between March 2006 and June 2015 were enrolled. EFT was measured during the diastolic phase of the parasternal long axis view. We excluded patients with prior percutaneous coronary intervention, old age (* 70 years old), valvular heart disease, symptomatic arrhythmias and diabetes. We divided patients into two groups based on the HUTT (positive vs. negative). RESULTS There were 329 patients (41.3%) with a negative HUTT result and 468 patients (58.7%) with a positive result. The HUTT-positive patients showed a significantly lower waist circumference, body mass index and systolic and diastolic blood pressure, although a significantly higher EFT as compared to the HUTT-negative patients (HUTT-positive, 5.69 ± 1.76 mm vs. HUTT-negative, 5.24 ± 1.60 mm; p < 0.001). EFT > 5.4 mm was associated with a positive HUTT result with 51.7% sensitivity and 63.8% specificity (p < 0.001) on receiving operator characteristic analysis. Multivariate Cox regression analysis revealed that EFT (hazard ratio: 1.02, 95% confidence interval: 1.01-1.30, p = 0.004) was an independent predictor of HUTT-positivity. CONCLSION EFT was significantly correlated with positive HUTT, which suggests an association between EFT and autonomic dysregulation.
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Affiliation(s)
- Kyoung Im Cho
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Young Soo Lee
- Division of Cardiology, Department of Internal Medicine, Catholic University of Daegu College of Medicine, Daegu, Korea
| | - Byong Kyu Kim
- Division of Cardiology, Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea
| | - Bong Joon Kim
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Kee Sik Kim
- Division of Cardiology, Department of Internal Medicine, Catholic University of Daegu College of Medicine, Daegu, Korea
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Cho KI, Jo EA, Cho SH, Kim BH. The Influence of Epicardial Fat and Nonalcoholic Fatty Liver Disease on Heart Rate Recovery in Metabolic Syndrome. Metab Syndr Relat Disord 2017; 15:226-232. [DOI: 10.1089/met.2016.0132] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Kyoung Im Cho
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
- Convergence Medicine and Exercise Science Research Institute, Kosin University College of Medicine, Busan, South Korea
| | - Eun Ah Jo
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
- Convergence Medicine and Exercise Science Research Institute, Kosin University College of Medicine, Busan, South Korea
| | - Sang Hoon Cho
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Bo Hyun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Hospital and Biomedical Research Institute, Busan, South Korea
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Choi JH. The Relation of Epicardial Fat Thickness, Neutrophil to Lymphocyte Ratio and Circadian Rhythm of Blood Pressure. J Cardiovasc Ultrasound 2017; 24:272-273. [PMID: 28090252 PMCID: PMC5234335 DOI: 10.4250/jcu.2016.24.4.272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 11/22/2022] Open
Affiliation(s)
- Jae Hyuk Choi
- Division of Cardiology, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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12
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Kim BJ, Cho KI, Choi JH, Park DH, Yu GI, Im SI, Kim HS, Heo JH, Cha TJ. Epicardial Fat Thickness and Neutrophil to Lymphocyte Ratio are Increased in Non-Dipper Hypertensive Patients. J Cardiovasc Ultrasound 2016; 24:294-302. [PMID: 28090257 PMCID: PMC5234339 DOI: 10.4250/jcu.2016.24.4.294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 11/22/2022] Open
Abstract
Background In this study, we aimed to investigate the relationship between echocardiographic epicardial fat thickness (EFT), neutrophil to lymphocyte ratio (NLR; an important inflammatory marker), and diurnal blood pressure (BP) changes in patients with recently diagnosed essential hypertension. Methods A total of 647 patients underwent echocardiography and 24 hours of ambulatory BP monitoring. EFT was measured by echocardiography, while NLR was measured by dividing the neutrophil count by the lymphocyte count. Patients were categorized into three groups according to BP pattern: the normotensive group, the dipper group, and the non-dipper group. Results The mean EFT was highest in the non-dipper group (non-dipper group, 7.3 ± 3.0 mm; dipper group, 6.1 ± 2.0 mm; control group, 5.6 ± 2.0 mm; p < 0.001). NLR was also highest in the non-dipper group (non-dipper, 2.75 ± 2.81; dipper, 2.01 ± 1.32; control, 1.92 ± 1.11; p < 0.001). EFT was significantly correlated with age (r = 0.160, p < 0.001) and NLR (r = 0.353, p < 0.001). Furthermore, an EFT ≥ 7.0 mm was associated with the non-dipper BP pattern with 51.3% sensitivity and 71.6% specificity [95% confidence interval (CI) = 0.56–0.65, p < 0.001]. In a multivariate analysis, EFT [adjusted odds ratio (OR) = 3.99, 95% CI = 1.22–13.10, p = 0.022] and NLR (OR = 1.34, 95% CI = 1.05–1.71, p = 0.018) were independent parameters that distinguished a non-dipper pattern after adjustment for cardiovascular risk factors. Conclusion EFT and NLR are independently associated with impaired diurnal BP profiles in hypertensive individuals. EFT (as measured by echocardiography) and NLR appear to be helpful in stratifying cardiometabolic risk.
