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Mohamed WAS, Ishak KN, Baharum N, Zainudin NAZ, Lim HY, Noh MFM, Ahmad WAW, Zaman Huri H, Zuhdi ASM, Sukahri S, Govindaraju K, Abd Jamil AH. Ethnic disparities and its association between epicardial adipose tissue thickness and cardiometabolic parameters. Adipocyte 2024; 13:2314032. [PMID: 38373876 PMCID: PMC10877981 DOI: 10.1080/21623945.2024.2314032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/30/2024] [Indexed: 02/21/2024] Open
Abstract
Excessive deposit of epicardial adipose tissue (EAT) were recently shown to be positively correlated with cardiovascular disease (CVD). This study aims to investigate the thickness of EAT and its association with the components of metabolic syndrome among multi-ethnic Malaysians with and without acute coronary syndrome (ACS). A total of 213 patients were recruited, with the thickness of EAT were quantified non-invasively using standard two-dimensional echocardiography. EAT thickness among the Malaysian population was prompted by several demographic factors and medical comorbidities, particularly T2DM and dyslipidaemia. ACS patients have significantly thicker EAT compared to those without ACS (4.1 mm vs 3.7 mm, p = 0.035). Interestingly, among all the races, Chinese had the thickest EAT distribution (4.6 mm vs 3.8 mm), with age (p = 0.04 vs p < 0.001), and overall diastolic blood pressure (p = 0.028) was also found to be associated with EAT thickness. Further study is warranted to investigate its role as a cardiovascular risk marker among Malaysians with ACS.
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Affiliation(s)
- WAS Mohamed
- Nutrition, Metabolism and Cardiovascular Research Centre (NMCRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
- Department of Pharmaceutical Life Sciences, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur, Malaysia
| | - KN Ishak
- Nutrition, Metabolism and Cardiovascular Research Centre (NMCRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
| | - N Baharum
- Centre for Coordination of Clinical Research Network (CCRN), Institute for Clinical Research (ICR), Shah Alam, Malaysia
| | - NAZ Zainudin
- Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
| | - Han Yin Lim
- Nutrition, Metabolism and Cardiovascular Research Centre (NMCRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
| | - MFM Noh
- Nutrition, Metabolism and Cardiovascular Research Centre (NMCRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
| | - WAW Ahmad
- Cardiology Unit, Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - H Zaman Huri
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur, Malaysia
| | - ASM Zuhdi
- Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
| | - S Sukahri
- Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health (MOH), Shah Alam, Malaysia
| | - K Govindaraju
- Department of Pharmaceutical Life Sciences, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur, Malaysia
| | - AH Abd Jamil
- Department of Pharmaceutical Life Sciences, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur, Malaysia
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Meyer HJ, Dermendzhiev T, Kirsten H, Hetz M, Kleber C, Denecke T, Metze M, Werdehausen R, Hempel G, Struck MF. Epicardial adipose tissue defined by initial polytrauma CT of mechanically ventilated trauma patients: retrospective single-center cohort study to predict short-term outcomes. Emerg Radiol 2024:10.1007/s10140-024-02242-0. [PMID: 38872046 DOI: 10.1007/s10140-024-02242-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/13/2024] [Indexed: 06/15/2024]
Abstract
PURPOSE Epicardial adipose tissue (EAT) detected by computed tomography (CT) is associated with morbidity and mortality in patients with COVID-19 and other critical care patient cohorts, whereas their prognostic relevance in trauma patients remains unclear. The present study explored associations with four potential short-term outcomes in trauma patients. METHODS All consecutive trauma patients requiring emergency tracheal intubation and mechanical ventilation before initial whole-body CT imaging at a level-1 trauma center over a 12-year period (2008-2019) were reanalyzed for this study. EAT was measured semiquantitatively in initial CT and analyzed regarding associations with 24-hour and 30-day mortality using Cox proportional hazard models. In survivors, associations of EAT with intensive care unit length of stay (ICU LOS) and mechanical ventilation duration were analyzed using linear regression analyses. RESULTS Four hundred fifty-five patients (74.7% male) with a median age of 49 years, and a median injury severity score (ISS) of 26 points were analyzed. In univariable analysis, EAT index was significantly associated with 24-hour and 30-day mortality (p = 0.007, and p = 0.013, respectively). After adjustment for significant predictors age, body mass index, and ISS, no significant associations were confirmed (p = 0.622, and p = 0.903, respectively). In a subanalysis of 353 survivors, EAT index was significantly associated with ICU LOS and mechanical ventilation duration in univariable analyses (p = 0.031, and p = 0.014, respectively), but not in multivariable analyses (p = 0.81 and p = 0.46, respectively). CONCLUSION EAT index was associated with short-term outcomes in severely injured trauma patients, which not remained significant in multivariable analysis, suggesting that its prognostic capability is limited.
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Affiliation(s)
- Hans-Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Liebigstr.20, 04103, Leipzig, Germany.
| | - Tihomir Dermendzhiev
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Liebigstr.20, 04103, Leipzig, Germany
| | - Holger Kirsten
- Institute for Medical Informatics Statistics and Biometry, University of Leipzig, Härtelstr 16-18, 04107, Leipzig, Germany
| | - Michael Hetz
- Department of Orthopedics, Trauma and Plastic Surgery, University Hospital Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Christian Kleber
- Department of Orthopedics, Trauma and Plastic Surgery, University Hospital Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Timm Denecke
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Liebigstr.20, 04103, Leipzig, Germany
| | - Michael Metze
- Department of Cardiology, Medical Department IV, University Hospital Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Robert Werdehausen
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Liebigstr.20, 04103, Leipzig, Germany
| | - Gunther Hempel
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Liebigstr.20, 04103, Leipzig, Germany
| | - Manuel F Struck
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Liebigstr.20, 04103, Leipzig, Germany
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Doğru Ş, Akkuş F, Metin ÜS, Acar A. Fetal Epicardial Fat Thickness in Obese Pregnant Women: Its Effect on Fetal Cardiac Function and Neonatal Outcomes. Z Geburtshilfe Neonatol 2024. [PMID: 38503305 DOI: 10.1055/a-2267-5478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVE This study aimed to evaluate fetal epicardial fat thickness (EFT) together with fetal myocardial performance index (MPI) and its effects on neonatal outcomes in obese pregnant women. MATERIALS AND METHODS A total of 102 pregnant women, 51 obese and 51 of normal weight, were included in this prospective study. Fetal EFT, and MPI measurements were performed for all patients. RESULTS Fetal EFT and Mod-MPI showed a statistically significant difference between obese pregnant women and the control group (p=0.0001, p=0.001). The optimal fetal EFT predictive cut-off value for the 5th-minute APGAR score below 7 was 1.22 mm, with a sensitivity of 86.96% and a specificity of 54.43% (p=0.001). CONCLUSION Fetal EFT and mod-MPI were higher in obese pregnant women. It is encouraging that fetal EFT predicts low APGAR, but more important information can be obtained if postnatal follow-up of these cardiac changes caused by obesity can be performed.
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Affiliation(s)
- Şükran Doğru
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Meram, Turkey
| | - Fatih Akkuş
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Meram, Turkey
| | - Ülfet Sena Metin
- Obstetrics and Gynecology, Necmettin Erbakan Universitesi Meram Tip Fakultesi, Konya, Turkey
| | - Ali Acar
- Obstetrics and Gynecology, Necmettin Erbakan Universitesi Meram Tip Fakultesi, Konya, Turkey
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Weidlich M, Hamm B, Schaafs LA, Elgeti T. Epicardial fat volume and its association with cardiac arrhythmias in CT coronary angiography. Pol J Radiol 2024; 89:e122-e127. [PMID: 38510546 PMCID: PMC10953510 DOI: 10.5114/pjr.2024.135797] [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: 11/22/2023] [Accepted: 02/01/2024] [Indexed: 03/22/2024] Open
Abstract
Purpose This retrospective study aimed to investigate the epicardial fat volume in cardiac computed tomography (CT), its relationship with cardiac arrhythmias, and its correlation with the coronary artery disease reporting and data system (CAD-RADS) score. Material and methods Ninety-six patients who underwent CT coronary angiography (CTCA) were included in this study. Patient data, including demographic information, clinical history, and imaging data were collected retrospectively. Epicardial fat volume was quantified using a standardised algorithm, the CAD-RADS scoring system was applied to assess the extent of coronary artery disease (CAD). Descriptive statistics, correlation analyses, and receiver operating characteristics methods were used. Results The study found a significant correlation between epicardial fat volume and CAD-RADS score (r2 = 0.31; p < 0.001), indicating the known influence of epicardial fat on CAD risk. Moreover, patients with higher epicardial fat volumes were more likely to experience cardiac tachyarrhythmia (p < 0.001). Receiver operating characteristic analysis established a threshold value of 123 cm3 for epicardial fat volume to predict tachyarrhythmia with 80% sensitivity (AUC = 0.69). Conclusions In this study a volume of at least 123 cm3 epicardial fat in native coronary calcium scans is associated with cardiac tachyarrhythmia. In these patients, careful selection of suitable imaging protocols is advised.
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Affiliation(s)
- Matthias Weidlich
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Lars-Arne Schaafs
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Elgeti
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Chan J, Thakur U, Tan S, Muthalaly RG, Thakkar H, Goel V, Cheen YC, Dey D, Brown AJ, Wong DTL, Nerlekar N. Inter-software and inter-scan variability in measurement of epicardial adipose tissue: a three-way comparison of a research-specific, a freeware and a coronary application software platform. Eur Radiol 2023; 33:8445-8453. [PMID: 37369831 PMCID: PMC10667389 DOI: 10.1007/s00330-023-09878-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/26/2023] [Accepted: 04/27/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVES Epicardial adipose tissue (EAT) is a proposed marker of cardiovascular risk; however, clinical application may be limited by variability in post-processing software platforms. We assessed inter-vendor agreement of EAT volume (EATv) and attenuation on both contrast-enhanced (CE) and non-contrast CT (NCT) using a standard coronary CT reporting software (Vitrea), an EAT research-specific software (QFAT) and a freeware imaging software (OsiriX). METHODS Seventy-six consecutive patients undergoing simultaneous CE and NCT had complete volumetric EAT measurement. Between-software, within-software NCT vs. CE, and inter- and intra-observer agreement were evaluated with analysis by ANOVA (with post hoc adjustment), Bland-Altman with 95% levels of agreement (LoA) and intraclass correlation coefficient (ICC). RESULTS Mean EATv (freeware 53 ± 31 mL vs. research 93 ± 43 mL vs. coronary 157 ± 64 mL) and attenuation (freeware - 72 ± 25 HU vs. research - 75 ± 3 HU vs. coronary - 61 ± 10 HU) were significantly different between all vendors (ANOVA p < 0.001). EATv was consistently higher in NCT vs. CE for all software packages, with most reproducibility found in research software (bias 26 mL, 95% LoA: 2 to 56 mL), compared to freeware (bias 11 mL 95% LoA: - 46 mL to 69 mL) and coronary software (bias 10 mL 95% LoA: - 127 to 147 mL). Research software had more comparable NCT vs. CE attenuation (- 75 vs. - 72 HU) compared to freeware (- 72 vs. - 57 HU) and coronary (- 61 vs. - 39 HU). Excellent inter-observer agreement was seen with research (ICC 0.98) compared to freeware (ICC 0.73) and coronary software (ICC 0.75) with narrow LoA on Bland-Altman analysis. CONCLUSION There are significant inter-vendor differences in EAT assessment. Our study suggests that research-specific software has better agreement and reproducibility compared to freeware or coronary software platforms. KEY POINTS • There are significant differences between EAT volume and attenuation values between software platforms, regardless of scan type. • Non-contrast scans routinely have higher mean EAT volume and attenuation; however, this finding is only consistently seen with research-specific software. • Of the three analyzed packages, research-specific software demonstrates the highest reproducibility, agreement, and reliability for both inter-scan and inter-observer agreement.
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Affiliation(s)
- Jasmine Chan
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, VIC, Australia
| | - Udit Thakur
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, VIC, Australia
| | - Sean Tan
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, VIC, Australia
| | - Rahul G Muthalaly
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, VIC, Australia
| | - Harsh Thakkar
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, VIC, Australia
| | - Vinay Goel
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, VIC, Australia
| | - Yeong-Chee Cheen
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, VIC, Australia
| | - Damini Dey
- Cedars Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA, USA
| | - Adam J Brown
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, VIC, Australia
| | - Dennis T L Wong
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, VIC, Australia
| | - Nitesh Nerlekar
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, VIC, Australia.
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
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El Shahawy ES, Hassan AA, El Shahawy MS. Epicardial Fat Volume as a Good Predictor for Multivessel Coronary Artery Disease. High Blood Press Cardiovasc Prev 2023; 30:427-434. [PMID: 37726552 DOI: 10.1007/s40292-023-00590-5] [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: 03/27/2023] [Accepted: 06/16/2023] [Indexed: 09/21/2023] Open
Abstract
INTRODUCTION Epicardial adipose tissue may have an important role in the pathogenesis of coronary artery disease (CAD). AIM We aimed to study the association between epicardial fat volume (EFV) and presence of obstructive as well as multivessel CAD. METHODS A total of 87 adult subjects with suspected CAD who underwent both quantified by multidetector computerized tomography (MDCT) and Invasive Coronary Angiography (ICA) were enrolled in this observational study. EVF was measured by MDCT by calculating the sum of cross- sectional areas of fat multiplied by slice thickness. EFV measurement and its association with the presence of obstructive CAD (defined as coronary artery stenosis > 70%) was evaluated. RESULTS Overall, 89.6% patients had obstructive CAD with higher EFV as compared to 10.3% patients with non-obstructive CAD (57 ± 20.14 cm3 vs. 44 ± 7.4 cm3; P < 0.001). Furthermore, EFV was significantly increased in group II as compared with group I (74 ± 24.3 ml vs. 53 ± 16.2 ml; P < 0.003). On the hand, the coronary calcium score (CAC) was insignificantly increased in group II as compared with group I (486.1 vs. 211.2; P = 0.10). Multivariate analysis revealed that, EFV might be an independent risk factor for not only the presence of obstructive CAD (odds ratio [OR], 1.062; 95% CI 1.018- 1.108; P < 0.005) but also in predicting multivessel disease affection. CONCLUSIONS Our results demonstrated that, EFV was significantly increased not only with obstructive CAD, independent of other traditional risk factors and CAC score, but also it can be considered a good predictor of multivessel disease occurrence.
