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Duca F, Mascherbauer K, Donà C, Koschutnik M, Binder C, Nitsche C, Halavina K, Beitzke D, Loewe C, Bartko P, Waldmann E, Mascherbauer J, Hengstenberg C, Kammerlander A. Association of epicardial adipose tissue on magnetic resonance imaging with cardiovascular outcomes: Quality over quantity? Obesity (Silver Spring) 2024; 32:1670-1679. [PMID: 39192763 DOI: 10.1002/oby.24105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/14/2024] [Accepted: 06/03/2024] [Indexed: 08/29/2024]
Abstract
OBJECTIVE Epicardial adipose tissue (EAT) quantity is associated with poor cardiovascular outcomes. However, the quality of EAT may be of incremental prognostic value. Cardiac magnetic resonance (CMR) is the gold standard for tissue characterization but has never been applied for EAT quality assessment. We aimed to investigate EAT quality measured on CMR T1 mapping as a predictor of poor outcomes in an all-comer cohort. METHODS We investigated the association of EAT area and EAT T1 times (EAT-T1) with a composite endpoint of nonfatal myocardial infarction, heart failure hospitalization, and all-cause death. RESULTS A total of 966 participants were included (47.2% female; mean age: 58.4 years) in this prospective observational CMR registry. Mean EAT area and EAT-T1 were 7.3 cm2 and 268 ms, respectively. On linear regression, EAT-T1 was not associated with markers of obesity, dyslipidemia, or comorbidities such as diabetes (p > 0.05 for all). During a follow-up of 57.7 months, a total of 280 (29.0%) events occurred. EAT-T1 was independently associated (adjusted hazard ratio per SD: 1.202; 95% CI: 1.022-1.413; p = 0.026) with the composite endpoint when adjusted for established clinical risk. CONCLUSIONS EAT quality (as assessed via CMR T1 times), but not EAT quantity, is independently associated with a composite endpoint of nonfatal myocardial infarction, heart failure hospitalization, and all-cause death.
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Affiliation(s)
- Franz Duca
- Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | | | - Carolina Donà
- Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | | | - Christina Binder
- Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Christian Nitsche
- Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Kseniya Halavina
- Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Dietrich Beitzke
- Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria
| | - Christian Loewe
- Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria
| | - Philipp Bartko
- Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Elisabeth Waldmann
- Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Julia Mascherbauer
- Division of Cardiology, Medical University of Vienna, Vienna, Austria
- Department of Internal Medicine 3, University Hospital, Karl Landsteiner University of Health Sciences, Krems, Austria
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Miller RJH, Slomka PJ. Current status and future directions in artificial intelligence for nuclear cardiology. Expert Rev Cardiovasc Ther 2024; 22:367-378. [PMID: 39001698 DOI: 10.1080/14779072.2024.2380764] [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: 04/29/2024] [Accepted: 07/12/2024] [Indexed: 07/18/2024]
Abstract
INTRODUCTION Myocardial perfusion imaging (MPI) is one of the most commonly ordered cardiac imaging tests. Accurate motion correction, image registration, and reconstruction are critical for high-quality imaging, but this can be technically challenging and has traditionally relied on expert manual processing. With accurate processing, there is a rich variety of clinical, stress, functional, and anatomic data that can be integrated to guide patient management. AREAS COVERED PubMed and Google Scholar were reviewed for articles related to artificial intelligence in nuclear cardiology published between 2020 and 2024. We will outline the prominent roles for artificial intelligence (AI) solutions to provide motion correction, image registration, and reconstruction. We will review the role for AI in extracting anatomic data for hybrid MPI which is otherwise neglected. Lastly, we will discuss AI methods to integrate the wealth of data to improve disease diagnosis or risk stratification. EXPERT OPINION There is growing evidence that AI will transform the performance of MPI by automating and improving on aspects of image acquisition and reconstruction. Physicians and researchers will need to understand the potential strengths of AI in order to benefit from the full clinical utility of MPI.