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Affiliation(s)
- Bong Joon Kim
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Kyoung Im Cho
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Ji Hun Choi
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Dong Hyun Park
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Ga In Yu
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Sung Il Im
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Hyun Su Kim
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Jeong Ho Heo
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Tae-Joon Cha
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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Kim DJ, Cho KI, Cho EA, Lee JW, Park HJ, Kim SM, Kim HS, Heo JH. Association among epicardial fat, heart rate recovery and circadian blood pressure variability in patients with hypertension. Clin Hypertens 2016; 21:24. [PMID: 26893934 PMCID: PMC4750792 DOI: 10.1186/s40885-015-0034-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 11/02/2015] [Indexed: 11/27/2022] Open
Abstract
Background Epicardial fat tissue is known to have an unique endocrine function which affect the cardiac autonomic system. Heart rate recovery (HRR) is a simple non-invasive measurement that assesses autonomic nervous system dysfunction. We aimed to investigate the association among epicardial fat thickness (EFT), HRR and circadian blood pressure (BP) variation in patients with hypertension. Methods A total of 358 consecutive patients who underwent both 24-hour ambulatory BP monitoring (ABPM) and a treadmill test were enrolled. Echocardiographic EFT and HRR, defined as peak heart rate minus heart rate after a 1-min recovery time, were measured. Patients were classified according to the ABPM; 147 patients with hypertension with a dipping pattern at night (dippers), 140 patients with hypertension with a non-dipping pattern at night (non-dippers) and 71 normotensive controls. Results EFT was significantly higher in hypertensive patients, especially in the non-dipper group, compared to the controls (non-dippers, 7.5 ± 2.9 mm; dippers, 6.6 ± 1.6 mm; controls, 5.5 ± 2.1 mm; p < 0.001). HRR was significantly lower in both hypertensive groups as compared to the control group and was the lowest in the non-dipper group (non-dipper, 26.6 ± 18.6; dipper, 29.5 ± 21.5; control, 71.4 ± 19.8; p < 0.001). EFT was significantly correlated with age, body mass index, 24-hour mean systolic BP and 24 h mean BP variability, whereas exercise duration, metabolic equivalents (METs) and HRR were inversely correlated with EFT. Furthermore, EFT > 6.7 mm was associated with a blunted HRR with 76 % sensitivity and 61 % specificity (ROC area under curve: 0.71, 95 % confidence interval, CI = 0.65–0.76, p < 0.001). In a multivariate analysis, EFT (odds ratio, OR = 3.53, 95 % CI = 1.20–10.37, p = 0.022) and 24-hour mean BP variability (OR = 1.09, 95 % CI = 1.03–1.16, p = 0.005) were independent predictors of a blunted HRR defined as HRR ≤ 12 beats (n = 63) in patients with hypertension. Conclusion EFT and HRR were significantly correlated with circadian BP variability in patients with hypertension. EFT and circadian BP variability were independent predictors of blunted HRR, which suggests a link between epicardial fat and autonomic dysregulation in hypertension.