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Affiliation(s)
- Eman S El Shahawy
- Department of Cardiology, Faculty of Medicine (for girls), Al-Azhar University, Cairo, Nasr city, 11651, Egypt.
| | - Asmaa A Hassan
- Department of Cardiology, Faculty of Medicine (for girls), Al-Azhar University, Cairo, Nasr city, 11651, Egypt
| | - Mohamed S El Shahawy
- Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Gameil MA, Elsherbiny HA, Youssry IE, Gawad SA, Arafat AAELH. Potential impact of epicardial fat thickness, pentraxin-3, and high-sensitive C-reactive protein on the risk of non-proliferative diabetic retinopathy. J Diabetes Metab Disord 2023; 22:735-742. [PMID: 37255764 PMCID: PMC10225378 DOI: 10.1007/s40200-023-01195-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/02/2023] [Indexed: 02/24/2023]
Abstract
Purpose We tried to clarify the potential association between systemic inflammatory markers like high-sensitive C-reactive protein (Hs-CRP), pentraxin-3 (PTX3), and epicardial fat thickness (EFT) with the non-proliferative diabetic retinopathy (NPDR) in patients with type 2 diabetes mellitus (T2D). Previous studies dealt with diabetic retinopathy as a whole entity rather than early stages of diabetic retinopathy. Early detection of various determinants of NPDR is prioritized in clinical practice. Methods A case-control study was conducted at Mansoura University Hospital, included 207 Egyptian subjects divided into 3 groups; 69 diabetic patients without retinopathy, 69 diabetic patients with NPDR, and 69 healthy control subjects. Participants were subjected to clinical history taking, physical examination, and laboratory assessment of Hs-CRP and plasma PTX3. Transthoracic echocardiography was applied to estimate EFT. Results Hs-CRP, PTX3, and EFT were significantly higher in patients with T2D without retinopathy than control cohort (p = 0.033, p < 0.00 and p < 0.00, respectively). Moreover, patients with NPDR showed significantly higher values of Hs-CRP, PTX3, and EFT than diabetic comparators without retinopathy (p = 0.002, p = 0.012, and p < 0.001, respectively). Although, NPDR was positively correlated with Hs-CRP, PTX3, and EFT (p < 0.001), Hs-CRP was not an independent determinant of NPDR meanwhile, EFT (OR = 1.094, 95%CI: 1.036-1.154, P = 0.001) and PTX3 (OR = 16.145, 95%CI: 1.676-155.551, P = 0.016) were. Conclusion Plasma pentraxin-3 and epicardial fat thickness showed more significant association with NPDR than high-sensitive C-reactive protein in patients with type 2 diabetes mellitus.
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Affiliation(s)
- Mohammed Ali Gameil
- Endocrinology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Egypt
| | - Hanan Abdelhay Elsherbiny
- Endocrinology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Egypt
| | - Ibrahim Elsayed Youssry
- Cardiovascular Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Egypt
| | - Sara Abdel Gawad
- Ophthalmology Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Egypt
| | - Ahmed Abd EL-Hakim Arafat
- Endocrinology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Egypt
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Nafakhi H, Elwali HQ, Al-Sharea KMK, Al-Mosawi AA. Relationship of cardiovascular risk factors, pericardial fat, and carotid thickness with coronary plaque type in patients with diabetes mellitus. J Diabetes Metab Disord 2023; 22:713-719. [PMID: 37255796 PMCID: PMC10225442 DOI: 10.1007/s40200-023-01190-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 06/01/2023]
Abstract
Background There is paucity of data on the potential predictors of coronary plaque types among patients with diabetes mellitus(DM). Aims To assess the association of cardiovascular risk factors, pericardial fat volume (PFV) assessed by multi-detector CT(MDCT)angiography, and internal carotid intima media thickness with coronary atherosclerotic plaque types in patients with type 2 DM. Patients and methods Patients with suspected coronary artery disease who underwent 64-slice MDCT angiography were enrolled in this retrospective study. Results A total of 784 patients were enrolled in this study, 198 of whom had DM and 586 of whom did not. The prevalence of calcified and mixed plaques was significantly higher in the DM group than without DM group, while no significant difference was found in the distribution of non-calcified plaque between groups. There was significant association between smoking [OR(CI) = 4(2-10),P = 0.001] and increased age[OR(CI) = 1.1(1-1.3),P = 0.023] and calcified plaque presence. Regarding mixed and non-calcified plaque, increased PFV[OR(CI) = 1.1(1-1.3),P = 0.001] and positive family history[OR(CI) = 4(2-12),P = 0.049] showed a significant association with coronary mixed plaque presence while no significant association was observed between cardiovascular risk factors, PFV, and internal carotid intima media thickness and non-calcified plaque presence in patients with DM. Conclusion Increased PFV showed significant and independent association with mixed coronary plaques development, which suggests that PFV may be used as an imaging marker for early detection of increased risk for future coronary events in patients with DM.
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Affiliation(s)
- Hussein Nafakhi
- Internal medicine department, Medicine College, University of Kufa, P.O. 21, Kufa, Najaf, Iraq
| | | | - Kareem M Khalaf Al-Sharea
- Diabetes and endocrine center, Al-Sader teaching medical city, Najaf health directorate, Najaf, Iraq
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Thapa S, Selvaraj BS, Davis PN, Smith B, Givan AH, Perez-Rivera JA, Woodard P, Klingensmith JD, Fernandez-del-Valle M. Vigorous-intensity exercise as a modulator of cardiac adipose tissue in women with obesity: a cross-sectional and randomized pilot study. Front Endocrinol (Lausanne) 2023; 14:1104441. [PMID: 37223011 PMCID: PMC10200876 DOI: 10.3389/fendo.2023.1104441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/28/2023] [Indexed: 05/25/2023] Open
Abstract
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.
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Affiliation(s)
- Sumsen Thapa
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, United States
| | - Bharath S. Selvaraj
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, United States
- Iowa Digestive Disease Center, Heartland Medical Research, Inc., Clive, IA, United States
| | - Paige N. Davis
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, United States
- Department of Cardiopulmonary Rehabilitation, Charleston Area Medical Center (CAMC) Memorial Hospital at West Virginia, Charleston, WV, United States
| | - Bryan Smith
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, United States
| | - Amy H. Givan
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, United States
- Division of Rehabilitation Sciences, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Jose A. Perez-Rivera
- Department of Cardiology, University Hospital of Burgos, Burgos, Spain
- Facultad de Ciencias de la Salud, Universidad Isabel I, Isabel, Spain
| | - Pamela K. Woodard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Jon D. Klingensmith
- Department of Electrical and Computer Engineering, Southern Illinois University Edwardsville, Edwardsville, IL, United States
| | - Maria Fernandez-del-Valle
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, United States
- Department of Functional Biology, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
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Cielonko LA, Sabati AA, Chambers MA, Newbern D, Swing E, Chakravarthy V, Mullen J, Schmidt J, Lutz N, Shaibi GQ, Olson M. Impact of overweight and obesity on epicardial adipose tissue in children with type 1 diabetes. J Pediatr Endocrinol Metab 2023; 36:371-377. [PMID: 36829271 DOI: 10.1515/jpem-2022-0412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 02/06/2023] [Indexed: 02/26/2023]
Abstract
OBJECTIVES Epicardial adipose tissue (EAT) thickness, a novel marker of cardiovascular disease (CVD), is increased in children with a healthy weight and type 1 diabetes (T1D). The prevalence of obesity has increased in children with T1D and may confer additional CVD risk. The purpose of this study was to examine EAT thickness in youth with and without T1D in the setting of overweight/obesity. METHODS Youth with overweight/obesity and T1D (n=38) or without T1D (n=34) between the ages of 6-18 years were included in this study. Echocardiogram using spectral and color flow Doppler was used to measure EAT and cardiac function. Waist circumference, blood pressure, and HbA1c, were used to calculate estimated glucose disposal rate (eGDR) to estimate insulin resistance in children with T1D. RESULTS EAT thickness was not significantly different in youth with T1D compared to controls (2.10 ± 0.67 mm vs. 1.90 ± 0.59 mm, p=0.19). When groups were combined, EAT significantly correlated with age (r=0.449, p≤0.001), BMI (r=0.538, p≤0.001), waist circumference (r=0.552, p≤0.001), systolic BP (r=0.247, p=0.036), myocardial performance index (r=-0.287, p=0.015), ejection fraction (r=-0.442, p≤0.001), and cardiac output index (r=-0.306, p=0.009). In the group with T1D, diastolic BP (r=0.39, p=0.02) and eGDR (r=-0.48, p=0.002) correlated with EAT. CONCLUSIONS EAT was associated with measures of adiposity and insulin resistance but does not differ by diabetes status among youth with overweight/obesity. These findings suggest that adiposity rather than glycemia is the main driver of EAT thickness among youth with T1D.
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Affiliation(s)
- Luke A Cielonko
- Division of Endocrinology, Cook Children's Medical Center, Fort Worth, TX, USA
- Division of Pediatric Endocrinology & Diabetes, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Arash A Sabati
- Division of Pediatric Cardiology, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Melissa A Chambers
- Division of Pediatric Endocrinology & Diabetes, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Dorothee Newbern
- Division of Pediatric Endocrinology & Diabetes, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Edward Swing
- Division of Graduate Medical Education, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Varshini Chakravarthy
- Division of Pediatric Endocrinology & Diabetes, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - John Mullen
- Division of Pediatric Cardiology, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Jaclyn Schmidt
- Division of Pediatric Cardiology, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Natalie Lutz
- Division of Pediatric Endocrinology & Diabetes, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Gabriel Q Shaibi
- Division of Pediatric Endocrinology & Diabetes, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Micah Olson
- Division of Pediatric Endocrinology & Diabetes, Phoenix Children's Hospital, Phoenix, AZ, USA
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11
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Henry JA, Abdesselam I, Deal O, Lewis AJ, Rayner J, Bernard M, Dutour A, Gaborit B, Kober F, Soghomonian A, Sgromo B, Byrne J, Bege T, Neubauer S, Borlaug BA, Rider OJ. Changes in epicardial and visceral adipose tissue depots following bariatric surgery and their effect on cardiac geometry. Front Endocrinol (Lausanne) 2023; 14:1092777. [PMID: 36761185 PMCID: PMC9905224 DOI: 10.3389/fendo.2023.1092777] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023] Open
Abstract
Introduction Obesity affects cardiac geometry, causing both eccentric (due to increased cardiac output) and concentric (due to insulin resistance) remodelling. Following bariatric surgery, reversal of both processes should occur. Furthermore, epicardial adipose tissue loss following bariatric surgery may reduce pericardial restraint, allowing further chamber expansion. We investigated these changes in a serial imaging study of adipose depots and cardiac geometry following bariatric surgery. Methods 62 patients underwent cardiac magnetic resonance (CMR) before and after bariatric surgery, including 36 with short-term (median 212 days), 37 medium-term (median 428 days) and 32 long-term (median 1030 days) follow-up. CMR was used to assess cardiac geometry (left atrial volume (LAV) and left ventricular end-diastolic volume (LVEDV)), LV mass (LVM) and LV eccentricity index (LVei - a marker of pericardial restraint). Abdominal visceral (VAT) and epicardial (EAT) adipose tissue were also measured. Results Patients on average had lost 21kg (38.9% excess weight loss, EWL) at 212 days and 36kg (64.7% EWL) at 1030 days following bariatric surgery. Most VAT and EAT loss (43% and 14%, p<0.0001) occurred within the first 212 days, with non-significant reductions thereafter. In the short-term LVM (7.4%), LVEDV (8.6%) and LAV (13%) all decreased (all p<0.0001), with change in cardiac output correlated with LVEDV (r=0.35,p=0.03) and LAV change (r=0.37,p=0.03). Whereas LVM continued to decrease with time (12% decrease relative to baseline at 1030 days, p<0.0001), both LAV and LVEDV had returned to baseline by 1030 days. LV mass:volume ratio (a marker of concentric hypertrophy) reached its nadir at the longest timepoint (p<0.001). At baseline, LVei correlated with baseline EAT (r=0.37,p=0.0040), and decreased significantly from 1.09 at baseline to a low of 1.04 at 428 days (p<0.0001). Furthermore, change in EAT following bariatric surgery correlated with change in LVei (r=0.43,p=0.0007). Conclusions Cardiac volumes show a biphasic response to weight loss, initially becoming smaller and then returning to pre-operative sizes by 1030 days. We propose this is due to an initial reversal of eccentric remodelling followed by reversal of concentric remodelling. Furthermore, we provide evidence for a role of EAT contributing to pericardial restraint, with EAT loss improving markers of pericardial restraint.