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Affiliation(s)
- Robert J H Miller
- Departments of Medicine (Division of Artificial Intelligence in Medicine), Biomedical Sciences, and Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Cardiac Sciences, University of Calgary, Calgary, Canada
| | - Piotr J Slomka
- Departments of Medicine (Division of Artificial Intelligence in Medicine), Biomedical Sciences, and Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Ahmed B, Farb MG, Gokce N. Cardiometabolic implications of adipose tissue aging. Obes Rev 2024:e13806. [PMID: 39076025 DOI: 10.1111/obr.13806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 03/14/2024] [Accepted: 07/05/2024] [Indexed: 07/31/2024]
Abstract
Adipose tissue is a large endocrine organ that serves numerous physiological functions. As we age, adipose tissue remodels and can develop functional changes that alters its phenotype, potentially contributing to metabolic and cardiovascular disorders. Aging adipose tissue is characterized by regional redistribution of fat, accumulation of senescent cells, fibrosis, and decline in adipocyte differentiation capacities, which collectively impact adipose tissue function and whole body health. A notable transformation involves increased accumulation of intra-abdominal visceral adipose tissue and ectopic fat around internal organs such as the heart, blood vessels, liver, and kidneys that alter their functions. Other changes associated with aging include alterations in adipokine secretion and changes in adipocyte size and numbers. Aging adipocytes play a role in mediating chronic inflammation, metabolic dysfunction, and insulin resistance. Visceral adipose tissue, which increases in volume with aging, is in particular associated with inflammation, angiogenic dysfunction, and microvascular abnormalities, and mediators released by visceral fat may have adverse consequences systemically in multiple target organs, including the cardiovascular system. Understanding mechanisms underlying adipose tissue aging and its impact on cardiovascular health are important for developing interventions and treatments to promote healthy aging and reduce cardiometabolic disease risk.
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Affiliation(s)
- Bulbul Ahmed
- Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Melissa G Farb
- Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Noyan Gokce
- Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts, USA
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Cho DH, Park SM. Epicardial Adipose Tissue and Heart Failure, Friend or Foe? Diabetes Metab J 2024; 48:373-384. [PMID: 38310880 PMCID: PMC11140396 DOI: 10.4093/dmj.2023.0190] [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: 06/20/2023] [Accepted: 12/11/2023] [Indexed: 02/06/2024] Open
Abstract
Heart failure (HF) management guidelines recommend individualized assessments based on HF phenotypes. Adiposity is a known risk factor for HF. Recently, there has been an increased interest in organ-specific adiposity, specifically the role of the epicardial adipose tissue (EAT), in HF risk. EAT is easily assessable through various imaging modalities and is anatomically and functionally connected to the myocardium. In pathological conditions, EAT secretes inflammatory cytokines, releases excessive fatty acids, and increases mechanical load on the myocardium, resulting in myocardial remodeling. EAT plays a pathophysiological role in characterizing both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). In HFrEF, EAT volume is reduced, reflecting an impaired metabolic reservoir, whereas in HFpEF, the amount of EAT is associated with worse biomarker and hemodynamic profiles, indicating increased EAT activity. Studies have examined the possibility of therapeutically targeting EAT, and recent studies using sodium glucose cotransporter 2 inhibitors have shown potential in reducing EAT volume. However, further research is required to determine the clinical implications of reducing EAT activity in patients with HF.