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Affiliation(s)
- Da-Jung Kim
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, 34, Amnam-dong, Seo-gu, Busan, 602-702 Korea
| | - Kyoung-Im Cho
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, 34, Amnam-dong, Seo-gu, Busan, 602-702 Korea
| | - Eun-A Cho
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, 34, Amnam-dong, Seo-gu, Busan, 602-702 Korea
| | - Jin-Wook Lee
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, 34, Amnam-dong, Seo-gu, Busan, 602-702 Korea
| | - Hyun-Joon Park
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, 34, Amnam-dong, Seo-gu, Busan, 602-702 Korea
| | - Sun-Min Kim
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, 34, Amnam-dong, Seo-gu, Busan, 602-702 Korea
| | - Hyun-Su Kim
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, 34, Amnam-dong, Seo-gu, Busan, 602-702 Korea
| | - Jung Ho Heo
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, 34, Amnam-dong, Seo-gu, Busan, 602-702 Korea
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Kaplan O, Kurtoglu E, Nar G, Yasar E, Gozubuyuk G, Dogan C, Boz AU, Hidayet S, Pekdemir H. Evaluation of Electrocardiographic T-peak to T-end Interval in Subjects with Increased Epicardial Fat Tissue Thickness. Arq Bras Cardiol 2015; 105:566-72. [PMID: 26465871 PMCID: PMC4693660 DOI: 10.5935/abc.20150124] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 08/10/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The association between periatrial adiposity and atrial arrhythmias has been shown in previous studies. However, there are not enough available data on the association between epicardial fat tissue (EFT) thickness and parameters of ventricular repolarization. Thus, we aimed to evaluate the association of EFT thickness with indices of ventricular repolarization by using T-peak to T-end (Tp-e) interval and Tp-e/QT ratio. METHODS The present study included 50 patients whose EFT thickness ≥ 9 mm (group 1) and 40 control subjects with EFT thickness < 9 mm (group 2). Transthoracic echocardiographic examination was performed in all participants. QT parameters, Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead electrocardiogram. RESULTS QTd (41.1 ± 2.5 vs 38.6 ± 3.2, p < 0.001) and corrected QTd (46.7 ± 4.7 vs 43.7 ± 4, p = 0.002) were significantly higher in group 1 when compared to group 2. The Tp-e interval (76.5 ± 6.3, 70.3 ± 6.8, p < 0.001), cTp-e interval (83.1 ± 4.3 vs. 76±4.9, p < 0.001), Tp-e/QT (0.20 ± 0.02 vs. 0.2 ± 0.02, p < 0.001) and Tp-e/QTc ratios (0.2 ± 0.01 vs. 0.18 ± 0.01, p < 0.001) were increased in group 1 in comparison to group 2. Significant positive correlations were found between EFT thickness and Tp-e interval (r = 0.548, p < 0.001), cTp-e interval (r = 0.259, p = 0.01), and Tp-e/QT (r = 0.662, p < 0.001) and Tp-e/QTc ratios (r = 0.560, p < 0.001). CONCLUSION The present study shows that Tp-e and cTp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in subjects with increased EFT, which may suggest an increased risk of ventricular arrhythmia.
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Affiliation(s)
- Ozgur Kaplan
- Department of Cardiology, School of Medicine, İstanbul Bilim University, İstanbul, Turkey
| | | | - Gokay Nar
- Department of Cardiology, Education And Research Hospital, Ahi Evran University, Kırsehir, Turkey
| | - Erdogan Yasar
- Department of Cardiology, Malatya State Hospital, Malatya, Turkey
| | - Gokhan Gozubuyuk
- Department of Cardiology, Malatya State Hospital, Malatya, Turkey
| | - Cem Dogan
- Department of Cardiology, Malatya State Hospital, Malatya, Turkey
| | - Ahmet Ugur Boz
- Department of Cardiology, Malatya State Hospital, Malatya, Turkey
| | - Sıho Hidayet
- Department of Cardiology, Malatya State Hospital, Malatya, Turkey
| | - Hasan Pekdemir
- Department of Cardiology, School of Medicine, İnönü University, Malatya, Turkey
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Ulucan S, Keser A, Kaya Z, Katlandur H. Epicardial fat and coronary atherosclerosis: the effect of autonomic nervous system function. J Cardiovasc Med (Hagerstown) 2015. [PMID: 26222783 DOI: 10.2459/jcm.0000000000000268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Seref Ulucan
- Department of Cardiology, Mevlana University, Faculty of Medicine, Konya, Turkey
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16
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Effect of percutaneous coronary intervention on heart rate recovery in patients with coronary artery disease. Coron Artery Dis 2015; 26:442-7. [PMID: 25974268 DOI: 10.1097/mca.0000000000000264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to investigate the effect of percutaneous coronary intervention (PCI) on heart rate recovery (HRR) in patients with angiographically defined coronary artery disease, and to search for a noninvasive method for evaluating the effect of revascularization. METHODS From June 2012 to July 2013, 56 consecutive male patients with coronary artery disease were enrolled in the PCI group. Correspondingly, in the control group there were 56 consecutive male patients with chest pain but a normal coronary artery verified by angiography. The exercise treadmill test was performed 3 days before and 7 days after intervention in the PCI group, and 3 days before angiography in the control group. RESULTS The peak heart rate, metabolic equivalents, and the Duke score were notably lower in the PCI group before intervention compared with the control group (P<0.01). In contrast, preintervention ST depression in the PCI group was significantly higher than that in the control group (P<0.01). Preintervention HRR values from 1 to 6 min were much lower in the PCI group compared with the control group (P<0.01). HRR values from 1 to 6 min in the PCI group post intervention increased significantly compared with preintervention HRR values (P<0.01), especially at 3, 4, 5, and 6 min. HRR values at 1, 2, and 3 min increased sharply post intervention. CONCLUSION Successful revascularization through PCI could improve HRR in patients with major coronary artery involvement. Moreover, HRR measurement may be used as a noninvasive method for evaluating the effect of revascularization.