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Affiliation(s)
- J. A. Henry
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - I. Abdesselam
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - O. Deal
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - A. J. Lewis
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - J. Rayner
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - M. Bernard
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
| | - A. Dutour
- Aix-Marseille Univ, APHM, INSERM, INRAE, C2VN, Department of Endocrinology, Metabolic Diseases and Nutrition, Marseille, France
| | - B. Gaborit
- Aix-Marseille Univ, APHM, INSERM, INRAE, C2VN, Department of Endocrinology, Metabolic Diseases and Nutrition, Marseille, France
| | - F. Kober
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
| | - A. Soghomonian
- Aix-Marseille Univ, APHM, INSERM, INRAE, C2VN, Department of Endocrinology, Metabolic Diseases and Nutrition, Marseille, France
| | - B. Sgromo
- Department of Upper GI Surgery, Churchill Hospital, Oxford, United Kingdom
| | - J. Byrne
- Division of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - T. Bege
- Aix-Marseille Univ, APHM, Department of Digestive Surgery, Hôpital Nord, Marseille, France
| | - S. Neubauer
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - B. A. Borlaug
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - O. J. Rider
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
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12
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Cao Y, Dong Z, Yang D, Wang X. LSD1 in beige adipocytes protects cardiomyocytes against oxygen and glucose deprivation. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2023; 26:30-36. [PMID: 36594068 PMCID: PMC9790061 DOI: 10.22038/ijbms.2022.65006.14313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 11/05/2022] [Indexed: 01/04/2023]
Abstract
Objectives Epicardial adipose tissue (EpAT) is known for its role in supporting the cardiomyocytes. Lysine-specific demethylase 1 (LSD1), a typical lysine demethylase, is an essential regulator for the maintenance of beige adipocytes. However, the effect of LSD1 in the adipogenic differentiation of beige adipocytes in EpAT, and its function on oxygen and glucose deprivation (OGD)-injured cardiomyocytes remain unclear. Materials and Methods Heart tissues from young mice and elder mice were collected for immunohistochemical staining. LSD1 in 3T3-L1 cells was knocked down by LSD1-shRNA lentivirus infection. The qRT-PCR, western blotting, and Oil Red O staining were employed to detect the adipogenic differentiation of 3T3-L1 cells and formation of beige adipocytes. The cardiomyocytes co-cultured with beige adipocytes were used for OGD treatment. Cell apoptosis was analyzed by flow cytometry. The lactate dehydrogenase (LDH) and superoxide dismutase (SOD) activity were analyzed using commercially available kits. Results The decrease of LSD1 was related to the age-dependent loss of beige adipocytes in mice EpAT. LSD1 knockdown inhibited the adipogenic differentiation of 3T3-L1 cells and formation of beige adipocytes. The down-regulation of LSD1 in 3T3-L1 cells decreased the protective effect of mature adipocytes on OGD-injured cardiomyocytes. Conclusion The decreased expression of LSD1 in mice EpAT was associated with age-dependent ablation of beige adipocytes. The protective effect of beige adipocytes on OGD-injured cardiomyocytes is reduced by knockdown of LSD1 in adipocytes. The present study provided exciting insights into establishing novel therapies against age-dependent cardiac diseases.
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Affiliation(s)
- Yiqiu Cao
- Department of Cardiac Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, People’s Republic of China ,The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, People’s Republic of China,These authors contributed eqully to this work
| | - Zhu Dong
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, People’s Republic of China,Department of Cardiovascular Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, People’s Republic of China,These authors contributed eqully to this work
| | - Dongpeng Yang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, People’s Republic of China,Department of Cardiovascular Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, People’s Republic of China,Department of Cardiovascular Surgery, Guangzhou Red Cross Hospital, Jinan University, 510235, People’s Republic of China
| | - Xiaowu Wang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, People’s Republic of China,Department of Cardiovascular Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, People’s Republic of China,Corresponding author: Xiaowu Wang. Department of Cardiovascular Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, People’s Republic of China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, People’s Republic of China. Tel/Fax: +86-02062782788;
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13
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Yaribeygi H, Maleki M, Nasimi F, Jamialahmadi T, Stanford FC, Sahebkar A. Benefits of GLP-1 Mimetics on Epicardial Adiposity. Curr Med Chem 2023; 30:4256-4265. [PMID: 36642880 PMCID: PMC10293101 DOI: 10.2174/0929867330666230113110431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 01/17/2023]
Abstract
The epicardial adipose tissue, which is referred to as fats surrounding the myocardium, is an active organ able to induce cardiovascular problems in pathophysiologic conditions through several pathways, such as inflammation, fibrosis, fat infiltration, and electrophysiologic problems. So, control of its volume and thickness, especially in patients with diabetes, is highly important. Incretin-based pharmacologic agents are newly developed antidiabetics that could provide further cardiovascular benefits through control and modulating epicardial adiposity. They can reduce cardiovascular risks by rapidly reducing epicardial adipose tissues, improving cardiac efficiency. We are at the first steps of a long way, but current evidence demonstrates the sum of possible mechanisms. In this study, we evaluate epicardial adiposity in physiologic and pathologic states and the impact of incretin-based drugs.
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Affiliation(s)
- Habib Yaribeygi
- Research Center of Physiology, Semnan University of Medical Sciences, Semnan, Iran
| | - Mina Maleki
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Nasimi
- Research Center of Physiology, Semnan University of Medical Sciences, Semnan, Iran
| | - Tannaz Jamialahmadi
- Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatima C. Stanford
- Massachusetts General Hospital, MGH Weight Center, Department of Medicine-Division of Endocrinology-Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Harvard Medical School, Boston, MA, USA
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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14
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Xu Y, Hrybouski S, Paterson DI, Li Z, Lan Y, Luo L, Shen X, Xu L. Comparison of epicardial adipose tissue volume quantification between ECG-gated cardiac and non-ECG-gated chest computed tomography scans. BMC Cardiovasc Disord 2022; 22:545. [PMID: 36513994 PMCID: PMC9746017 DOI: 10.1186/s12872-022-02958-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 10/04/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND This study investigated accuracy and consistency of epicardial adipose tissue (EAT) quantification in non-ECG-gated chest computed tomography (CT) scans. METHODS EAT volume was semi-automatically quantified using a standard Hounsfield unit threshold (- 190, - 30) in three independent cohorts: (1) Cohort 1 (N = 49): paired 120 kVp ECG-gated cardiac non-contrast CT (NCCT) and 120 kVp non-ECG-gated chest NCCT; (2) Cohort 2 (N = 34): paired 120 kVp cardiac NCCT and 100 kVp non-ECG-gated chest NCCT; (3) Cohort 3 (N = 32): paired non-ECG-gated chest NCCT and chest contrast-enhanced CT (CECT) datasets (including arterial phase and venous phase). Images were reconstructed with the slice thicknesses of 1.25 mm and 5 mm in the chest CT datasets, and 3 mm in the cardiac NCCT datasets. RESULTS In Cohort 1, the chest NCCT-1.25 mm EAT volume was similar to the cardiac NCCT EAT volume, while chest NCCT-5 mm underestimated the EAT volume by 7.5%. In Cohort 2, 100 kVp chest NCCT-1.25 mm were 13.2% larger than 120 kVp cardiac NCCT EAT volumes. In Cohort 3, the chest arterial CECT and venous CECT dataset underestimated EAT volumes by ~ 28% and ~ 18%, relative to chest NCCT datasets. All chest CT-derived EAT volumes were similarly associated with significant coronary atherosclerosis with cardiac CT counterparts. CONCLUSION The 120 kVp non-ECG-gated chest NCCT-1.25 mm images produced EAT volumes comparable to cardiac NCCT. Chest CT EAT volumes derived from consistent imaging settings are excellent alternatives to the cardiac NCCT to investigate their association with coronary artery disease.
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Affiliation(s)
- Yuancheng Xu
- Department of Urology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Stanislau Hrybouski
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
| | - D. Ian Paterson
- Department of Cardiology, Mackenzie Health Science Centre, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Zhiyang Li
- Department of General Surgery, the Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Yulong Lan
- Department of Cardiology, the Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Lin Luo
- Department of Radiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Xinping Shen
- Department of Radiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Lingyu Xu
- Department of Cardiology, Mackenzie Health Science Centre, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- University of Alberta, 2C2, Mackenzie Health Science Centre, 8440 - 112 St, Edmonton, Alberta, T6G 2B7, Canada
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15
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Role of obesity and blood pressure in epicardial adipose tissue thickness in children. Pediatr Res 2022; 92:1681-1688. [PMID: 35322187 DOI: 10.1038/s41390-022-02022-x] [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] [Received: 10/01/2021] [Revised: 03/02/2022] [Accepted: 03/06/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Elevated body mass index (BMI) has been associated with cardiac changes, such as higher epicardial adipose tissue (EAT) thickness. This fat has been identified as a predictive factor of cardiovascular diseases during adulthood. However, few studies have tested the association of multiple cardiovascular risk factors (high weight or blood pressure) with EAT in adolescents and children. Therefore, the main objective of this current research was to determine the impact of BMI, overweight, obesity, and blood pressure on EAT thickness in children. METHODS A descriptive cross-sectional study focused on elementary and high school students aged 6-16 years was carried out by utilizing diverse measurements and instruments, such as echocardiography. RESULTS EAT thickness (N = 228) was linked to sex (more predominant in boys 2.3 ± 0.6; p = 0.044), obesity (2.3 ± 0.6; p < 0.001), and hypertension (2.6 ± 0.6; p = 0.036). The logistic regression indicated that age, sex, and BMI seemed to be more relevant factors in EAT thickness in children (adjusted R square = 0.22; p < 0.001). CONCLUSIONS This paper examined the associations of sex, age, and cardiovascular risk factors (arthrometric measures and blood pressure) with EAT thickness, indicating that it is necessary to assess whether the findings are associated with future events. IMPACT Excessive weight gain and blood pressure in the early stages of life have been associated with adipose tissue. This increase in weight and blood pressure has been attributed to alterations in the epicardial adipose tissue linked to anthropometric markers in adults, but no related study has been implemented in Spanish children. This study revealed how higher epicardial adipose tissue is linked to body mass index, other anthropometric parameters, and blood pressure in Spanish children. These measurements are related to high epicardial adipose tissue thickness, which in early stages does not imply pathology but increases the risk of developing cardiovascular diseases.
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16
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Podzolkov VI, Bragina AE, Osadchiy KK, Rodionova YN, Djafarova ZB, Khalenyan MH, Dishkaya SO. [Ectopic obesity in patients without manifested cardiovascular disease: regulations, frequency and clinical characteristics]. TERAPEVT ARKH 2022; 94:1072-1077. [PMID: 36286758 DOI: 10.26442/00403660.2022.09.201847] [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: 10/22/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
AIM To determine the frequency, distribution and characteristics of ectopic obesity in patients without manifested cardiovascular disease. MATERIALS AND METHODS We examined 320 patients without manifested cardiovascular disease (average age 63.813.9 years), 38 of them without cardiovascular risk factors (healthy referent group). Anthropometric indicators were measured, body mass index (BMI) was calculated. Degree, type of obesity, lipid profile were evaluated. All patients underwent multi-detector chest computed tomography in spiral mode on Toshiba Aquilion Prime scanner using standardized protocol. Perivascular adipose tissue (PVAT) and pericardial adipose tissue (PAT) were detected using specialized semi-automatic software Tissue Composition Module QCTPro (Mindways Software, Inc., USA) after scanner calibration with special phantom. PAT and PVAT exceeding the 90th percentile in the healthy referent group were considered as ectopic obesity. Statistical analysis was performed using Statistica 10.0 software (StatSoft Inc., USA). RESULTS PAT volume 3.2 cm3 and PVAT volume 0.4 cm3 were criteria for high pericardial and high perivascular fat; 81 (25.2%) patients had ectopic obesity, 85 (26.5%) patients abdominal obesity; 146 (42.9%) people had high pericardial fat, 134 (39.4%) high perivascular fat. The frequency of ectopic obesity in patients with arterial hypertension (AH) was statistically significantly higher compared to persons without AH. Significantly more often ectopic forms of obesity were detected in patients with overweight and obesity. The high pericardial fat and high perivascular fat were found in patients with overweight and normal body weight. When comparing the clinical characteristics of patients with abdominal and ectopic obesity, metabolic parameters, as well as the incidence of hypertension and dyslipidemia, did not differ significantly. CONCLUSION Ectopic obesity can develop outside of global obesity. In addition, this type of obesity is accompanied by metabolic disorders and AH, regardless of the abdominal distribution of adipose tissue.
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Affiliation(s)
- V I Podzolkov
- Sechenov First Moscow State Medical University (Sechenov University)
| | - A E Bragina
- Sechenov First Moscow State Medical University (Sechenov University)
| | - K K Osadchiy
- Sechenov First Moscow State Medical University (Sechenov University)
| | - Y N Rodionova
- Sechenov First Moscow State Medical University (Sechenov University)
| | - Z B Djafarova
- Sechenov First Moscow State Medical University (Sechenov University)
| | - M H Khalenyan
- Sechenov First Moscow State Medical University (Sechenov University)
| | - S O Dishkaya
- Sechenov First Moscow State Medical University (Sechenov University)
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Kulasekara M, Dinh VQ, Fernandez-del-Valle M, Klingensmith JD. Comparison of two-dimensional and three-dimensional U-Net architectures for segmentation of adipose tissue in cardiac magnetic resonance images. Med Biol Eng Comput 2022; 60:2291-2306. [PMID: 35726000 DOI: 10.1007/s11517-022-02612-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/07/2022] [Indexed: 10/18/2022]
Abstract
The process of identifying cardiac adipose tissue (CAT) from volumetric magnetic resonance imaging of the heart is tedious, time-consuming, and often dependent on observer interpretation. Many 2-dimensional (2D) convolutional neural networks (CNNs) have been implemented to automate the cardiac segmentation process, but none have attempted to identify CAT. Furthermore, the results from automatic segmentation of other cardiac structures leave room for improvement. This study investigated the viability of a 3-dimensional (3D) CNN in comparison to a similar 2D CNN. Both models used a U-Net architecture to simultaneously classify CAT, left myocardium, left ventricle, and right myocardium. The multi-phase model trained with multiple observers' segmentations reached a whole-volume Dice similarity coefficient (DSC) of 0.925 across all classes and 0.640 for CAT specifically; the corresponding 2D model's DSC across all classes was 0.902 and 0.590 for CAT specifically. This 3D model also achieved a higher level of CAT-specific DSC agreement with a group of observers with a Williams Index score of 0.973 in comparison to the 2D model's score of 0.822.
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18
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Epicardial Adipose Tissue: A Novel Potential Imaging Marker of Comorbidities Caused by Chronic Inflammation. Nutrients 2022; 14:nu14142926. [PMID: 35889883 PMCID: PMC9316118 DOI: 10.3390/nu14142926] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/09/2022] [Indexed: 12/11/2022] Open
Abstract
The observation of correlations between obesity and chronic metabolic and cardiovascular diseases has led to the emergence of strong interests in “adipocyte biology”, in particular in relation to a specific visceral adipose tissue that is the epicardial adipose tissue (EAT) and its pro-inflammatory role. In recent years, different imaging techniques frequently used in daily clinical practice have tried to obtain an EAT quantification. We provide a useful update on comorbidities related to chronic inflammation typical of cardiac adiposity, analyzing how the EAT assessment could impact and provide data on the patient prognosis. We assessed for eligibility 50 papers, with a total of 10,458 patients focusing the review on the evaluation of EAT in two main contexts: cardiovascular and metabolic diseases. Given its peculiar properties and rapid responsiveness, EAT could act as a marker to investigate the basal risk factor and follow-up conditions. In the future, EAT could represent a therapeutic target for new medications. The assessment of EAT should become part of clinical practice to help clinicians to identify patients at greater risk of developing cardiovascular and/or metabolic diseases and to provide information on their clinical and therapeutic outcomes.
