Subclinical atherosclerosis is associated with Epicardial Fat Thickness and hepatic steatosis in the general population (original) (raw)
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Cardiac Steatosis Associates With Visceral Obesity in Nondiabetic Obese Men
The Journal of Clinical Endocrinology & Metabolism, 2013
Background: Liver fat and visceral adiposity are involved in the development of the metabolic syndrome (MetS). Ectopic fat accumulation within and around the heart has been related to increased risk of heart disease. The aim of this study was to explore components of cardiac steatosis and their relationship to intra-abdominal ectopic fat deposits and cardiometabolic risk factors in nondiabetic obese men. Methods: Myocardial and hepatic triglyceride (TG) contents were measured with 1.5 T magnetic resonance spectroscopy, and visceral adipose (VAT), abdominal subcutaneous tissue (SAT), epicardial and pericardial fat by magnetic resonance imaging in 37 men with the MetS and in 40 men without the MetS. Results: Myocardial and hepatic TG contents, VAT, SAT, epicardial fat volumes, and pericardial fat volumes were higher in men with the MetS compared with subjects without the MetS (P Ͻ .001). All components of cardiac steatosis correlated with SAT, VAT, and hepatic TG content and the correlations seemed to be strongest with VAT. Myocardial TG content, epicardial fat, pericardial fat, VAT, and hepatic TG content correlated with waist circumference, body mass index, highdensity lipoprotein cholesterol TGs, very low-density lipoprotein-1 TGs, and the insulin-resistance homeostasis model assessment index. VAT was a predictor of TGs, high-density lipoprotein cholesterol, and measures of glucose metabolism, whereas age and SAT were determinants of blood pressure parameters. Conclusions: We suggest that visceral obesity is the best predictor of epicardial and pericardial fat in abdominally obese subjects. Myocardial TG content may present a separate entity that is influenced by factors beyond visceral adiposity.
Epicardial Fat and Hepatic Steatosis as Cardiovascular Risk Markers
Revista Argentina de Cardiología, 2020
Epicardial adipose tissue (EAT) is a metabolically active tissue which has raised great interest in the last decade as a cardiovascular risk marker. It is related with the production of proinflammatory cytokines and free fatty acids, the promotion of a state of hypercoagulability and with numerous cardiometabolic risk factors. Between EAT and coronary arteries, there is not only an intimate anatomical association, but also bidirectional physiological aspects of paracrine regulation. In addition, several studies have found a relationship between EAT and endothelial dysfunction, non-obstructive atheromatosis, oxidative stress, atrial fibrillation and diastolic dysfunction. Parallel to these findings, there is a tight association between hepatic steatosis (the most prevalent chronic hepatic disease), coronary atheromatosis and cardiovascular risk. One of the interesting and differential characteristics of hepatic steatosis with respect to coronary artery disease is its dynamic, and to ...