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Affiliation(s)
- Dong-Hyuk Cho
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Seong-Mi Park
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Cinti F, Leccisotti L, Sorice GP, Capece U, D'Amario D, Lorusso M, Gugliandolo S, Morciano C, Guarneri A, Guzzardi MA, Mezza T, Capotosti A, Indovina L, Ferraro PM, Iozzo P, Crea F, Giordano A, Giaccari A. Dapagliflozin treatment is associated with a reduction of epicardial adipose tissue thickness and epicardial glucose uptake in human type 2 diabetes. Cardiovasc Diabetol 2023; 22:349. [PMID: 38115004 PMCID: PMC10731727 DOI: 10.1186/s12933-023-02091-0] [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: 10/10/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVE We recently demonstrated that treatment with sodium-glucose cotransporter-2 inhibitors (SGLT-2i) leads to an increase in myocardial flow reserve in patients with type 2 diabetes (T2D) with stable coronary artery disease (CAD). The mechanism by which this occurs is, however, unclear. One of the risk factors for cardiovascular disease is inflammation of epicardial adipose tissue (EAT). Since the latter is often increased in type 2 diabetes patients, it could play a role in coronary microvascular dysfunction. It is also well known that SGLT-2i modify adipose tissue metabolism. We aimed to investigate the effects of the SGLT-2i dapagliflozin on metabolism and visceral and subcutaneous adipose tissue thickness in T2D patients with stable coronary artery disease and to verify whether these changes could explain observed changes in myocardial flow. METHODS We performed a single-center, prospective, randomized, double-blind, controlled clinical trial with 14 T2D patients randomized 1:1 to SGLT-2i dapagliflozin (10 mg daily) or placebo. The thickness of visceral (epicardial, mediastinal, perirenal) and subcutaneous adipose tissue and glucose uptake were assessed at baseline and 4 weeks after treatment initiation by 2-deoxy-2-[18F]fluoro-D-glucose Positron Emission Tomography/Computed Tomography during hyperinsulinemic euglycemic clamp. RESULTS The two groups were well-matched for baseline characteristics (age, diabetes duration, HbA1c, BMI, renal and heart function). Dapagliflozin treatment significantly reduced EAT thickness by 19% (p = 0.03). There was a significant 21.6% reduction in EAT glucose uptake during euglycemic hyperinsulinemic clamp in the dapagliflozin group compared with the placebo group (p = 0.014). There were no significant effects on adipose tissue thickness/metabolism in the other depots explored. CONCLUSIONS SGLT-2 inhibition selectively reduces EAT thickness and EAT glucose uptake in T2D patients, suggesting a reduction of EAT inflammation. This could explain the observed increase in myocardial flow reserve, providing new insights into SGLT-2i cardiovascular benefits.
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Affiliation(s)
- Francesca Cinti
- Centro Malattie Endocrine e Metaboliche, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lucia Leccisotti
- UOC di Medicina Nucleare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gian Pio Sorice
- Centro Malattie Endocrine e Metaboliche, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
- Sezione di Medicina Interna, Endocrinologia, Andrologia e Malattie Metaboliche, Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica - (DiMePRe-J), Università Degli Studi di Bari "Aldo Moro", Bari, Italy
| | - Umberto Capece
- Centro Malattie Endocrine e Metaboliche, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Domenico D'Amario
- Dipartimento di Scienze Cardiovascolari, UOC Di Cardiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, and Università Cattolica del Sacro Cuore, Rome, Italy
- Università del Piemonte Orientale , Dipartimento Medicina Translazionale, Novara, Italy
| | - Margherita Lorusso
- UOC di Medicina Nucleare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Shawn Gugliandolo
- Centro Malattie Endocrine e Metaboliche, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cassandra Morciano
- Centro Malattie Endocrine e Metaboliche, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze Cliniche e Sperimentali, Medicina Interna - Università degli Studi di Brescia, Brescia, BS, Italy
| | - Andrea Guarneri
- UOC di Medicina Nucleare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Angela Guzzardi
- Istituto di Fisiologia Clinica, Consiglio Nazionale delle Ricerche (CNR), Pisa, Italy
| | - Teresa Mezza
- Centro Malattie Endocrine e Metaboliche, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
- Pancreas Unit, CEMAD Centro Malattie dell'Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy
| | - Amedeo Capotosti
- UOSD Fisica Medica e Radioprotezione, Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario A. Gemelli IRCCS, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - Luca Indovina
- UOSD Fisica Medica e Radioprotezione, Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario A. Gemelli IRCCS, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - Pietro Manuel Ferraro
- U.O.S. Terapia Conservativa della Malattia Renale Cronica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Patricia Iozzo
- Istituto di Fisiologia Clinica, Consiglio Nazionale delle Ricerche (CNR), Pisa, Italy
| | - Filippo Crea
- Dipartimento di Scienze Cardiovascolari, UOC Di Cardiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Giordano
- UOC di Medicina Nucleare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Andrea Giaccari
- Centro Malattie Endocrine e Metaboliche, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy.