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Left atrial epicardial adipose tissue is closely associated with left atrial appendage flow velocity in patients with nonvalvular atrial fibrillation. Sci Rep 2022; 12:10742. [PMID: 35750694 PMCID: PMC9232655 DOI: 10.1038/s41598-022-13988-3] [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: 02/16/2022] [Accepted: 05/31/2022] [Indexed: 11/12/2022] Open
Abstract
Epicardial adipose tissue (EAT) can play an important role in the occurrence and development of atrial fibrillation and stroke. In this study, we explored the relationship between left atrial epicardial adipose tissue (LA-EAT) and left atrial appendage flow velocity (LAA-FV) in patients with nonvalvular atrial fibrillation (NV-AF). A total of 145 patients with NV-AF who underwent their first radiofrequency ablation were enrolled. They underwent left aortopulmonary vein computed tomography angiography (CTA) and transesophageal echocardiography (TEE) before AF ablation. Left atrial (LA) electroanatomical mapping was performed intraoperatively to assess left atrial voltage. Univariate regression analysis showed that LAA-FV was lower in patients with a low voltage zone (LAA-FV; 35.02 ± 10.78 cm/s vs. 50.60 ± 12.17 cm/s, P < 0.001). A multiple linear regression model showed that the left atrial low voltage zone (β = − 0.311 P < 0.001), LA-EAT volume (β = − 0.256 P < 0.001), left atrial appendage shape (β = − 0.216 P = 0.041), LAVI (β = − 0.153 P = 0.041), and type of atrial fibrillation (paroxysmal vs. persistence) (β = − 0.146 P < 0.048) were independent predictors of LAA-FV. In NV-AF patients, the increase in LA-EAT volume is related to the decrease in LAA-FV.
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Liao J, Huang L, Qu M, Chen B, Wang G. Artificial Intelligence in Coronary CT Angiography: Current Status and Future Prospects. Front Cardiovasc Med 2022; 9:896366. [PMID: 35783834 PMCID: PMC9247240 DOI: 10.3389/fcvm.2022.896366] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/18/2022] [Indexed: 12/28/2022] Open
Abstract
Coronary heart disease (CHD) is the leading cause of mortality in the world. Early detection and treatment of CHD are crucial. Currently, coronary CT angiography (CCTA) has been the prior choice for CHD screening and diagnosis, but it cannot meet the clinical needs in terms of examination quality, the accuracy of reporting, and the accuracy of prognosis analysis. In recent years, artificial intelligence (AI) has developed rapidly in the field of medicine; it played a key role in auxiliary diagnosis, disease mechanism analysis, and prognosis assessment, including a series of studies related to CHD. In this article, the application and research status of AI in CCTA were summarized and the prospects of this field were also described.
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Affiliation(s)
- Jiahui Liao
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
- School of Biomedical Engineering, Guangzhou Xinhua University, Guangzhou, China
| | - Lanfang Huang
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Meizi Qu
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Binghui Chen
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
- *Correspondence: Binghui Chen
| | - Guojie Wang
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
- Guojie Wang
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21
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Secchi F, Asteria C, Monti CB, Malavazos AE, Capra D, Alì M, Giassi CLA, Francesconi S, Basilico S, Giovanelli A, Morricone L, Sardanelli F. Quantification of epicardial adipose tissue in obese patients using an open-bore MR scanner. Eur Radiol Exp 2022; 6:25. [PMID: 35606555 PMCID: PMC9127004 DOI: 10.1186/s41747-022-00274-0] [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: 01/02/2022] [Accepted: 04/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background Our aim was to evaluate the reproducibility of epicardial adipose tissue (EAT) volume, measured on scans performed using an open-bore magnetic resonance scanner. Methods Consecutive patients referred for bariatric surgery, aged between 18 and 65 years who agreed to undergo cardiac imaging (MRI), were prospectively enrolled. All those with cardiac pathology or contraindications to MRI were excluded. MRI was performed on a 1.0-T open-bore scanner, and EAT was segmented on all scans at both systolic and diastolic phase by two independent readers (R1 with four years of experience and R2 with one year). Data were reported as median and interquartile range; agreement and differences were appraised with Bland-Altman analyses and Wilcoxon tests, respectively. Results Fourteen patients, 11 females (79%) aged 44 (41–50) years, underwent cardiac MRI. For the first and second readings, respectively, EAT volume was 86 (78–95) cm3 and 85 (79–91) cm3 at systole and 82 (74–95) cm3 and 81 (75–94) cm3 at diastole for R1, and 89 (79–99) cm3 and 93 (84–98) cm3 at systole and 92 (85–103) cm3 and 93 (82–94) cm3 at diastole for R2. R1 had the best reproducibility at diastole (bias 0.3 cm3, standard deviation of the differences (SD) 3.3 cm3). R2 had the worst reproducibility at diastole (bias 3.9 cm3, SD 12.1 cm3). The only significant difference between systole and diastole was at the first reading by R1 (p = 0.016). The greatest bias was that of inter-reader reproducibility at diastole (-9.4 cm3). Conclusions Reproducibility was within clinically acceptable limits in most instances.
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Affiliation(s)
- Francesco Secchi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy.,Department of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Carmela Asteria
- National Institute for Obesity Cure (INCO), IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Caterina B Monti
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
| | - Alexis Elias Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy.,Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Davide Capra
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy.
| | - Marco Alì
- Unit of Diagnostic Imaging and Stereotactic Radiosurgery, C.D.I. Centro Diagnostico Italiano S.p.A., Milan, Italy.,Bracco Imaging S.p.A., Via Caduti di Marcinelle 13, 20134, Milan, Italy
| | - Cecilia L A Giassi
- National Institute for Obesity Cure (INCO), IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Simona Francesconi
- National Institute for Obesity Cure (INCO), IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Sara Basilico
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Alessandro Giovanelli
- National Institute for Obesity Cure (INCO), IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Lelio Morricone
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy.,Department of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
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22
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Flinn B, Adams C, Chowdhury N, Gress T, Santanam N. Profiling of Non-Coding Regulators and Their Targets in Epicardial Fat from Patients with Coronary Artery Disease. Int J Mol Sci 2022; 23:ijms23105297. [PMID: 35628106 PMCID: PMC9141930 DOI: 10.3390/ijms23105297] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 11/24/2022] Open
Abstract
Epicardial fat is a continuously growing target of investigation in cardiovascular diseases due to both its anatomical proximity to the heart and coronary circulation and its unique physiology among adipose depots. Previous reports have demonstrated that epicardial fat plays key roles in coronary artery disease, but the non-coding RNA and transcriptomic alterations of epicardial fat in coronary artery disease have not been investigated thoroughly. Micro- and lncRNA microarrays followed by GO-KEGG functional enrichment analysis demonstrated sex-dependent unique mi/lncRNAs altered in human epicardial fat in comparison to subcutaneous fat in both patients with and without coronary artery disease (IRB approved). Among the 14 differentially expressed microRNAs in epicardial fat between patients with and without coronary artery disease, the hsa-miR-320 family was the most highly represented. IPW lncRNA interacted with three of these differentially expressed miRNAs. Next-generation sequencing and pathway enrichment analysis identified six unique mRNAs–miRNA pairs. Pathway enrichment identified inflammation, adipogenesis, and cardiomyocyte apoptosis as the most represented functions altered by the mi/lncRNAs and atherosclerosis and myocardial infarction among the highest cardiovascular pathologies associated with them. Overall, the epicardial fat in patients with coronary artery disease has a unique mi/lncRNA profile which is sex-dependent and has potential implications for regulating cardiac function.
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Affiliation(s)
- Brendin Flinn
- Department of Biomedical Sciences, Joan C Edwards School of Medicine, Marshall University, Huntington, WV 25755, USA;
| | - Christopher Adams
- Department of Cardiology, Joan C Edwards School of Medicine, Marshall University, Huntington, WV 25755, USA;
| | - Nepal Chowdhury
- Department of Cardiovascular and Thoracic Surgery, St. Mary’s Medical Center, Huntington, WV 25702, USA;
| | - Todd Gress
- Research Service, Hershel “Woody” Williams VA Medical Center, Huntington, WV 25704, USA;
| | - Nalini Santanam
- Department of Biomedical Sciences, Joan C Edwards School of Medicine, Marshall University, Huntington, WV 25755, USA;
- Correspondence: ; Tel.: +1-(304)-696-7321
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23
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Tharmaseelan H, Froelich MF, Nörenberg D, Overhoff D, Rotkopf LT, Riffel P, Schoenberg SO, Ayx I. Influence of local aortic calcification on periaortic adipose tissue radiomics texture features-a primary analysis on PCCT. Int J Cardiovasc Imaging 2022; 38:2459-2467. [PMID: 36434338 PMCID: PMC9700618 DOI: 10.1007/s10554-022-02656-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/22/2022] [Indexed: 12/14/2022]
Abstract
Perivascular adipose tissue is known to be metabolically active. Volume and density of periaortic adipose tissue are associated with aortic calcification as well as aortic diameter indicating a possible influence of periaortic adipose tissue on the development of aortic calcification. Due to better spatial resolution and signal-to-noise ratio, new CT technologies such as photon-counting computed tomography may allow the detection of texture alterations of periaortic adipose tissue depending on the existence of local aortic calcification possibly outlining a biomarker for the development of arteriosclerosis. In this retrospective, single-center, IRB-approved study, periaortic adipose tissue was segmented semiautomatically and radiomics features were extracted using pyradiomics. Statistical analysis was performed in R statistics calculating mean and standard deviation with Pearson correlation coefficient for feature correlation. For feature selection Random Forest classification was performed. A two-tailed unpaired t test was applied to the final feature set. Results were visualized as boxplots and heatmaps. A total of 30 patients (66.6% female, median age 57 years) were enrolled in this study. Patients were divided into two subgroups depending on the presence of local aortic calcification. By Random Forest feature selection a set of seven higher-order features could be defined to discriminate periaortic adipose tissue texture between these two groups. The t test showed a statistic significant discrimination for all features (p < 0.05). Texture changes of periaortic adipose tissue associated with the existence of local aortic calcification may lay the foundation for finding a biomarker for development of arteriosclerosis.
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Affiliation(s)
- Hishan Tharmaseelan
- grid.411778.c0000 0001 2162 1728Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Matthias F. Froelich
- grid.411778.c0000 0001 2162 1728Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Dominik Nörenberg
- grid.411778.c0000 0001 2162 1728Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Daniel Overhoff
- grid.411778.c0000 0001 2162 1728Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany ,Department of Diagnostic and Interventional Radiology and Neuroradiology, Bundeswehr Central Hospital Koblenz, Rübenacher Straße 170, 56072 Koblenz, Germany
| | - Lukas T. Rotkopf
- grid.7497.d0000 0004 0492 0584Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Philipp Riffel
- grid.411778.c0000 0001 2162 1728Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Stefan O. Schoenberg
- grid.411778.c0000 0001 2162 1728Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Isabelle Ayx
- grid.411778.c0000 0001 2162 1728Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
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Nyawo TA, Pheiffer C, Mazibuko-Mbeje SE, Mthembu SXH, Nyambuya TM, Nkambule BB, Sadie-Van Gijsen H, Strijdom H, Tiano L, Dludla PV. Physical Exercise Potentially Targets Epicardial Adipose Tissue to Reduce Cardiovascular Disease Risk in Patients with Metabolic Diseases: Oxidative Stress and Inflammation Emerge as Major Therapeutic Targets. Antioxidants (Basel) 2021; 10:1758. [PMID: 34829629 PMCID: PMC8614861 DOI: 10.3390/antiox10111758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 12/25/2022] Open
Abstract
Excess epicardial adiposity, within a state of obesity and metabolic syndrome, is emerging as an important risk factor for the development of cardiovascular diseases (CVDs). Accordingly, increased epicardial fat thickness (EFT) implicates the exacerbation of pathological mechanisms involving oxidative stress and inflammation within the heart, which may accelerate the development of CVDs. This explains increased interest in targeting EFT reduction to attenuate the detrimental effects of oxidative stress and inflammation within the setting of metabolic syndrome. Here, we critically discuss clinical and preclinical evidence on the impact of physical exercise on EFT in correlation with reduced CVD risk within a setting of metabolic disease. This review also brings a unique perspective on the implications of oxidative stress and inflammation as major pathological consequences that link increased EFT to accelerated CVD risk in conditions of metabolic disease.
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Affiliation(s)
- Thembeka A. Nyawo
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town 7505, South Africa; (T.A.N.); (C.P.); (S.X.H.M.)
- Centre for Cardiometabolic Research in Africa (CARMA), Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa; (H.S.-V.G.); (H.S.)
| | - Carmen Pheiffer
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town 7505, South Africa; (T.A.N.); (C.P.); (S.X.H.M.)
- Centre for Cardiometabolic Research in Africa (CARMA), Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa; (H.S.-V.G.); (H.S.)
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
| | | | - Sinenhlanhla X. H. Mthembu
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town 7505, South Africa; (T.A.N.); (C.P.); (S.X.H.M.)
- Department of Biochemistry, North-West University, Mafikeng Campus, Mmabatho 2735, South Africa;
| | - Tawanda M. Nyambuya
- Department of Health Sciences, Faculty of Health and Applied Sciences, Namibia University of Science and Technology, Windhoek 9000, Namibia;
| | - Bongani B. Nkambule
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa;
| | - Hanél Sadie-Van Gijsen
- Centre for Cardiometabolic Research in Africa (CARMA), Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa; (H.S.-V.G.); (H.S.)
| | - Hans Strijdom
- Centre for Cardiometabolic Research in Africa (CARMA), Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa; (H.S.-V.G.); (H.S.)
| | - Luca Tiano
- Department of Life and Environmental Sciences, Polytechnic University of Marche, 60131 Ancona, Italy;
| | - Phiwayinkosi V. Dludla
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town 7505, South Africa; (T.A.N.); (C.P.); (S.X.H.M.)