Association of Epicardial, Visceral, and Subcutaneous Fat With Cardiometabolic Diseases
Circulation Journal, 2017
been studied. Increasing evidence indicates a close association between EFV and atherosclerotic coronary artery disease (CAD). 9 However, little is known about the extent to which epicardial fat is related to cardiometabolic disorders compared with visceral and subcutaneous fat. Methods The clinical significance of epicardial, visceral, and subcutaneous fat tissue accumulation was investigated in 374 subjects who underwent cardiac CT. Subjects The present study was a physician-initiated observational study entitled "Correlation between adiponectin, coronary atherosclerosis, and volume of epicardial fat detected by cardiac CT (CACAO)" and a non-company sponsored
Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement
The Lancet Diabetes & Endocrinology, 2019
Findings from epidemiological studies over the past 30 years have shown that visceral adipose tissue, accurately measured by CT or MRI, is an independent risk marker of cardiovascular and metabolic morbidity and mortality. Emerging evidence also suggests that ectopic fat deposition, including hepatic and epicardial fat, might contribute to increased atherosclerosis and cardiometabolic risk. This joint position statement from the International Atherosclerosis Society and the International Chair on Cardiometabolic Risk Working Group on Visceral Obesity summarises the evidence for visceral adiposity and ectopic fat as emerging risk factors for type 2 diabetes, atherosclerosis, and cardiovascular disease, with a focus on practical recommendations for health professionals and future directions for research and clinical practice. We discuss the measurement of visceral and ectopic fat, pathophysiology and contribution to adverse health outcomes, response to treatment, and lessons from a public health programme targeting visceral and ectopic fat. We identify knowledge gaps and note the need to develop simple, clinically applicable tools to be able to monitor changes in visceral and ectopic fat over time. Finally, we recognise the need for public health messaging to focus on visceral and ectopic fat in addition to excess bodyweight to better combat the growing epidemic of obesity worldwide. Measurement of visceral and ectopic fat The development of medical imaging has been a remarkable advance that has revolutionised the study of human
Assosiation of Epicardial and Pericardial Fat Thickness with Coronary Artery Disease
Electronic physician, 2016
Introduction: Visceral adipose tissue is a known important risk factor for coronary artery disease (CAD). While some studies have suggested relationship between epicardial fat thickness (EFT) and CAD, there are no adequate studies for pericardial fat thickness (PFT). The aim of this study was to determine the association of EFT and PFT with CAD. Methods: This cross-sectional study was conducted on patients who were candidates for elective coronary artery angiography, referred to Emam Reza Hospital, Mashhad, Iran during Jan 2014-2016. Demographic and laboratory data were collected. Transthoracic echocardiography was performed to determine average EFT and PFT at the standard parasternal long-axis view at end-systole for 3 cardiac cycles. SCA was performed on the same day. The patients were divided into two groups: CAD (n=59) and non-CAD (n=41) based on presence or absence of epicardial coronary artery stenosis of > 50%. Chi-square, independent T-test, and receiver operating characteristic (ROC) curve were used by SPSS Version 16 for data analysis. Results: One hundred patients (44 women and 56 men) with an average age of 56.4 ± 9.9 years were studied. The two groups were not significantly different in demographic profile and cronary risk factors. While PFT was not significantly different between the two groups, EFT was significantly higher in CAD group (3.0 ± 3.69 vs. 1.2 ± 3.6, p <0.0001). Moreover, with the increase of the affected coronary arteries, EFT increased (p <0.0001). Gensini score had a strong correlation with amount of EFT (r = 0.765, p <0.0001). EFT with a cutoff value of 4.25 mm (sensitivity=79%, specificity=68%) was specified in predicting CAD. Conclusion: EFT measured by echocardiography can be used as an independent marker to predict CAD. More studies are needed to determine the predictive role of PFT for CAD.
Ectopic fat assessment focusing on cardiometabolic and renal risk
Endocrinology and metabolism (Seoul, Korea), 2014
It is well known that people with high levels of body fat are at higher risk for developing diabetes mellitus, kidney disease, and cardiovascular disorders. Since individuals who are slightly overweight, or even individuals of normal weight, can vary in body fat distribution, their metabolic profiles and the degree of association of these profiles with cardiometabolic risk factors may differ. Fat distribution might be more of a predictive factor for cardiorenometabolic risk than obesity itself, which has led researchers to investigate whether ectopic fat accumulation may partially account for the development of cardiorenometabolic disorders. In addition to visceral obesity, fat can accumulate in the liver and muscle, and these intrahepatic and intramuscular lipid stores are associated with insulin resistance and adverse metabolic phenotypes. More recently, pericardial fat, perivascular fat, and perirenal fat were found to be associated with coronary atherosclerosis, cardiovascular d...
Journal of cardiovascular and thoracic research, 2012
EAT is an independent factor in coronary artery disease (CAD). The objective of the current study was to define an echocardiographic cut-off point for EAT and to determine its diagnostic value in predicting the increase in CAD risk. Two hundred patients underwent coronary artery angiography for diagnosis of CAD and transthoracic echocardiography for measurement of EAT on the right ventricle (RV), RV apex and RV outlet tract. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the EAT cut-off points in the three above-mentioned areas for predicting the severity of CAD were measured. The relation between the EAT and CAD risk factors was evaluated as well. EAT was independent from gender, height, hypertension, diabetes, HDL, total cholesterol, ejection fraction, acute coronary syndrome, and the location of the coronary artery stenosis in the coronary artery in all three anatomical areas. EAT on RV and RV apex had a significant relation with ...