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Kaewmong P, Jongjit P, Boonkasemsanti A, Kittiwattanawong K, Kongtueng P, Matchimakul P, Tangphokhanon W, Pirintr P, Khonmee J, Buddhasiri S, Piboon P, Umsumarng S, Mektrirat R, Nganvongpanit K, Pongkan W. Histological study of seventeen organs from dugong ( Dugong dugon). PeerJ 2023; 11:e15859. [PMID: 37663296 PMCID: PMC10473042 DOI: 10.7717/peerj.15859] [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: 04/27/2023] [Accepted: 07/17/2023] [Indexed: 09/05/2023] Open
Abstract
Background Dugongs are marine mammals with a crescent-shaped tail fluke and a concave trailing margin that belong to the family Dugongidae., They are distributed widely in the warm coastal waters of the Indo-Pacific region. Importantly, the population of dugongs has decreased over the past decades as they have been classified as rare marine mammals. Previous studies have investigated the habitat and genetic diversity of dugongs. However, a comprehensive histological investigation of their tissue has not yet been conducted. This study provides unique insight into the organs of dugongs and compares them with other mammal species. Methods Tissue sections were stained with Harris's hematoxylin and eosin Y. The histological structure of 17 organ tissues obtained from eight systems was included in this study. Tissue sections were obtained from the urinary system (kidney), muscular system (striated skeletal muscle and smooth muscle), cardiovascular system (cardiac muscle (ventricle), coronary artery, and coronary vein), respiratory system (trachea and lung), gastrointestinal system (esophagus, stomach, small intestine, liver, and pancreas), reproductive system (testis), lymphatic system (spleen and thymus), and endocrine system (pancreas). Results While most structures were similar to those of other mammal species, there were some differences in the tissue sections of dugongs when compared with other mammalian species and manatees. These include the kidneys of dugongs, which were non-lobular and had a smooth, elongated exterior resulting in a long medullary crest, whereas the dugong pyloric epithelium did not have overlying stratified squamous cells and was noticably different from the Florida manatee. Discussion Histological information obtained from various organs of the dugong can serve as an essential foundation of basal data for future microanatomical studies. This information can also be used as high-value data in the diagnosis and pathogenesis of sick dugongs or those with an unknown cause of death.
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Affiliation(s)
| | | | | | | | - Piyamat Kongtueng
- Central Laboratory, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
- Research Center for Veterinary Biosciences and Veterinary Public Health, Chiang Mai University, Chiang Mai, Thailand
| | - Pitchaya Matchimakul
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wasan Tangphokhanon
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Prapawadee Pirintr
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jaruwan Khonmee
- Research Center for Veterinary Biosciences and Veterinary Public Health, Chiang Mai University, Chiang Mai, Thailand
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Songphon Buddhasiri
- Research Center for Veterinary Biosciences and Veterinary Public Health, Chiang Mai University, Chiang Mai, Thailand
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Promporn Piboon
- Research Center for Veterinary Biosciences and Veterinary Public Health, Chiang Mai University, Chiang Mai, Thailand
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sonthaya Umsumarng
- Research Center for Veterinary Biosciences and Veterinary Public Health, Chiang Mai University, Chiang Mai, Thailand
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Raktham Mektrirat
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Korakot Nganvongpanit
- Research Center for Veterinary Biosciences and Veterinary Public Health, Chiang Mai University, Chiang Mai, Thailand
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wanpitak Pongkan
- Research Center for Veterinary Biosciences and Veterinary Public Health, Chiang Mai University, Chiang Mai, Thailand
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
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Impact of Dysfunctional Adipose Tissue Depots on the Cardiovascular System. Int J Mol Sci 2022; 23:ijms232214296. [PMID: 36430774 PMCID: PMC9695168 DOI: 10.3390/ijms232214296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
Obesity with its associated complications represents a social, economic and health problem of utmost importance worldwide. Specifically, obese patients carry a significantly higher risk of developing cardiovascular disease compared to nonobese individuals. Multiple molecular mechanisms contribute to the impaired biological activity of the distinct adipose tissue depots in obesity, including secretion of proinflammatory mediators and reactive oxygen species, ultimately leading to an unfavorable impact on the cardiovascular system. This review summarizes data relating to the contribution of the main adipose tissue depots, including both remote (i.e., intra-abdominal, hepatic, skeletal, pancreatic, renal, and mesenteric adipose fat), and cardiac (i.e., the epicardial fat) adipose locations, on the cardiovascular system. Finally, we discuss both pharmacological and non-pharmacological strategies aimed at reducing cardiovascular risk through acting on adipose tissues, with particular attention to the epicardial fat.