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25
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Chun KH. Mouse model of the adipose organ: the heterogeneous anatomical characteristics. Arch Pharm Res 2021; 44:857-875. [PMID: 34606058 DOI: 10.1007/s12272-021-01350-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/20/2021] [Indexed: 12/24/2022]
Abstract
Adipose tissue plays a pivotal role in energy storage, hormone secretion, and temperature control. Mammalian adipose tissue is largely divided into white adipose tissue and brown adipose tissue, although recent studies have discovered the existence of beige adipocytes. Adipose tissues are widespread over the whole body and each location shows distinctive metabolic features. Mice are used as a representative experimental model system in metabolic studies due to their numerous advantages. Importantly, the adipose tissues of experimental animals and humans are not perfectly matched, and each adipose tissue exhibits both similar and specific characteristics. Nevertheless, the diversity and characteristics of mouse adipose tissue have not yet been comprehensively summarized. This review summarizes diverse information about the different types of adipose tissue being studied in mouse models. The types and characteristics of adipocytes were described, and each adipose tissue was classified by type, and features such as its distribution, origin, differences from humans, and metabolic characteristics were described. In particular, the distribution of widely studied adipose tissues was illustrated so that researchers can comprehensively grasp its location. Also, the adipose tissues misused or confusingly used among researchers were described. This review will provide researchers with comprehensive information and cautions needed to study adipose tissues in mouse models.
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Affiliation(s)
- Kwang-Hoon Chun
- Gachon Institute of Pharmaceutical Sciences, College of Pharmacy, Gachon University, Inchon, 21936, Republic of Korea.
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26
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Epicardial fat thickness is associated with retinopathy in patients with newly diagnosed hypertension. North Clin Istanb 2021; 8:365-370. [PMID: 34585071 PMCID: PMC8430367 DOI: 10.14744/nci.2020.23334] [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: 09/08/2020] [Accepted: 11/13/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Hypertensive retinopathy develops based on endothelial dysfunction, inflammation, and atherosclerosis. Epicardial fat secretes various cytokines associated with endothelial dysfunction, oxidative stress, inflammation, and atherosclerosis. We aimed to evaluate whether epicardial adipose tissue (EAT) thickness is a marker for retinopathy in newly diagnosed hypertensive patients. METHODS A total of 73 newly diagnosed hypertension (HT) patients were included in the study. Transthoracic echocardiography (TTE) was used to measure EAT thickness. To evaluate the presence of retinopathy in HT patients, hypertensive retinopathy staging was performed by ophthalmologists, according to Scheie classification. RESULTS Retinopathy was detected in 27 (37.0%) of 73 patients. EAT thickness in HT patients with retinopathy was higher than the group without retinopathy (5.07±1.45 mm vs. 4.19±1.20 mm, p=0.007). Low-density lipoprotein cholesterol (LDL-C) levels in HT patients with retinopathy were higher than the group without retinopathy (162.4±41.2 mg/dl vs. 138.1±35.6 mg/dl, p=0.010). As a result of the regression analysis, LDL-C (OR=1.016, 95% CI 1.001-1.031, p=0.043) and EAT thickness (OR=1.674, 95% CI 1.069-2.626, p=0.043) were the independent predictors of retinopathy. CONCLUSION Increased EAT thickness is associated with the presence of retinopathy in hypertensive patients.
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27
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Elmalı F, Tekindal MA, Altın C, Ateş C, Erol V. Optimization of change in epicardial fat thickness for obese patients who lost weight via the bariatric surgery method using central composite and Box-Behnken experimental designs. PeerJ 2021; 9:e11831. [PMID: 34430075 PMCID: PMC8349161 DOI: 10.7717/peerj.11831] [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: 01/06/2021] [Accepted: 06/30/2021] [Indexed: 11/20/2022] Open
Abstract
Background The aim of this study was to detect the optimal values for Age, Body Mass Index (BMI) and HOMA-IR of obese patients prior to surgery that results in a maximal decrease of visceral fat mass 6 months after bariatric surgery. Method In this study, 33 experimental set-ups were designed. This study was approved by Baskent University Medical and Health Sciences Research Board (Approval number: KA16/281). The study data consisted of 40 obese patients who lost weight through the bariatric surgery between February 2015 and December 2016. The values of BMI, Age and HOMA for the obese patients who lost weight through the bariatric surgery were evaluated in three categories and at three levels; the response variable was determined as the Change in Epicardial Fat Thickness (ΔEFT). Results As a result of CCD analysis, the optimum ΔEFT = 2.571 was determined when Age = 30.52, BMI = 45.30, and HOMA = 34.62. As a result of the BBD analysis, the optimum ΔEFT = 3.756 was determined, when Age = 38.36, BMI = 63.18, and HOMA = 14.95. The optimum ΔEFT was modeled with Contour and Response Surface plots. Conclusion Based on the two surface response models used in our study, the maximal decrease of visceral fat mass as assessed by measuring echography images of epicardial fat thickness can be obtained by bariatric surgery of persons who are between 31 and 38 year old, have a BMI between 45 and 63 kg/m2 and have a HOMA-IR 34 between 15 and 35. Central Composite Design and a Box-Behnken Design of suitable patient data predicted 35 optimal settings of independent variables for the maximal clinical response of an intervention.
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Affiliation(s)
- Ferhan Elmalı
- Faculty of Medicine, Department of Biostatistics, İzmir Katip Çelebi University, İzmir, Turkey
| | - Mustafa Agâh Tekindal
- Faculty of Medicine, Department of Biostatistics, İzmir Katip Çelebi University, İzmir, Turkey
| | - Cihan Altın
- Cardiology Department, İzmir Medikal Park, İzmir, Turkey
| | - Can Ateş
- Faculty of Medicine, Department of Biostatistics and Medical Informatics, Aksaray University, Aksaray, Turkey
| | - Varlık Erol
- Department of General Surgery, Medicana International İzmir, İzmir, Turkey
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Sousa JA, Mendonça MI, Serrão M, Borges S, Henriques E, Freitas S, Tentem M, Santos M, Freitas P, Ferreira A, Guerra G, Drumond A, Palma Reis R. Epicardial Adipose Tissue: The Genetics Behind an Emerging Cardiovascular Risk Marker. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2021; 15:11795468211029244. [PMID: 34276231 PMCID: PMC8255575 DOI: 10.1177/11795468211029244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 06/07/2021] [Indexed: 12/16/2022]
Abstract
Evidence points epicardial adipose tissue (EAT) as an emerging cardiovascular risk marker. Whether genetic polymorphisms linked with atherosclerosis are associated with higher EAT is still unknown. We aim to assess the role of genetic burden of atherosclerosis and its association to EAT in a cohort of asymptomatic individuals without coronary disease. A total of 996 participants were prospectively enrolled in a single Portuguese center. EAT volume was measured by Cardiac Computed Tomography and participants were distributed into 2 groups, above and below median EAT. SNPs were genotyped and linked to their respective pathophysiological axes. A multiplicative genetic risk score (mGRS) was constructed, representing the genetic burden of the studied SNPs. To evaluate the association between genetics and EAT, we compared both groups by global mGRS, mGRS by functional axes, and SNPs individually. Individuals above-median EAT were older, had a higher body mass index (BMI) and higher prevalence of hypertension, metabolic syndrome, diabetes, and dyslipidemia. They presented higher GRS, that remained an independent predictor of higher EAT volumes. The group with more EAT consistently presented higher polymorphic burden across numerous pathways. After adjustment, age, BMI, and mGRS of each functional axis emerged as independently related to higher EAT volumes. Amongst the 33 SNPs, MTHFR677 polymorphism emerged as the only significant and independent predictor of higher EAT volumes. Patients with higher polymorphism burden for atherosclerosis present higher EAT volumes. We present the first study in a Portuguese population, evaluating the genetic profile of EAT through GWAS and GRS, casting further insight into this complicated matter.
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Affiliation(s)
- João Adriano Sousa
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Maria Isabel Mendonça
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Marco Serrão
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Sofia Borges
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Eva Henriques
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Sónia Freitas
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Margarida Tentem
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Marina Santos
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Pedro Freitas
- Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, CHLO, Carnaxide, Portugal
| | - António Ferreira
- Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, CHLO, Carnaxide, Portugal
| | - Graça Guerra
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - António Drumond
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Roberto Palma Reis
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
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29
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Yuvaraj J, Cheng K, Lin A, Psaltis PJ, Nicholls SJ, Wong DTL. The Emerging Role of CT-Based Imaging in Adipose Tissue and Coronary Inflammation. Cells 2021; 10:1196. [PMID: 34068406 PMCID: PMC8153638 DOI: 10.3390/cells10051196] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/30/2021] [Accepted: 05/07/2021] [Indexed: 12/15/2022] Open
Abstract
A large body of evidence arising from recent randomized clinical trials demonstrate the association of vascular inflammatory mediators with coronary artery disease (CAD). Vascular inflammation localized in the coronary arteries leads to an increased risk of CAD-related events, and produces unique biological alterations to local cardiac adipose tissue depots. Coronary computed tomography angiography (CTA) provides a means of mapping inflammatory changes to both epicardial adipose tissue (EAT) and pericoronary adipose tissue (PCAT) as independent markers of coronary risk. Radiodensity or attenuation of PCAT on coronary CTA, notably, provides indirect quantification of coronary inflammation and is emerging as a promising non-invasive imaging implement. An increasing number of observational studies have shown robust associations between PCAT attenuation and major coronary events, including acute coronary syndrome, and 'vulnerable' atherosclerotic plaque phenotypes that are associated with an increased risk of the said events. This review outlines the biological characteristics of both EAT and PCAT and provides an overview of the current literature on PCAT attenuation as a surrogate marker of coronary inflammation.
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Affiliation(s)
- Jeremy Yuvaraj
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University and Monash Heart, Monash Health, Clayton, VIC 3168, Australia; (J.Y.); (K.C.); (S.J.N.)
| | - Kevin Cheng
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University and Monash Heart, Monash Health, Clayton, VIC 3168, Australia; (J.Y.); (K.C.); (S.J.N.)
| | - Andrew Lin
- Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA 90048, USA;
| | - Peter J. Psaltis
- Department of Medicine, University of Adelaide, Adelaide, SA 5005, Australia;
- South Australian Health Medical Research Institute, Adelaide, SA 5000, Australia
| | - Stephen J. Nicholls
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University and Monash Heart, Monash Health, Clayton, VIC 3168, Australia; (J.Y.); (K.C.); (S.J.N.)
| | - Dennis T. L. Wong
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University and Monash Heart, Monash Health, Clayton, VIC 3168, Australia; (J.Y.); (K.C.); (S.J.N.)
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Abstract
Cardiovascular diseases are the leading cause of death worldwide. Overweight and obesity are strongly associated with comorbidities such as hypertension and insulin resistance, which collectively contribute to the development of cardiovascular diseases and resultant morbidity and mortality. Forty-two percent of adults in the United States are obese, and a total of 1.9 billion adults worldwide are overweight or obese. These alarming numbers, which continue to climb, represent a major health and economic burden. Adipose tissue is a highly dynamic organ that can be classified based on the cellular composition of different depots and their distinct anatomical localization. Massive expansion and remodeling of adipose tissue during obesity differentially affects specific adipose tissue depots and significantly contributes to vascular dysfunction and cardiovascular diseases. Visceral adipose tissue accumulation results in increased immune cell infiltration and secretion of vasoconstrictor mediators, whereas expansion of subcutaneous adipose tissue is less harmful. Therefore, fat distribution more than overall body weight is a key determinant of the risk for cardiovascular diseases. Thermogenic brown and beige adipose tissue, in contrast to white adipose tissue, is associated with beneficial effects on the vasculature. The relationship between the type of adipose tissue and its influence on vascular function becomes particularly evident in the context of the heterogenous phenotype of perivascular adipose tissue that is strongly location dependent. In this review, we address the abnormal remodeling of specific adipose tissue depots during obesity and how this critically contributes to the development of hypertension, endothelial dysfunction, and vascular stiffness. We also discuss the local and systemic roles of adipose tissue derived secreted factors and increased systemic inflammation during obesity and highlight their detrimental impact on cardiovascular health.
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Affiliation(s)
- Mascha Koenen
- Laboratory of Molecular Metabolism, The Rockefeller University, New York (M.K., P.C.)
| | - Michael A Hill
- Dalton Cardiovascular Research Center, University of Missouri, Columbia (M.A.H., J.R.S.)
- Department of Medical Pharmacology and Physiology (M.A.H., J.R.S.), University of Missouri School of Medicine, Columbia
| | - Paul Cohen
- Laboratory of Molecular Metabolism, The Rockefeller University, New York (M.K., P.C.)
| | - James R Sowers
- Dalton Cardiovascular Research Center, University of Missouri, Columbia (M.A.H., J.R.S.)
- Department of Medical Pharmacology and Physiology (M.A.H., J.R.S.), University of Missouri School of Medicine, Columbia
- Diabetes and Cardiovascular Center (J.R.S.), University of Missouri School of Medicine, Columbia
- Department of Medicine (J.R.S.), University of Missouri School of Medicine, Columbia
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Association between Vascular Inflammation and Inflammation in Adipose Tissue, Spleen, and Bone Marrow in Patients with Psoriasis. Life (Basel) 2021; 11:life11040305. [PMID: 33915972 PMCID: PMC8065955 DOI: 10.3390/life11040305] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/22/2021] [Accepted: 03/29/2021] [Indexed: 12/29/2022] Open
Abstract
Psoriasis is associated with atherosclerotic cardiovascular disease (CVD) with significant overlap of inflammatory pathways. A link between vascular inflammation and inflammation in multiple adipose tissue types, spleen, and bone marrow may exist. Therefore, we investigated these associations using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients with psoriasis (n = 83) where half had established CVD. Carotid ultrasound imaging was also performed. Inflammation was measured by FDG uptake in the aorta, visceral- (VAT), subcutaneous- (SAT), and pericardial (PAT) adipose tissues, and spleen and bone marrow, respectively. Vascular inflammation was associated with FDG uptakes in all adipose tissues, including VAT (β = 0.26; p < 0.001), SAT (β = 0.28; p < 0.001), PAT (β = 0.24; p < 0.001), spleen (β = 1.35; p = 0.001), and bone marrow (β = 1.14; p < 0.001). Adjustments for age, sex, body mass index, and high sensitivity C-reactive protein did not change the results. These associations were generally preserved in the patients without prior CVD. No associations were observed between vascular inflammation and carotid intima-media thickness or presence of carotid plaques, respectively. The results suggest an inflammatory link between vascular and adipose tissues, spleen, and bone marrow in patients with psoriasis.
