Intra-thoracic fat, cardiometabolic risk factors, and subclinical cardiovascular disease in healthy, recently menopausal women screened for the Kronos Early Estrogen Prevention Study (KEEPS) (original) (raw)
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and visceral abdominal fat with cardiovascular disease burden: the Framingham Heart Study
2015
The aim of this study was to assess whether pericardial fat, intrathoracic fat, and visceral abdominal adipose tissue (VAT) are associated with the prevalence of cardiovascular disease (CVD). Methods and results Participants from the Framingham Heart Study Offspring cohort underwent abdominal and chest multidetector computed tomography to quantify volumes of pericardial fat, intrathoracic fat, and VAT. Relations between each fat depot and CVD were assessed using logistic regression. The analysis of 1267 participants (mean age 60 years, 53.8% women, 9.7% with prevalent CVD) demonstrated that pericardial fat [odds ratio (OR) 1.32, 95% confidence interval (CI) 1.11-1.57; P ¼ 0.002] and VAT (OR 1.35, 95% CI 1.11-1.57; P ¼ 0.003), but not intrathoracic fat (OR 1.14, 95% CI 0.93-1.39; P ¼ 0.22), were significantly associated with prevalent CVD in age-sex-adjusted models and after adjustment for body mass index and waist circumference. After multivariable adjustment, associations were attenuated (P. 0.14). Only pericardial fat was associated with prevalent myocardial infarction after adjusting for conventional measures of adiposity (OR 1.37, 95% CI 1.03-1.82; P ¼ 0.03). Conclusion Pericardial fat and VAT, but not intrathoracic fat, are associated with CVD independent of traditional measures of obesity but not after further adjustment for traditional risk factor. Taken together with our prior work, these findings may support the hypothesis that pericardial fat contributes to coronary atherosclerosis.
Journal of Cardiovascular Computed Tomography, 2019
Background: Cardiac fat is emerging as an important parameter for cardiovascular risk stratification. Accurate and reproducible volumetric measurements can facilitate in the serial assessment of cardiac fat by computed tomography (CT). We assessed the intra-and inter-observer variability of cardiac fat volumetric measurements using a semi-automated CT software. Methods: We used non-contrast coronary calcium CT scans to quantify epicardial and intrathoracic fat volumes. Two expert readers analyzed baseline and follow up CT scans of 45 subjects by using a semi-automated CT software (QFAT 2.0, Cedars Sinai-Medical Center). Correlation and Bland-Altman analysis was performed for both intra-and inter-observer comparisons for each cardiac fat type. Results: The intra-observer correlation coefficients ranged between 0.86 to 0.99 and 0.87 to 0.99 for epicardial (median fat per reader (cm 3) 20.9 to 25.7) and intra-thoracic (median fat per reader
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.
Nutrition, Metabolism and Cardiovascular Diseases, 2016
Background and aims: Abdominal obesity and hepatic steatosis are ectopic fat depots associated with Metabolic Syndrome (MetS). Epicardial Fat Thickness (EFT) is a newly discovered one, increasing with obesity, insulin resistance and MetS. Therefore we studied whether different ectopic fat markers, and EFT in particular, are associated with MetS and markers of subclinical cardiovascular disease. Methods and results: 868 subjects from the PLIC Study were included, EFT, aortic calcifications, carotid Intima-Media Thickness (c-IMT) and echocardiographic parameters were determined by ultrasound; extra-cardiac atherosclerotic lesions were defined in presence of plaques at both carotid and aortic levels. Hepatic steatosis degrees were defined according to a scoring system. Abdominal adiposity was determined using Dual X-ray Absorbimetry (DEXA). Independently from age, women showed higher EFT versus men (4.5 (0.20e9.00) mm vs 4.00 (0.10 e8.00) mm, p Z 0.013); EFT was thicker in post-menopausal women (independently from hormone-replacement therapy). EFT, liver steatosis and abdominal adiposity increased with MetS (p < 0.001). EFT was the only ectopic fat marker associated with cardiac dysfunction (OR Z 1.340 [1.088e1.651 95% C.I., p Z 0.006); liver steatosis and EFT were associated with extra-cardiac plaques (OR Z 2.529 [1.328e4.819] 95% C.I., p < 0.001 and OR Z 1.195 [1.008e1.299] 95% C.I., p Z 0.042; respectively). On top of cardiovascular risk factors, only EFT improved the discrimination of subjects with cardiac dysfunction and atherosclerotic plaques. Conclusions: EFT is associated with left ventricular dysfunction and subclinical atherosclerosis. Our data suggest that EFT may represent an additional tool for the stratification of cardiovascular risk.