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Abstract
It is important to understand how different human organs coordinate and interact with each other. Since obesity and cardiac disease frequently coincide, the crosstalk between adipose tissues and heart has drawn attention. We appreciate that specific peptides/proteins, lipids, nucleic acids, and even organelles shuttle between the adipose tissues and heart. These bioactive components can profoundly affect the metabolism of cells in distal organs, including heart. Importantly, this process can be dysregulated under pathophysiological conditions. This also opens the door to efforts targeting these mediators as potential therapeutic strategies to treat patients who manifest diabetes and cardiovascular disease. Here, we summarize the recent progress toward a better understanding of how the adipose tissues and heart interact with each other.
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Naryzhnaya NV, Koshelskaya OA, Kologrivova IV, Suslova TE, Kharitonova OA, Andreev SL, Gorbunov AS, Kurbatov BK, Boshchenko AA. Production of Reactive Oxygen Species by Epicardial Adipocytes Is Associated with an Increase in Postprandial Glycemia, Postprandial Insulin, and a Decrease in Serum Adiponectin in Patients with Severe Coronary Atherosclerosis. Biomedicines 2022; 10:biomedicines10082054. [PMID: 36009601 PMCID: PMC9405686 DOI: 10.3390/biomedicines10082054] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 12/26/2022] Open
Abstract
Purpose. This work investigates the relations between the production of reactive oxygen species (ROS) by epicardial adipose tissue (EAT) adipocytes and parameters of glucose/insulin metabolism, circulating adipokines levels, and severity of coronary atherosclerosis in patients with coronary artery disease (CAD); establishing significant determinants describing changes in ROS EAT in this category of patients. Material and methods. This study included 19 patients (14 men and 5 women, 53−72 y.o., 6 patients with diabetes mellitus type 2; 5 patients with prediabetes), with CAD, who underwent coronary artery bypass graft surgery. EAT adipocytes were isolated by the enzymatic method from intraoperative explants obtained during coronary artery bypass grafting. The size of EAT adipocytes and ROS level were determined. Results. The production of ROS by EAT adipocytes demonstrated a direct correlation with the level of postprandial glycemia (rs = 0.62, p < 0.05), and an inverse correlation with serum adiponectin (rs = −0.50, p = 0.026), but not with general and abdominal obesity, EAT thickness, and dyslipidemia. Regression analysis demonstrated that the increase in ROS of EAT adipocytes occurs due to the interaction of the following factors: postprandial glycemia (β = 0.95), postprandial insulin (β = 0.24), and reduced serum adiponectin (β = −0.20). EAT adipocytes in patients with diabetes and prediabetes manifested higher ROS production than in patients with normoglycemia. Although there was no correlation between the production of ROS by EAT adipocytes and Gensini score in the total group of patients, higher rates of oxidative stress were observed in EAT adipocytes from patients with a Gensini score greater than median Gensini score values (≥70.55 points, Gr.B), compared to patients with less severe coronary atherosclerosis (<70.55 points, Gr.A). Of note, the frequency of patients with diabetes and prediabetes was higher among the patients with the most severe coronary atherosclerosis (Gr.B) than in the Gr.A. Conclusions. Our data have demonstrated for the first time that systemic impairments of glucose/insulin metabolism and a decrease in serum adiponectin are significant independent determinants of oxidative stress intensity in EAT adipocytes in patients with severe coronary atherosclerosis. The possible input of the interplay between oxidative stress in EAT adipocytes and metabolic disturbances to the severity of coronary atherosclerosis requires further investigation.