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Kim YH, Jeong MK, Park H, Park SK. Effects of Regular Taekwondo Intervention on Health-Related Physical Fitness, Cardiovascular Disease Risk Factors and Epicardial Adipose Tissue in Elderly Women with Hypertension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2935. [PMID: 33809392 PMCID: PMC7999820 DOI: 10.3390/ijerph18062935] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 12/18/2022]
Abstract
Regular exercise has been proven to prevent hypertension and to help in the management of hypertension. There is a lack of studies examining changes in these issues as a result of Taekwondo training intervention. The aim of the current trial is to identify the effects of a regular Taekwondo (TKD) training program on health-related physical fitness (HRPF), cardiovascular disease (CVD) risk factors, inflammatory factors, and epicardial adipose tissue (EAT) in elderly women with hypertension. To accomplish this, 20 participants, who were older women with hypertension, were divided into a TKD group (n = 10) and a control group (n = 10). The TKD program was conducted in program for 90 min, three times a week, for 12 weeks. Outcomes, including body composition, blood pressure (BP), HRPF, cardiovascular risk factor and EAT, were measured before and after the Taekwondo program. The 12-week TKD program improved body composition, BP, HRPF, CVD risk factor, and EAT in elderly women with hypertension relative to controls. Meanwhile, EAT and interukin-1β (r = 0.530, p < 0.05), monocyte chemotactic protein-1 (r = 0.524, p < 0.05), triglyceride (r = 0.493, p < 0.05) and sedentary behavior (r = 0.459, p < 0.05) presented a positive correlation, while EAT and lean body mass (r = -0.453, p < 0.05) showed a negative correlation. The 12-week regular TKD training intervention was found to be effective in reducing the thickness of EAT measured by multi-detector computed tomography and can also enhance health-related physical fitness and risk factors of CVD in older individuals with hypertension.
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Affiliation(s)
- Yun Hwan Kim
- College of Arts and Sports, Dong-A University, Busan 49315, Korea; (Y.H.K.); (M.K.J.)
| | - Min Ki Jeong
- College of Arts and Sports, Dong-A University, Busan 49315, Korea; (Y.H.K.); (M.K.J.)
| | - Hyuntae Park
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Korea
- Institute of Convergence Bio-Health, Dong-A University, Busan 49315, Korea
| | - Sang Kab Park
- College of Arts and Sports, Dong-A University, Busan 49315, Korea; (Y.H.K.); (M.K.J.)
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Monti CB, Capra D, Malavazos A, Florini G, Parietti C, Schiaffino S, Sardanelli F, Secchi F. Subcutaneous, Paracardiac, and Epicardial Fat CT Density Before/After Contrast Injection: Any Correlation with CAD? J Clin Med 2021; 10:jcm10040735. [PMID: 33673256 PMCID: PMC7918165 DOI: 10.3390/jcm10040735] [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: 12/28/2020] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023] Open
Abstract
Adipose tissue, in particular epicardial adipose tissue, has been identified as a potential biomarker of cardiovascular pathologies such as coronary artery disease (CAD) in the light of its metabolic activity and close anatomic and pathophysiologic relationship to the heart. Our purpose was to evaluate epicardial adipose tissue density at both unenhanced and contrast-enhanced computed tomography (CT), along with CT densities of paracardiac and subcutaneous adipose tissue, as well as the relations of such densities with CAD. We retrospectively reviewed patients who underwent cardiac CT at our institution for CAD assessment. We segmented regions of interest on epicardial, paracardiac, and subcutaneous adipose tissue on unenhanced and contrast-enhanced scans. A total of 480 patients were included, 164 of them presenting with CAD. Median epicardial adipose tissue density measured on contrast-enhanced scans (−81.5 HU; interquartile range −84.9 to −78.0) was higher than that measured on unenhanced scans (−73.4 HU; −76.9 to −69.4) (p < 0.001), whereas paracardiac and subcutaneous adipose tissue densities were not (p ≥ 0.055). Patients with or without CAD, did not show significant differences in density of epicardial, paracardiac, and subcutaneous adipose tissue either on unenhanced or contrast-enhanced scans (p ≥ 0.092). CAD patients may experience different phenomena (inflammation, fibrosis, increase in adipose depots) leading to rises or drops in epicardial adipose tissue density, resulting in variations that are difficult to detect.
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Affiliation(s)
- Caterina Beatrice Monti
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy; (C.B.M.); (D.C.); (F.S.)
| | - Davide Capra
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy; (C.B.M.); (D.C.); (F.S.)
| | - Alexis Malavazos
- Clinical Nutrition and Cardiovascular Prevention Unit and High Specialty Center for Dietetics, Nutritional Education and Cardiometabolic Prevention, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milano, Italy;
| | - Giorgia Florini
- School of Medicine and Surgery, Università degli Studi di Milano, 20122 Milano, Italy; (G.F.); (C.P.)
| | - Carlo Parietti
- School of Medicine and Surgery, Università degli Studi di Milano, 20122 Milano, Italy; (G.F.); (C.P.)
| | - Simone Schiaffino
- Department of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milano, Italy;
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy; (C.B.M.); (D.C.); (F.S.)
- Department of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milano, Italy;
| | - Francesco Secchi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy; (C.B.M.); (D.C.); (F.S.)
- Department of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milano, Italy;
- Correspondence:
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Sadouni M, Boldeanu I, Durand M, Juneau D, Blais S, Tremblay C, Chartrand-Lefebvre C. Quantification of epicardial fat using non contrast cardiac CT in an HIV population: Reproducibility and association with other body fat indices. Eur J Radiol Open 2021; 8:100317. [PMID: 33490311 PMCID: PMC7804835 DOI: 10.1016/j.ejro.2020.100317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/14/2020] [Accepted: 12/21/2020] [Indexed: 12/20/2022] Open
Abstract
Assessment of epicardial fat volume is highly reproducible. Epicardial fat volume and epicardial fat area have a good correlation to BMI. Epicardial fat volume correlates best with DEXA-derived total body fat and trunk fat. Epicardial fat volume should be considered over other CT assessment methods when quantifying epicardial fat in HIV patients.
Purpose To assess the reproducibility of different epicardial fat measurement and their association with other adiposity measurements in HIV-infected and non-HIV-infected patients. Methods and materials In this cross-sectional study, 167 HIV-infected and 58 non-HIV-infected consecutive participants (200 males; mean age 56 years) with low/intermediate cardiovascular risk were recruited between 2012 and 2017 from a large prospective cohort and underwent non-contrast cardiac CT. Two independent observers measured epicardial fat volume, area and thickness in all participants. For intra-observer agreement, one observer did a second assessment in a subset of 40 patients. Agreement was assessed with the intraclass correlation coefficient (ICC). Pearson's correlation was estimated to assess the association between epicardial fat, body-mass index (BMI) and dual-energy x-ray absorptiometry (DEXA) derived percentage of body fat. Results Inter-observer agreement was excellent for epicardial fat volume (ICC 0.75) and area (ICC 0.95) and good for epicardial fat thickness (ICC near the left anterior descending artery (LAD) 0.64, ICC near right coronary artery (RCA) 0.64). Intra-observer agreement was excellent for epicardial fat volume (ICC 0.97), area (ICC 0.99), thickness at LAD (ICC 0.71) and good for epicardial fat thickness at RCA (ICC 0.68). Epicardial fat volume had a better correlation to total body fat (r = 0.28, p < 0.001) and trunk fat (r = 0.37, p < 0.001), in comparison to other epicardial fat indices. Conclusion Assessment of epicardial fat volume is highly reproducible in both HIV-infected and non-HIV-infected patients and shows a superior correlation with DEXA-based body and trunk fat measurements. Epicardial fat volume should be considered over other CT assessment methods when quantifying epicardial fat in HIV patients.
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Affiliation(s)
- Manel Sadouni
- Department of Radiology and Nuclear Medicine, University of Montreal Hospital (CHUM), Montreal, Québec, Canada.,Research Center of the CHUM, Montreal, Québec, Canada
| | - Irina Boldeanu
- Department of Radiology and Nuclear Medicine, University of Montreal Hospital (CHUM), Montreal, Québec, Canada.,Research Center of the CHUM, Montreal, Québec, Canada
| | - Madeleine Durand
- Research Center of the CHUM, Montreal, Québec, Canada.,Internal Medicine Unit, CHUM, Montréal, Québec, Canada
| | - Daniel Juneau
- Department of Radiology and Nuclear Medicine, University of Montreal Hospital (CHUM), Montreal, Québec, Canada.,Research Center of the CHUM, Montreal, Québec, Canada
| | - Simon Blais
- Department of Radiology and Nuclear Medicine, University of Montreal Hospital (CHUM), Montreal, Québec, Canada
| | - Cécile Tremblay
- Research Center of the CHUM, Montreal, Québec, Canada.,Microbiology Unit, CHUM, Montréal, Québec, Canada
| | - Carl Chartrand-Lefebvre
- Department of Radiology and Nuclear Medicine, University of Montreal Hospital (CHUM), Montreal, Québec, Canada.,Research Center of the CHUM, Montreal, Québec, Canada
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Zhang H, Viveiros A, Nikhanj A, Nguyen Q, Wang K, Wang W, Freed DH, Mullen JC, MacArthur R, Kim DH, Tymchak W, Sergi CM, Kassiri Z, Wang S, Oudit GY. The Human Explanted Heart Program: A translational bridge for cardiovascular medicine. Biochim Biophys Acta Mol Basis Dis 2021; 1867:165995. [PMID: 33141063 PMCID: PMC7581399 DOI: 10.1016/j.bbadis.2020.165995] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/12/2020] [Accepted: 10/15/2020] [Indexed: 12/17/2022]
Abstract
The progression of cardiovascular research is often impeded by the lack of reliable disease models that fully recapitulate the pathogenesis in humans. These limitations apply to both in vitro models such as cell-based cultures and in vivo animal models which invariably are limited to simulate the complexity of cardiovascular disease in humans. Implementing human heart tissue in cardiovascular research complements our research strategy using preclinical models. We established the Human Explanted Heart Program (HELP) which integrates clinical, tissue and molecular phenotyping thereby providing a comprehensive evaluation into human heart disease. Our collection and storage of biospecimens allow them to retain key pathogenic findings while providing novel insights into human heart failure. The use of human non-failing control explanted hearts provides a valuable comparison group for the diseased explanted hearts. Using HELP we have been able to create a tissue repository which have been used for genetic, molecular, cellular, and histological studies. This review describes the process of collection and use of explanted human heart specimens encompassing a spectrum of pediatric and adult heart diseases, while highlighting the role of these invaluable specimens in translational research. Furthermore, we highlight the efficient procurement and bio-preservation approaches ensuring analytical quality of heart specimens acquired in the context of heart donation and transplantation.
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Affiliation(s)
- Hao Zhang
- Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Anissa Viveiros
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada; Department of Physiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Anish Nikhanj
- Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Quynh Nguyen
- Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Kaiming Wang
- Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Wei Wang
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada; Division of Cardiac Surgery, Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Darren H Freed
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada; Division of Cardiac Surgery, Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - John C Mullen
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada; Division of Cardiac Surgery, Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Roderick MacArthur
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada; Division of Cardiac Surgery, Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Daniel H Kim
- Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Wayne Tymchak
- Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Consolato M Sergi
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada; Division of Anatomical Pathology, Department of Laboratory Medicine & Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Zamaneh Kassiri
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada; Department of Physiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Shaohua Wang
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada; Division of Cardiac Surgery, Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Gavin Y Oudit
- Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
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AlZaim I, Hammoud SH, Al-Koussa H, Ghazi A, Eid AH, El-Yazbi AF. Adipose Tissue Immunomodulation: A Novel Therapeutic Approach in Cardiovascular and Metabolic Diseases. Front Cardiovasc Med 2020; 7:602088. [PMID: 33282920 PMCID: PMC7705180 DOI: 10.3389/fcvm.2020.602088] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/22/2020] [Indexed: 12/12/2022] Open
Abstract
Adipose tissue is a critical regulator of systemic metabolism and bodily homeostasis as it secretes a myriad of adipokines, including inflammatory and anti-inflammatory cytokines. As the main storage pool of lipids, subcutaneous and visceral adipose tissues undergo marked hypertrophy and hyperplasia in response to nutritional excess leading to hypoxia, adipokine dysregulation, and subsequent low-grade inflammation that is characterized by increased infiltration and activation of innate and adaptive immune cells. The specific localization, physiology, susceptibility to inflammation and the heterogeneity of the inflammatory cell population of each adipose depot are unique and thus dictate the possible complications of adipose tissue chronic inflammation. Several lines of evidence link visceral and particularly perivascular, pericardial, and perirenal adipose tissue inflammation to the development of metabolic syndrome, insulin resistance, type 2 diabetes and cardiovascular diseases. In addition to the implication of the immune system in the regulation of adipose tissue function, adipose tissue immune components are pivotal in detrimental or otherwise favorable adipose tissue remodeling and thermogenesis. Adipose tissue resident and infiltrating immune cells undergo metabolic and morphological adaptation based on the systemic energy status and thus a better comprehension of the metabolic regulation of immune cells in adipose tissues is pivotal to address complications of chronic adipose tissue inflammation. In this review, we discuss the role of adipose innate and adaptive immune cells across various physiological and pathophysiological states that pertain to the development or progression of cardiovascular diseases associated with metabolic disorders. Understanding such mechanisms allows for the exploitation of the adipose tissue-immune system crosstalk, exploring how the adipose immune system might be targeted as a strategy to treat cardiovascular derangements associated with metabolic dysfunctions.