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Rabkin SW. The relationship between epicardial fat and indices of obesity and the metabolic syndrome: a systematic review and meta-analysis. Metab Syndr Relat Disord 2013; 12:31-42. [PMID: 24219127 DOI: 10.1089/met.2013.0107] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Epicardial fat (epicardial adipose tissue, EAT) has been implicated in the pathogenesis of coronary artery disease (CAD). The objective of this study was to examine the relationship between EAT and generalized obesity, central or visceral adipose tissue (VAT), and the components of the metabolic syndrome--systolic blood pressure (SBP), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and fasting blood glucose (FBG)--that are linked to CAD. A systematic review of the literature, following meta-analysis guidelines, was conducted until May, 2013, using the search strategy "Obesity" OR "abdominal obesity" OR "metabolic syndrome" OR "metabolic syndrome X" AND "epicardial fat". Thirty-eight studies fulfilled the criteria. There was a highly significant (P<0.00001) correlation between EAT and body mass index (BMI), waist circumference (WC), or VAT. The correlation between EAT and VAT was significantly (P<0.0001) greater than the correlation between EAT and WC, which in turn was significantly greater than the correlation between EAT and BMI. Overall, EAT was 7.5 ± 0.1 mm in thickness in the metabolic syndrome (n=427) compared to 4.0 ± 0.1 mm in controls (n=301). EAT correlated significantly (P<0.0001) with SBP, TGs, HDL, and FBG, but the strength of the association was less than one-half of the relationship of EAT to indices of obesity. The results of multivariate analysis were less consistent but show a relationship between EAT and metabolic syndrome independent of BMI. In summary, the very strong correlation between EAT and VAT suggests a relationship between these two adipose tissue depots. Measurement of EAT can be useful to indicate VAT. Whereas EAT correlates significantly with each of the components of the metabolic syndrome- SBP, TGs, HDL, or FBG-the magnitude of the relationship is considerably and significantly less than the relationship of EAT to BMI. These data show the strong relationship between EAT and BMI but especially with WC and VAT. They also demonstrate the smaller magnitude of the association of EAT with standard coronary risk factors, related to the metabolic syndrome, and suggest that the unique features of this adipose tissue warrant detailed investigation.
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Affiliation(s)
- Simon W Rabkin
- Department of Medicine (Cardiology), University of British Columbia , Vancouver, British Columbia, Canada
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18
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Pierdomenico SD, Pierdomenico AM, Cuccurullo F, Iacobellis G. Meta-analysis of the relation of echocardiographic epicardial adipose tissue thickness and the metabolic syndrome. Am J Cardiol 2013; 111:73-8. [PMID: 23040591 DOI: 10.1016/j.amjcard.2012.08.044] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 08/20/2012] [Accepted: 08/20/2012] [Indexed: 10/27/2022]
Abstract
Epicardial adipose tissue (EAT) is an emerging cardiometabolic risk factor, and its thickness can be measured using echocardiography. The relation of EAT to the metabolic syndrome (MS) is still unclear. A meta-analysis of published reports was performed to provide comprehensive insight on the association of EAT thickness as assessed by echocardiography and the MS. A systematic search was conducted for reports on echocardiographic EAT thickness in patients with and without the MS. Nine studies were identified. The pooled population consisted of 2,027 subjects, of whom 1,030 had the MS. EAT thickness was significantly higher in patients with the MS than in those without (standardized difference in means 1.15 mm, 95% confidence interval 0.78 to 1.53, p = 0.0001). Subgroup meta-analysis showed no difference between patients with and those without the MS by MS criteria used and echocardiographic cardiac cycle of measurement but did show a significant difference by ethnicity, with a greater difference in Caucasian subjects (standardized difference in means 1.75 mm, 95% confidence interval 1.43 to 2.07) than in other ethnic groups. In conclusion, echocardiographic EAT thickness is significantly higher in patients with the MS than in those without, but differences exist by ethnicity.