Epicardial adipose tissue is an independent predictor of coronary atherosclerotic burden
2011
Introduction: Epicardial adipose tissue (EAT) may play an active role in the development of coronary artery disease (CAD). The aim of this work was to study the relations between EAT, abdominal visceral fat (AVF), and coronary atherosclerotic burden as assessed by multislice computed tomography (MSCT). Population and methods: Two hundred fifteen patients without known CAD referred to 64-SCT during a 6-months period were included. All patients underwent a standardized protocol including quantification of AVF, EAT, coronary artery calcification (CAC), and coronary angiography by MSCT. Results: Two hundred fifteen patients, with mean age of 58 ± 11 years, in which 61% were males, with mean body mass index (BMI) of 28 ± 4 kg/m 2 were included. EAT volume was directly associated with male sex, age, BMI, abdominal circumference, AVF, number of coronary segments with atherosclerotic plaques (p b 0.01 for all), number of segments with significant stenoses, and presence of metabolic syndrome components (p b 0.05). CAC increased by 14.7% per additional 10 ml of EAT volume. Adjusting for age, gender, and AVF changed this increase to 7.5%. After adjusting for all considered confounders, there was still an independent association, with a CAC increase of 3.7% per additional 10 ml of EAT. A significant interaction was found between EAT volume and gender and between EAT volume and obesity: an increase of EAT was associated with an increase of additional 8% of CAC in men, and additional increase of 5% in non-obese individuals (p b 0.001 for both). Conclusion: EAT volume positively relates to coronary atherosclerotic burden, as assessed by CAC; this correlation was shown to be independent of AVF.
Echocardiographic epicardial fat thickness and coronary artery disease
2007
besity is recognized as an important risk factor for the development of all features of metabolic syndrome and atherosclerotic cardiovascular disease. 1-9 An estimation of visceral adipose tissue is important, and several methods are applied as a surrogate for the assessment of body composition and visceral adipose tissue. Epicardial adipose tissue is true visceral fat deposited around the heart, particularly around subepicardial coronary vessels. While little is known about the pathophysiologic and metabolic roles of epicardial fat, it has been implicated in the development of coronary atherosclerosis. 10 Recent reports have shown that epicardial adipose tissue expresses numerous genes for cytokines and proteins associated with atherosclerosis. 11-13 The association between epicardial fat and coronary artery disease has not been studied in clinical settings. Transthoracic echocardiography provides a reliable measurement of epicardial fat thickness. 14 Thus, the present study was designed to assess the association between epi-cardial fat thickness, measured using transthoracic echocardiography, and the severity of coronary artery stenosis. Methods Study Population Two hundred and three consecutive patients, who underwent coronary angiography, were studied. The patients' clinical diagnoses on admission were acute myocardial infarction in 74 patients (36.5%), unstable angina in 106 patients (51.1%) and stable angina in 23 patients (11.3%). We excluded patients who had severe degree of valvular heart disease (3 patients), cardiomyopathy (1 patient) and pericardial effusion (1 patient). Moreover, we excluded those whose transthoracic echocardiographic imaging was inadequate for the measurement of epicardial fat thickness (14 patients). On admission, blood sampling was performed to measure total cholesterol, triglyceride, high-density lipoproteincholesterol, low-density lipoprotein-cholesterol, lipoprotein (a), fibrinogen and high-sensitivity C-reactive protein in overnight fasting state. Height (m) and body weight (kg) were used to calculate body mass index. Coronary Angiography In a fasting state, coronary angiography was performed using the Judkins' method, following the puncture of the femoral artery or via a radial artery approach. The severity of coronary atherosclerotic lesions was evaluated from at