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Krishnan A, Sharma H, Yuan D, Trollope AF, Chilton L. The Role of Epicardial Adipose Tissue in the Development of Atrial Fibrillation, Coronary Artery Disease and Chronic Heart Failure in the Context of Obesity and Type 2 Diabetes Mellitus: A Narrative Review. J Cardiovasc Dev Dis 2022; 9:jcdd9070217. [PMID: 35877579 PMCID: PMC9318726 DOI: 10.3390/jcdd9070217] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 12/07/2022] Open
Abstract
Cardiovascular diseases (CVDs) are a significant burden globally and are especially prevalent in obese and/or diabetic populations. Epicardial adipose tissue (EAT) surrounding the heart has been implicated in the development of CVDs as EAT can shift from a protective to a maladaptive phenotype in diseased states. In diabetic and obese patients, an elevated EAT mass both secretes pro-fibrotic/pro-inflammatory adipokines and forms intramyocardial fibrofatty infiltrates. This narrative review considers the proposed pathophysiological roles of EAT in CVDs. Diabetes is associated with a disordered energy utilization in the heart, which promotes intramyocardial fat and structural remodeling. Fibrofatty infiltrates are associated with abnormal cardiomyocyte calcium handling and repolarization, increasing the probability of afterdepolarizations. The inflammatory phenotype also promotes lateralization of connexin (Cx) proteins, undermining unidirectional conduction. These changes are associated with conduction heterogeneity, together creating a substrate for atrial fibrillation (AF). EAT is also strongly implicated in coronary artery disease (CAD); inflammatory adipokines from peri-vascular fat can modulate intra-luminal homeostasis through an “outside-to-inside” mechanism. EAT is also a significant source of sympathetic neurotransmitters, which promote progressive diastolic dysfunction with eventual cardiac failure. Further investigations on the behavior of EAT in diabetic/obese patients with CVD could help elucidate the pathogenesis and uncover potential therapeutic targets.
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Affiliation(s)
- Anirudh Krishnan
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia; (A.K.); (H.S.); (D.Y.)
| | - Harman Sharma
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia; (A.K.); (H.S.); (D.Y.)
| | - Daniel Yuan
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia; (A.K.); (H.S.); (D.Y.)
| | - Alexandra F. Trollope
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia;
| | - Lisa Chilton
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Correspondence:
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Abstract
Interest in epicardial adipose tissue (EAT) is growing rapidly, and research in this area appeals to a broad, multidisciplinary audience. EAT is unique in its anatomy and unobstructed proximity to the heart and has a transcriptome and secretome very different from that of other fat depots. EAT has physiological and pathological properties that vary depending on its location. It can be highly protective for the adjacent myocardium through dynamic brown fat-like thermogenic function and harmful via paracrine or vasocrine secretion of pro-inflammatory and profibrotic cytokines. EAT is a modifiable risk factor that can be assessed with traditional and novel imaging techniques. Coronary and left atrial EAT are involved in the pathogenesis of coronary artery disease and atrial fibrillation, respectively, and it also contributes to the development and progression of heart failure. In addition, EAT might have a role in coronavirus disease 2019 (COVID-19)-related cardiac syndrome. EAT is a reliable potential therapeutic target for drugs with cardiovascular benefits such as glucagon-like peptide 1 receptor agonists and sodium–glucose co-transporter 2 inhibitors. This Review provides a comprehensive and up-to-date overview of the role of EAT in cardiovascular disease and highlights the translational nature of EAT research and its applications in contemporary cardiology. In this Review, Iacobellis provides a comprehensive overview of the role of epicardial adipose tissue (EAT) in cardiovascular disease, including coronary artery disease, heart failure and atrial fibrillation, discusses imaging techniques for EAT assessment and highlights the therapeutic potential of targeting EAT in cardiovascular disease. Epicardial adipose tissue (EAT) has anatomical and functional interactions with the heart owing to the shared circulation and the absence of muscle fascia separating the two organs. EAT can be clinically measured with cardiac imaging techniques that can help to predict and stratify cardiovascular risk. Regional distribution of EAT is important because pericoronary EAT and left atrial EAT differently affect the risk of coronary artery diseases and atrial fibrillation, respectively. EAT has a role in the development of several cardiovascular diseases through complex mechanisms, including gene expression profile, pro-inflammatory and profibrotic proteome, neuromodulation, and glucose and lipid metabolism. EAT could be a potential therapeutic target for novel cardiometabolic medications that modulate adipose tissue such as glucagon-like peptide 1 receptor agonists and sodium–glucose co-transporter 2 inhibitors. EAT might be a reservoir of severe acute respiratory syndrome coronavirus 2 and an amplifier of coronavirus disease 2019 (COVID-19)-related cardiac syndrome.
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Affiliation(s)
- Gianluca Iacobellis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami, Miami, FL, USA.