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Affiliation(s)
- Ibrahim AlZaim
- Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon
| | - Safaa H Hammoud
- Department of Pharmacology and Therapeutics, Beirut Arab University, Beirut, Lebanon
| | - Houssam Al-Koussa
- Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon
| | - Alaa Ghazi
- Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon
| | - Ali H Eid
- Department of Pharmacology and Therapeutics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Department of Basic Medical Sciences, College of Medicine, Qatar University, Doha, Qatar
- Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University, Doha, Qatar
| | - Ahmed F El-Yazbi
- Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
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The Pivotal Role of Adipocyte-Na K peptide in Reversing Systemic Inflammation in Obesity and COVID-19 in the Development of Heart Failure. Antioxidants (Basel) 2020; 9:antiox9111129. [PMID: 33202598 PMCID: PMC7697697 DOI: 10.3390/antiox9111129] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 01/10/2023] Open
Abstract
This review summarizes data from several laboratories that have demonstrated a role of the Na/K-ATPase, specifically its α1 subunit, in the generation of reactive oxygen species (ROS) via the negative regulator of Src. Together with Src and other signaling proteins, the Na/K-ATPase forms an oxidant amplification loop (NKAL), amplifies ROS, and participates in cytokines storm in obesity. The development of a peptide fragment of the α1 subunit, NaKtide, has been shown to negatively regulate Src. Several groups showed that the systemic administration of the cell permeable modification of NaKtide (pNaKtide) or its selective delivery to fat tissue—adipocyte specific expression of NaKtide—ameliorate the systemic elevation of inflammatory cytokines seen in chronic obesity. Severe acute respiratory syndrome – coronavirus 2 (SARS-CoV-2), the RNA Coronavirus responsible for the COVID-19 global pandemic, invades cells via the angiotensin converting enzyme 2 (ACE-2) receptor (ACE2R) that is appended in inflamed fat tissue and exacerbates the formation of the cytokines storm. Both obesity and heart and renal failure are well known risks for adverse outcomes in patients infected with COVID-19. White adipocytes express ACE-2 receptors in high concentration, especially in obese patients. Once the virus invades the white adipocyte cell, it creates a COVID19–porphyrin complex which degrades and produces free porphyrin and iron and increases ROS. The increased formation of ROS and activation of the NKAL results in a further potentiated formation of ROS production, and ultimately, adipocyte generation of more inflammatory mediators, leading to systemic cytokines storm and heart failure. Moreover, chronic obesity also results in the reduction of antioxidant genes such as heme oxygenase-1 (HO-1), increasing adipocyte susceptibility to ROS and cytokines. It is the systemic inflammation and cytokine storm which is responsible for many of the adverse outcomes seen with COVID-19 infections in obese subjects, leading to heart failure and death. This review will also describe the potential antioxidant drugs and role of NaKtide and their demonstrated antioxidant effect used as a major strategy for improving obesity and epicardial fat mediated heart failure in the context of the COVID pandemic.
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Gać P, Czerwińska K, Poręba M, Macek P, Mazur G, Poręba R. Environmental Tobacco Smoke Exposure Estimated Using the SHSES Scale and Epicardial Adipose Tissue Thickness in Hypertensive Patients. Cardiovasc Toxicol 2020; 21:79-87. [PMID: 32809142 PMCID: PMC7790793 DOI: 10.1007/s12012-020-09598-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/11/2020] [Indexed: 02/08/2023]
Abstract
The aim of the study was to assess the relationship between environmental tobacco smoke exposure (ETS) and epicardial adipose tissue thickness (EATT) in hypertensive patients. A total of 96 patients with essential hypertension were recruited for this study. The group consisted of 48 females and 48 males with the mean age of 69.32 ± 9.54 years. ETS was assessed with The Secondhand Smoke Exposure Scale (SHSES). EATT was assessed in 128-slice dual source coronary computed tomography angiography. In accordance to SHSES scale patients were divided into subgroups: subgroup A-no ETS exposure (SHSES = 0 points, n = 48), subgroup B-low ETS exposure (SHSES = 1-3 points, n = 11), subgroup C-medium ETS exposure (SHSES = 4-7 points, n = 20) and subgroup D-high ETS exposure (SHSES = 8-11 points, n = 17). Within the study group the mean EATT was 5.75 ± 1.85 mm and the mean SHSES score was 3.05 ± 3.74. EATT was statistically significantly higher in subgroup D than in subgroups A and B (A: 5.28 ± 1.64 mm, B: 5.04 ± 2.64 mm, D: 7.04 ± 2.64 mm, pA-D and pB-D < 0.05). There was a positive linear correlation between the exposure to ETS expressed by the SHSES scale and EATT (r = 0.44, p < 0.05). Regression analysis showed that higher SHSES score, higher BMI, and higher systolic and diastolic blood pressure are independent risk factors for higher EATT values. Contrary, the use of ACE inhibitors and β-blockers appeared to be independent protecting factor against higher EATT values. There is an unfavorable positive relationship between ETS exposure estimated using the SHSES scale and EATT in hypertensive patients.
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Affiliation(s)
- Paweł Gać
- Department of Hygiene, Wroclaw Medical University, Mikulicza-Radeckiego 7, 50-368, Wrocław, Poland. .,Centre of Diagnostic Imaging, 4th Military Hospital, Weigla 5, 50-981, Wrocław, Poland.
| | - Karolina Czerwińska
- Department of Hygiene, Wroclaw Medical University, Mikulicza-Radeckiego 7, 50-368, Wrocław, Poland
| | - Małgorzata Poręba
- Department of Pathophysiology, Wroclaw Medical University, Marcinkowskiego 1, 50-368, Wrocław, Poland
| | - Piotr Macek
- Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Borowska 213, 50-556, Wrocław, Poland
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Borowska 213, 50-556, Wrocław, Poland
| | - Rafał Poręba
- Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Borowska 213, 50-556, Wrocław, Poland
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39
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De Munck TJI, Soeters PB, Koek GH. The role of ectopic adipose tissue: benefit or deleterious overflow? Eur J Clin Nutr 2020; 75:38-48. [PMID: 32801303 DOI: 10.1038/s41430-020-00713-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/01/2020] [Accepted: 08/04/2020] [Indexed: 12/11/2022]
Abstract
Ectopic adipose tissues (EAT) are present adjacent to many organs and have predominantly been described in overweight and obesity. They have been suggested to be related to fatty acid overflow and to have harmful effects. The objective of this semi-comprehensive review is to explore whether EAT may play a supportive role rather than interfering with its function, when the adjacent organ is challenged metabolically and functionally. EAT are present adhered to different tissues or organs, including lymph nodes, heart, kidney, ovaries and joints. In this review, we only focused on epicardial, perinodal, and peritumoral fat since these locations have been studied in more detail. Evidence was found that EAT volume significantly increased, associated with chronic metabolic challenges of the corresponding tissue. In vitro evidence revealed transfer of fatty acids from peritumoral and perinodal fat to the adjacent tissue. Cytokine expression in these EAT is upregulated when the adjacent tissue is challenged. In these tissues, glycolysis is enhanced, whereas fatty acid oxidation is increased. Together with more direct evidence, this shows that glucose is oxidized to a lesser degree, but used to support anabolic metabolism of the adjacent tissue. In these situations, browning occurs, resulting from upregulation of anabolic metabolism, stimulated by uncoupling proteins 1 and 2 and possibly 3. In conclusion, the evidence found is fragmented but the available data support the view that accumulation and browning of adipocytes adjacent to the investigated organs or tissues may be a normal physiological response promoting healing and (patho)physiological growth.
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Affiliation(s)
- Toon J I De Munck
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, The Netherlands. .,School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.
| | - Peter B Soeters
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.,Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ger H Koek
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.,Department of Surgery, Klinikum RWTH Aachen, Aachen, Germany
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40
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Ndrepepa G. Epicardial adipose tissue: An anatomic component of obesity & metabolic syndrome in close proximity to myocardium & coronary arteries. Indian J Med Res 2020; 151:509-512. [PMID: 32719222 PMCID: PMC7602928 DOI: 10.4103/ijmr.ijmr_2692_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Gjin Ndrepepa
- Department of Adult Cardiology, Deutsches Herzzentrum München, Technical University, Munich, Germany
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41
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Kazemi A, Keshtkar A, Rashidi S, Aslanabadi N, Khodadad B, Esmaeili M. Segmentation of cardiac fats based on Gabor filters and relationship of adipose volume with coronary artery disease using FP-Growth algorithm in CT scans. Biomed Phys Eng Express 2020; 6:055009. [PMID: 33444240 DOI: 10.1088/2057-1976/aba441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Heart mediastinal and epicardial fat tissues are related to several adverse metabolic effects and cardiovascular risk factors, especially coronary artery disease (CAD). The manual segmentation of those fats is that the high dependence on user intervention and time-consuming analyzes. As a result, the automated measurement of cardiac fats could be considered as one of the most important biomarkers for cardiovascular risks in imaging and medical visualization by physicians. In this paper, we validate an automatic approach for the cardiac fat segmentation in non-contrast CT images then investigate the correlation between cardiac fat volume and CAD using the association rule mining algorithm. The pre-processing step includes threshold and contrast enhancement, the feature extraction step includes Gabor filter bank based on GLCM, the cardiac fat segmentation step is predicated on pattern recognition classification algorithms, and eventually, the step of investigating the relationship between cardiac fat volume and CAD is using FP-Growth algorithm. Experimental validation using CT images of two databases points to a good performance in cardiac fat segmentation. Experiments showed that the accuracy of the designed algorithm using the ensemble classifier with the best performance over other classifiers for the cardiac fat segmentation was 99.2%, with a sensitivity of 96.3% and a specificity of 99.8%. The results of using the FP-Growth algorithm showed that the low volume of epicardial (Confidence = 0.6818, Lift = 1.0626) and mediastinal (Confidence = 0.6696, Lift = 1.0436) fat are associated with healthy individuals and the high volume of epicardial (Confidence = 0.8, Lift = 2.2326) and mediastinal (Confidence = 0.75, Lift = 2.093) fat are related to individuals of CAD. As a result, cardiac fats can be used as a reliable biomarker tool in predicting the extent of CAD stenosis.
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Affiliation(s)
- Ali Kazemi
- Department of Biomedical Engineering, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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42
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Si Y, Cui Z, Liu J, Ding Z, Han C, Wang R, Liu T, Sun L. Pericardial adipose tissue is an independent risk factor of coronary artery disease and is associated with risk factors of coronary artery disease. J Int Med Res 2020; 48:300060520926737. [PMID: 32493096 PMCID: PMC7273777 DOI: 10.1177/0300060520926737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective Pericardial adipose tissue volume (PATV) is related to the mechanism of coronary artery disease (CAD), but its association with CAD risk factors is not clear. This study aimed to investigate the relationships between PATV and its associated factors. Methods A total of 682 inpatients were consecutively enrolled in this study. Patients were divided into the high PATV group (PATV ≥174.5 cm3; n = 506) and low PATV group (PATV < 174.5 cm3; n = 176). Multiple linear regression analysis was conducted to evaluate the related factors of PATV. Multivariable logistic regression was used to analyze the risk factors of CAD. Results Left ventricular fat volume, right ventricular fat volume, body mass index, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were significant and independent risk factors of enlargement of PATV. Increased PATV was identified as an independent risk factor of CAD, and increased pulse pressure was also independently and positively correlated with CAD. Conclusions PATV is significantly correlated with the classic risk factors of CAD. Pulse pressure is also correlated with PATV. PATV is an independent risk factor of CAD, and pericardial adipose tissue may alternatively be used in non-invasive diagnostic examination of CAD.
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Affiliation(s)
- Yueqiao Si
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Zhixin Cui
- Department of Radiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Jingyi Liu
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Zhenjiang Ding
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Chao Han
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Ruijuan Wang
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Tong Liu
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
| | - Lixian Sun
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, HeBei, China
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43
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Mechanisms linking adipose tissue inflammation to cardiac hypertrophy and fibrosis. Clin Sci (Lond) 2020; 133:2329-2344. [PMID: 31777927 DOI: 10.1042/cs20190578] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/08/2019] [Accepted: 11/13/2019] [Indexed: 12/13/2022]
Abstract
Adipose tissue is classically recognized as the primary site of lipid storage, but in recent years has garnered appreciation for its broad role as an endocrine organ comprising multiple cell types whose collective secretome, termed as adipokines, is highly interdependent on metabolic homeostasis and inflammatory state. Anatomical location (e.g. visceral, subcutaneous, epicardial etc) and cellular composition of adipose tissue (e.g. white, beige, and brown adipocytes, macrophages etc.) also plays a critical role in determining its response to metabolic state, the resulting secretome, and its potential impact on remote tissues. Compared with other tissues, the heart has an extremely high and constant demand for energy generation, of which most is derived from oxidation of fatty acids. Availability of this fatty acid fuel source is dependent on adipose tissue, but evidence is mounting that adipose tissue plays a much broader role in cardiovascular physiology. In this review, we discuss the impact of the brown, subcutaneous, and visceral white, perivascular (PVAT), and epicardial adipose tissue (EAT) secretome on the development and progression of cardiovascular disease (CVD), with a particular focus on cardiac hypertrophy and fibrosis.
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44
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Argan O, Avci E, Safak O, Yildirim T. Epicardial Adipose Tissue Predicts Severe Mitral Annular Calcification in Patients Aged ≥60 Years. Med Sci Monit 2020; 26:e921553. [PMID: 32388532 PMCID: PMC7238797 DOI: 10.12659/msm.921553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Epicardial adipose tissue (EAT) has been shown to be associated with diabetes mellitus (DM), hypertension (HT), coronary artery calcification, and atherosclerotic disease. Mitral annular calcification (MAC) is also associated with atherosclerosis. The purpose of this study was to assess the relationship between EAT and severe MAC. MATERIAL AND METHODS The study enrolled 102 patients who had severe MAC and 107 patients who did not have MAC, as determined by echocardiographic examination. EAT was measured by transthoracic echocardiography. The parasternal long-axis view was used to measure the maximal EAT thickness. RESULTS Patients with severe MAC were older (p<0.001) and were more likely to be female (p<0.001). Epicardial adipose tissue (p=0.001) and urea (p=0.004) were also higher and eGFR was lower (p<0.001) in patients with severe MAC. EAT (OR: 15.96, CI %: 1.04 - 24.604, p<0.05), female sex, CAD, DM, eGFR, and age were independent predictors of severe MAC. The AUC for the EAT to predict severe MAC was 0.699 (95%, CI: 0.625 - 0.774, p<0.001). CONCLUSIONS Our data suggest that EAT is an independent predictor for the presence of severe MAC. Routine echocardiographic assessment of EAT is a cheap and noninvasive method for evaluating patient cardiovascular risk classification.