Correlation between body fat components and coronary heart disease risk scores
Introduction: Though body fat is well known risk factor for coronary heart disease, it is not known whether components of body fat can be considered equivalent to coronary heart disease prediction scores in predicting future risk of coronary heart disease. Aim: To test correlation between coronary heart disease risk scores and components of body fat. Material and methods: The study subjects were evaluated clinically. Anthropometric data were obtained. Serum fasting lipid profile was tested. Body fat and components were tested by Omron karada scan. Framingham score, PROCAM score and Vascular age were calculated. Correlation between coronary heart disease risk scores with subcutaneous tissue fat, visceral fat, total body fat, WHR and BMI was tested by Pearsons correlation. Results and Data Analysis: Our study included 103 patients. 44.7% study subjects were diabetic. 35% of the male patients were smokers. Framingham Risk score was significantly higher in males (p value 0.0000). BMI, Total body fat percentage, tissue fat and visceral fat levels were not found to correlate with coronary heart disease risk scores. Regression analysis showed visceral fat as the strongest correlate of each of the coronary heart disease risk scores, and WHR was the next most significant independent predictor of these outcomes. Conclusion: WHR, visceral fat are best correlates of coronary heart disease risk scores and can be considered as surrogates of coronary heart disease risk prediction scores in clinical practice.
European Journal of Radiology, 2012
Background: Coronary atherosclerosis has traditionally been proposed to be associated with several cardiovascular risk factors and anthropometric measures. However, clinical data regarding the independent value of visceral adipose tissue in addition to such traditional predictors remains obscure. Materials and methods: We subsequently studied 719 subjects (age: 48.1 ± 8.3 years, 25% females) who underwent multidetector computed tomography (MDCT) for coronary calcium score (CCS) quantification. Baseline demographic data and anthropometric measures were taken with simultaneous body fat composition estimated. Visceral adipose tissue of pericardial and thoracic peri-aortic fat was quantified by MDCT using TeraRecon Aquarius workstation (San Mateo, CA). Traditional cardiovascular risk stratification was calculated by metabolic (NCEP ATP III) and Framingham (FRS) scores and high-sensitivity CRP (Hs-CRP) was taken to represent systemic inflammation. The independent value of visceral adipose tissue to systemic inflammation and CCS was assessed by utilizing multivariable regression analysis. Results: Of all subjects enrolled in this study, the mean values for pericardial and peri-aortic adipose tissue were 74.23 ± 27.51 and 7.23 ± 3.69 ml, respectively. Higher visceral fat quartile groups were associated with graded increase of risks for cardiovascular diseases. Both adipose burdens strongly correlated with anthropometric measures including waist circumference, body weight and body mass index (all p < 0.001). In addition, both visceral amount correlates well with ATP and FRS scores, all lipid profiles and systemic inflammation marker in terms of Hs-CRP (all p < 0.001). After adjustment for baseline variables, both visceral fat were independently related to Hs-CRP levels (all p < 0.05), but only pericardial fat exerted independent role in coronary calcium deposit. Conclusion: Both visceral adipose tissues strongly correlated with systemic inflammation beyond traditional cardiovascular risks and anthropometric measures, though only pericardial fat exerted independent role in coronary calcium deposit. Our data suggested that visceral adipose tissue may thus contribute to systemic inflammation and play an independent role in the pathogenesis of atherosclerosis.