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Konwerski M, Gąsecka A, Opolski G, Grabowski M, Mazurek T. Role of Epicardial Adipose Tissue in Cardiovascular Diseases: A Review. BIOLOGY 2022; 11:355. [PMID: 35336728 PMCID: PMC8945130 DOI: 10.3390/biology11030355] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 02/01/2023]
Abstract
Cardiovascular diseases (CVDs) are the leading causes of death worldwide. Epicardial adipose tissue (EAT) is defined as a fat depot localized between the myocardial surface and the visceral layer of the pericardium and is a type of visceral fat. EAT is one of the most important risk factors for atherosclerosis and cardiovascular events and a promising new therapeutic target in CVDs. In health conditions, EAT has a protective function, including protection against hypothermia or mechanical stress, providing myocardial energy supply from free fatty acid and release of adiponectin. In patients with obesity, metabolic syndrome, or diabetes mellitus, EAT becomes a deleterious tissue promoting the development of CVDs. Previously, we showed an adverse modulation of gene expression in pericoronary adipose tissue in patients with coronary artery disease (CAD). Here, we summarize the currently available evidence regarding the role of EAT in the development of CVDs, including CAD, heart failure, and atrial fibrillation. Due to the rapid development of the COVID-19 pandemic, we also discuss data regarding the association between EAT and the course of COVID-19. Finally, we present the potential therapeutic possibilities aiming at modifying EAT's function. The development of novel therapies specifically targeting EAT could revolutionize the prognosis in CVDs.
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Affiliation(s)
| | | | | | | | - Tomasz Mazurek
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warszawa, Poland; (M.K.); (A.G.); (G.O.); (M.G.)
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Rami AZA, Hamid AA, Anuar NNM, Aminuddin A, Ugusman A. Exploring the Relationship of Perivascular Adipose Tissue Inflammation and the Development of Vascular Pathologies. Mediators Inflamm 2022; 2022:2734321. [PMID: 35177953 PMCID: PMC8846975 DOI: 10.1155/2022/2734321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/11/2022] [Accepted: 01/21/2022] [Indexed: 12/18/2022] Open
Abstract
Initially thought to only provide mechanical support for the underlying blood vessels, perivascular adipose tissue (PVAT) has now emerged as a regulator of vascular function. A healthy PVAT exerts anticontractile and anti-inflammatory actions on the underlying vasculature via the release of adipocytokines such as adiponectin, nitric oxide, and omentin. However, dysfunctional PVAT produces more proinflammatory adipocytokines such as leptin, resistin, interleukin- (IL-) 6, IL-1β, and tumor necrosis factor-alpha, thus inducing an inflammatory response that contributes to the pathogenesis of vascular diseases. In this review, current knowledge on the role of PVAT inflammation in the development of vascular pathologies such as atherosclerosis and hypertension was discussed.
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Affiliation(s)
- Afifah Zahirah Abd Rami
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Adila A. Hamid
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Nur Najmi Mohamad Anuar
- Center for Toxicology & Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abd Aziz, 50300 Kuala Lumpur, Malaysia
| | - Amilia Aminuddin
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Azizah Ugusman
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, 56000 Kuala Lumpur, Malaysia
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Gruzdeva OV, Dyleva YA, Belik EV, Sinitsky MY, Stasev AN, Kokov AN, Brel NK, Krivkina EO, Bychkova EE, Tarasov RS, Barbarash OL. Relationship between Epicardial and Coronary Adipose Tissue and the Expression of Adiponectin, Leptin, and Interleukin 6 in Patients with Coronary Artery Disease. J Pers Med 2022; 12:jpm12020129. [PMID: 35207618 PMCID: PMC8877574 DOI: 10.3390/jpm12020129] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 12/11/2022] Open
Abstract
Adipose tissue (AT) is an endocrine and paracrine organ that synthesizes biologically active adipocytokines, which affect inflammation, fibrosis, and atherogenesis. Epicardial and perivascular fat depots are of great interest to researchers, owing to their potential effects on the myocardium and blood vessels. The aim of the study was to assess the expression and secretion of adipocytokine genes in the AT of patients with coronary artery disease (CAD) and patients with aortic or mitral valve replacement. This study included 84 patients with CAD and 50 patients with aortic or mitral valve replacement. Adipocytes were isolated from subcutaneous, epicardial (EAT), and perivascular AT (PVAT), and were cultured for 24 h. EAT exhibited the lowest level of adiponectin gene expression and secretion, regardless of nosology, and high expression levels of the leptin gene and interleukin-6 (IL-6). However, EAT adipocytes in patients with CAD were characterized by more pronounced changes in comparison with the group with heart defects. High leptin and IL-6 levels resulted in increased pro-inflammatory activity, as observed in both EAT and PVAT adipocytes, especially in individuals with CAD. Therefore, our results revealed the pathogenetic significance of alterations in the adipokine and cytokine status of adipocytes of EAT and PVAT in patients with CAD.