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Affiliation(s)
- Onur Argan
- Department of Cardiology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Eyup Avci
- Department of Cardiology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Ozgen Safak
- Department of Cardiology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Tarik Yildirim
- Department of Cardiology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
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45
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Nerlekar N, Thakur U, Lin A, Koh JQS, Potter E, Liu D, Muthalaly RG, Rashid HN, Cameron JD, Dey D, Wong DTL. The Natural history of Epicardial Adipose Tissue Volume and Attenuation: A long-term prospective cohort follow-up study. Sci Rep 2020; 10:7109. [PMID: 32346001 PMCID: PMC7188860 DOI: 10.1038/s41598-020-63135-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 03/04/2020] [Indexed: 12/11/2022] Open
Abstract
Epicardial adipose tissue (EAT) is associated with cardiovascular risk. The longitudinal change in EAT volume (EATv) and density (EATd), and potential modulators of these parameters, has not been described. We prospectively recruited 90 patients with non-obstructive coronary atherosclerosis on baseline computed tomography coronary angiography (CTCA) performed for suspected coronary artery disease to undergo a repeat research CTCA. EATv in millilitres (mL) and EATd in Hounsfield units (HU) were analysed and multivariable regression analysis controlling for traditional cardiovascular risk factors (CVRF) performed to assess for any predictors of change. Secondary analysis was performed based on statin therapy. The median duration between CTCA was 4.3years. Mean EATv increased at follow-up (72 ± 33 mL to 89 ± 43 mL, p < 0.001) and mean EATd decreased (baseline −76 ± 6 HU vs. −86 ± 5 HU, p < 0.001). There were no associations between baseline variables of body mass index, age, sex, hypertension, hyperlipidaemia, diabetes or smoking on change in EATv or EATd. No difference in baseline, follow-up or delta EATv or EATd was seen in patients with (60%) or without baseline statin therapy. In this select group of patients, EATv consistently increased and EATd consistently decreased at long-term follow-up and these changes were independent of CVRF, age and statin use. Together with the knowledge of strong associations between EAT and cardiac disease, these findings may suggest that EAT is an independent parameter rather than a surrogate for cardiovascular risk.
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Affiliation(s)
- Nitesh Nerlekar
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia.
| | - Udit Thakur
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - Andrew Lin
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - Ji Quan Samuel Koh
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - Elizabeth Potter
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - David Liu
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - Rahul G Muthalaly
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - Hashrul N Rashid
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - James D Cameron
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - Damini Dey
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Dennis T L Wong
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
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46
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Yuvaraj J, Lin A, Nerlekar N, Rashid H, Cameron JD, Seneviratne S, Nicholls S, Psaltis PJ, Wong DTL. Is spontaneous coronary artery dissection (SCAD) related to vascular inflammation and epicardial fat? -insights from computed tomography coronary angiography. Cardiovasc Diagn Ther 2020; 10:239-241. [PMID: 32420105 DOI: 10.21037/cdt.2020.01.09] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Jeremy Yuvaraj
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - Andrew Lin
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - Nitesh Nerlekar
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - Hashrul Rashid
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - James D Cameron
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - Sujith Seneviratne
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia
| | - Stephen Nicholls
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia.,South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Peter J Psaltis
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia.,South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Dennis T L Wong
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Clayton, Victoria, Australia.,South Australian Health and Medical Research Institute, Adelaide, Australia
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47
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Argan O, Avci E, Yildirim T, Safak O. Epicardial adipose tissue is a predictor of ascending aortic dilatation in hypertensive patients, but not paracardial adipose tissue. BMC Cardiovasc Disord 2020; 20:142. [PMID: 32192428 PMCID: PMC7082936 DOI: 10.1186/s12872-020-01431-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/12/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Ascending aortic aneurysms are one of the major causes of mortality. In recent years, there is a growing interest of epicardial adipose tissue (EAT) and related diseases. The aim of this study was to investigate the relationship of EAT, and PAT with ascending aortic dilatation (AAD). METHODS We included 934 patients with hypertension in this study. The patients were evaluated by a complete transthoracic echocardiographic examination, including measurements of EAT, PAT, and aortic dimensions. Aortic size index (ASI) was used for diagnosing AAD. The patients were divided into two groups: dilated ascending aorta diameter (ASI ≥ 21 mm / m2, n = 102) or normal aortic diameter (ASI < 21 mm / m2, n = 832) according to the ASI. Characteristics of these patients were compared before and after propensity score matching analysis. RESULTS Patients with AAD were older (72.3 ± 11.6 vs. 61.7 ± 12.7 years, p < 0.001), had more female gender (66% vs. 54%,p = 0.021) than patients with normal ascending aorta (AA). After propensity score matching analysis (77 vs. 77), EAT [OR:1.461, %95CI (1.082-1.974), p = 0.013] was independently associated with AAD in multivariate logistic regression analysis. In ROC curve analysis, EAT > 0.45 cm had 51.9% sensitivity and 62.3% specificity [AUC = 0.617, P = 0.012, 95% CI (0.529-0.707)]. CONCLUSION Based on our findings, increased EAT may be suggested as an independent risk factor for AAD due to local or systemic effects in hypertensive patients.
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Affiliation(s)
- Onur Argan
- Department of Cardiology, Balikesir University Medical Faculty, 10440, Balıkesir, Turkey.
| | - Eyup Avci
- Department of Cardiology, Balikesir University Medical Faculty, 10440, Balıkesir, Turkey
| | - Tarik Yildirim
- Department of Cardiology, Balikesir University Medical Faculty, 10440, Balıkesir, Turkey
| | - Ozgen Safak
- Department of Cardiology, Balikesir University Medical Faculty, 10440, Balıkesir, Turkey
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48
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Kleinaki Z, Agouridis AP, Zafeiri M, Xanthos T, Tsioutis C. Epicardial adipose tissue deposition in patients with diabetes and renal impairment: Analysis of the literature. World J Diabetes 2020; 11:33-41. [PMID: 32064034 PMCID: PMC6969709 DOI: 10.4239/wjd.v11.i2.33] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/11/2019] [Accepted: 12/15/2019] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus (DM) is defined as a chronic disease of disordered metabolism with an ongoing increase in prevalence and incidence rates. Renal disease in patients with diabetes is associated with increased morbidity and premature mortality, particularly attributed to their very high cardiovascular risk. Since this group of patients frequently lacks specific symptomatology prior to the adverse events, a screening tool for the identification of high-risk patients is necessary. The epicardial adipose tissue (EAT) is a biologically active organ having properties similar to visceral adipose tissue and has been associated with metabolic diseases and coronary artery disease. Superior to conventional cardiovascular risk factors and anthropometric measures, including body mass index and waist circumference, the EAT can early predict the development of coronary artery disease. Assessment of EAT can be performed by two-dimensional echocardiography, magnetic resonance imaging or computer tomography. However, its role and significance in patients with DM and nephropathy has not been thoroughly evaluated. The aim of the current editorial is to evaluate all available evidence regarding EAT in patients with DM and renal impairment. Systematic search of the literature revealed that patients with DM and nephropathy have increased EAT measurements, uncontrolled underlying disease, high body mass index and raised cardiovascular risk markers. Acknowledging the practical implications of this test, EAT assessment could serve as a novel and non-invasive biomarker to identify high-risk patients for cardiovascular adverse events.
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Affiliation(s)
- Zoi Kleinaki
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus
| | - Aris P Agouridis
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus
| | - Maria Zafeiri
- Diabetes and Obesity Center, Konstantopouleio Hospital, Athens 14233, Greece
| | - Theodoros Xanthos
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus
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Kropidlowski C, Meier-Schroers M, Kuetting D, Sprinkart A, Schild H, Thomas D, Homsi R. CMR based measurement of aortic stiffness, epicardial fat, left ventricular myocardial strain and fibrosis in hypertensive patients. IJC HEART & VASCULATURE 2020; 27:100477. [PMID: 32099896 PMCID: PMC7026624 DOI: 10.1016/j.ijcha.2020.100477] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/06/2020] [Accepted: 01/24/2020] [Indexed: 12/17/2022]
Abstract
Introduction A combined assessment of different parameters of cardiovascular (CV) risk and prognosis can be supportive and performed with cardiac magnetic resonance (CMR). Aortic stiffness, epicardial fat volume (EFV), left ventricular (LV) strain and fibrosis were evaluated within a single CMR examination and results were related to the presence of hypertension (HTN) and diabetes mellitus (DM). Methods 20 healthy controls (57.2 ± 8.2 years(y); 26.2 ± 3.9 kg/m2), 31 hypertensive patients without DM (59.6 ± 6.7 y; 28.4 ± 4.7 kg/m2) and 12 hypertensive patients with DM (58.8 ± 9.9y; 30.7 ± 6.3 kg/m2) were examined at 1.5Tesla. Aortic stiffness was evaluated by calculation of aortic pulse wave velocity (PWV), EFV by a 3D-Dixon sequence. Longitudinal & circumferential systolic myocardial strain (LS; CS) were analyzed and T1-relaxation times (T1) were determined to detect myocardial fibrosis. Results EFV was highest in hypertensive patients with diabetes (78.4 ± 28.0 ml/m2) followed by only hypertensive patients (64.2 ± 27.3 ml/m2) and lowest in controls (50.3 ± 22.7 ml/m2; p < 0.05). PWV was higher in hypertensive patients with diabetes (9.8 ± 3.3 m/s) compared to only hypertensive patients (8.6 ± 1.7 m/s; p < 0.05) and to controls (8.1 ± 1.9 m/s; p < 0.05). LS&CS were worse in hypertensive patients with diabetes (LS:-20.9 ± 5.1% and CS: -24.4 ± 5.7%) compared to both only hypertensive patients (LS: -24.7 ± 4.6%; CS: -27.1 ± 5.0%; p < 0.05) and to controls (LS: -25.5 ± 3.8; CS: -28.3 ± 4.1%; p < 0.05). Both hypertensive groups with and without DM had higher T1́s (994.0 ± 43.2 ms; 991.6 ± 35.5 ms) than controls (964.6 ± 40.3 ms; p < 0.05). Conclusion CMR revealed increased aortic stiffness and EFV in hypertensive patients, which were even higher in the presence of DM. Also signs of LV myocardial fibrosis and a reduced strain were revealed. These parameters support the assessment of CV risk and prognosis. They can accurately be measured with CMR within a single examination when normally different techniques are needed.
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Affiliation(s)
| | | | - Daniel Kuetting
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Alois Sprinkart
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Hans Schild
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Daniel Thomas
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Rami Homsi
- Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
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50
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Yamaguchi S, Otaki Y, Tamarappoo B, Yoshida J, Ikenaga H, Friedman J, Berman D, Dey D, Shiota T. The association between epicardial adipose tissue thickness around the right ventricular free wall evaluated by transthoracic echocardiography and left atrial appendage function. Int J Cardiovasc Imaging 2020; 36:585-593. [PMID: 31894526 DOI: 10.1007/s10554-019-01748-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 12/13/2019] [Indexed: 12/28/2022]
Abstract
Epicardial adipose tissue (EAT) is associated with the development of atrial fibrillation (AF). EAT thickness identified on transthoracic echocardiography (TTE). The relationship between EAT volume and left atrial appendage (LAA) function is not well-known. We aimed to investigate the associations between EAT thickness and LAA emptying flow velocity and LAA orifice area. This single-center retrospective study enrolled 202 patients who underwent both TTE and transesophageal echocardiography (TEE). EAT thickness was measured on TTE in parasternal long-axis view. We measured LAA orifice areas in 41 patients with 3-dimensional TEE data. Spearman's correlation coefficient was used to determine the relationships between EAT thickness and LAA emptying flow velocity and LAA orifice area. We created a receiver operating characteristic curve for low LAA emptying flow velocity (< 20 cm/s) and determined the best cutoff for EAT thickness according to the maximum Youden index. There was a significant negative correlation between EAT thickness and LAA emptying flow velocity (ρ = - 0.56, P < 0.001) and a significant positive correlation between EAT thickness and LAA orifice area (ρ = 0.38, P = 0.014). The best EAT thickness cutoff value for low LAA emptying flow velocity was > 5.1 mm (c-statistics, 75.7%). A thickened EATT was associated with low LAA emptying flow velocity, which increases the risk of thromboembolic phenomena in the presence of AF.
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Affiliation(s)
- Satoshi Yamaguchi
- Smidt Heart Institute, Cedars-Sinai Medical Center, 8700, Beverly Blvd., Los Angeles, CA, 90048, USA. .,Department of Cardiology, Nakagami Hospital, 610 Noborikawa, Okinawa, 904-2195, Japan.
| | - Yuka Otaki
- Smidt Heart Institute, Cedars-Sinai Medical Center, 8700, Beverly Blvd., Los Angeles, CA, 90048, USA
| | - Balaji Tamarappoo
- Smidt Heart Institute, Cedars-Sinai Medical Center, 8700, Beverly Blvd., Los Angeles, CA, 90048, USA
| | - Jun Yoshida
- Smidt Heart Institute, Cedars-Sinai Medical Center, 8700, Beverly Blvd., Los Angeles, CA, 90048, USA
| | - Hiroki Ikenaga
- Smidt Heart Institute, Cedars-Sinai Medical Center, 8700, Beverly Blvd., Los Angeles, CA, 90048, USA
| | - John Friedman
- Smidt Heart Institute, Cedars-Sinai Medical Center, 8700, Beverly Blvd., Los Angeles, CA, 90048, USA
| | - Daniel Berman
- Smidt Heart Institute, Cedars-Sinai Medical Center, 8700, Beverly Blvd., Los Angeles, CA, 90048, USA
| | - Damini Dey
- Smidt Heart Institute, Cedars-Sinai Medical Center, 8700, Beverly Blvd., Los Angeles, CA, 90048, USA
| | - Takahiro Shiota
- Smidt Heart Institute, Cedars-Sinai Medical Center, 8700, Beverly Blvd., Los Angeles, CA, 90048, USA
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