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Erdem A, Uenishi M, Matsumoto K, Küçükdurmaz Z, Kato R, Sahin S, Yazıcı M. Cardiac autonomic function in metabolic syndrome: a comparison of ethnic Turkish and Japanese patients. J Interv Card Electrophysiol 2012; 35:253-8. [PMID: 23080331 DOI: 10.1007/s10840-012-9741-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Accepted: 09/14/2012] [Indexed: 01/18/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS) prevalence shows some differences at various regions of the world in terms of race and ethnicity. The cardiac autonomic functions between Turkish and Japanese MetS patients with heart rate turbulence (HRT) and heart rate variability (HRV) were compared as the aim of this study. METHODS This study consists of 149 nondiabetic subjects with MetS. All patients were further classified into subgroups based on ethnicity (76 from Turkey, 73 from Japan). Twenty-four-hour ambulatory Holter ECG recording was applied to all subjects whose HRV and HRT (total onset (TO), total slope (TS)) parameters were analyzed. RESULTS The waist circumference was the only demographic parameter that was significantly different between the Turkish and Japanese patients with MetS (99.31 ± 6.12 vs 91.12 ± 6.89 for men and 91.48 ± 7.45 vs 86.26 ± 5.78 for woman; p < 0.001 and <0.001). There was a significant difference between Turkish and Japanese patients with MetS in terms of the HRT values. (TO Turkish, 0.77 ± 0.19 %; TO Japanese, 0.49 ± 1.03 %, p = 0.031; TS Turkish, 1.93 ± 1.26; TS Japanese, 2.44 ± 1.37, p = 0.041, respectively). As for HRV parameters, standard deviation of all NN intervals index was only different between Turkish and Japanese patients with MetS (90.79 ± 58.94, 128.18 ± 105.30; p = 0.034, respectively). CONCLUSION HRT and some HRV scores of ethnic Turkish MetS patients are worse than the scores of ethnic Japan MetS patients. We think that these differences are related to the central obesity.
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Affiliation(s)
- Alim Erdem
- Cardiology Department, Abant Izzet Baysal University, Bolu, Turkey.
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Çanga A, Kocaman SA, Çetin M, Erdogan T, Durakoglugil ME, Çiçek Y, Ugurlu Y, Satiroglu Ö. Increased Epicardial Adipose Tissue Thickness Is Correlated with Ascending Aortic Diameter. TOHOKU J EXP MED 2012; 226:183-90. [PMID: 22343433 DOI: 10.1620/tjem.226.183] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Aytun Çanga
- Department of Cardiology, Rize Education and Research Hospital
| | | | - Mustafa Çetin
- Department of Cardiology, Rize Education and Research Hospital
| | - Turan Erdogan
- Department of Cardiology, Rize University Medical Faculty
| | | | - Yüksel Çiçek
- Department of Cardiology, Rize University Medical Faculty
| | - Yavuz Ugurlu
- Department of Cardiology, Rize Education and Research Hospital
| | - Ömer Satiroglu
- Department of Cardiology, Rize University Medical Faculty
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Kilicaslan B, Ozdogan O, Aydin M, Dursun H, Susam I, Ertas F. Increased Epicardial Fat Thickness Is Associated with Cardiac Functional Changes in Healthy Women. TOHOKU J EXP MED 2012; 228:119-24. [DOI: 10.1620/tjem.228.119] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Baris Kilicaslan
- Department of Cardiology, Tepecik Research and Training Hospital
| | - Oner Ozdogan
- Department of Cardiology, Tepecik Research and Training Hospital
| | - Mehmet Aydin
- Department of Cardiology, Tepecik Research and Training Hospital
| | - Huseyin Dursun
- Department of Cardiology, Tepecik Research and Training Hospital
| | - Ibrahim Susam
- Department of Cardiology, Tepecik Research and Training Hospital
| | - Faruk Ertas
- Departmet of Cardiology, Dicle University Medical Faculty
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