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Suh SH, Oh TR, Choi HS, Kim CS, Lee J, Oh YK, Jung JY, Lee KB, Oh KH, Ma SK, Bae EH, Kim SW. Association of High Serum Adiponectin Level With Adverse Cardiovascular Outcomes and Progression of Coronary Artery Calcification in Patients With Pre-dialysis Chronic Kidney Disease. Front Cardiovasc Med 2022; 8:789488. [PMID: 35097010 PMCID: PMC8792836 DOI: 10.3389/fcvm.2021.789488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/14/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Serum adiponectin level predicts cardiovascular (CV) outcomes and progression of coronary artery calcification (CAC) in the general population, although the association has not been validated in patients with chronic kidney disease (CKD). In this study, we investigated the association of high serum adiponectin level with the risk of adverse CV outcomes and progression of CAC in patients with pre-dialysis CKD. Methods: A total of 1,127 patients with pre-dialysis CKD from a nationwide prospective cohort of patients with pre-dialysis CKD in Korea were divided into the tertile by serum adiponectin level at the baseline. CV outcome of interest was fatal and non-fatal CV events and all-cause mortality. Progression of CAC was defined as coronary artery calcium score (CACS) change more than 200 during a 4-year follow-up. Results: Cox regression analysis revealed that high serum adiponectin is associated with increased risk of fatal and non-fatal CV events (adjusted hazard ratio 2.799, 95% CI 1.348–5.811). In contrast, high serum adiponectin level was not significantly associated with all-cause mortality (adjusted hazard ratio 0.655, 95% CI 0.203–2.113). Binary logistic regression analysis revealed that high serum adiponectin level is also associated with increased risk of progression of CAC (adjusted odds ratio [OR] 2.078, 95% CI 1.014–4.260). Subgroup analyses demonstrated that the association of high serum adiponectin with increased risk of fatal and non-fatal CV events is not modified by age, gender, history of diabetes, estimated glomerular filtration rate (eGFR), or spot urine albumin-to-creatinine ratio (ACR). Conclusions: High serum adiponectin level is associated with adverse CV outcomes and progression of CAC in patients with pre-dialysis CKD.
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Affiliation(s)
- Sang Heon Suh
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
| | - Tae Ryom Oh
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
| | - Hong Sang Choi
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
| | - Chang Seong Kim
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
| | - Joongyub Lee
- Department of Prevention and Management, School of Medicine, Inha University, Incheon, South Korea
| | - Yun Kyu Oh
- Department of Internal Medicine, Seoul National University, Seoul, South Korea
| | - Ji Yong Jung
- Division of Nephrology, Department of Internal Medicine, Gachon University of Gil Medical Center, Incheon, South Korea
| | - Kyu-Beck Lee
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University, Seoul, South Korea
| | - Seong Kwon Ma
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
| | - Eun Hui Bae
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
- *Correspondence: Eun Hui Bae
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
- Soo Wan Kim
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Gruzdeva OV, Dyleva YA, Belik EV, Sinitsky MY, Kozyrin KA, Barbarash OL. Characteristics of adipocytokine expression by local fat depots of the heart: Relationship with the main risk factors for cardio-vascular diseases. Front Endocrinol (Lausanne) 2022; 13:991902. [PMID: 36157437 PMCID: PMC9493308 DOI: 10.3389/fendo.2022.991902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
In our study we investigated the relationships between adipocytokines in adipose tissue (AT) and cardiovascular disease (CVD) risk factors; (2) Methods: fat tissue biopsies were obtained from 134 patients with stable CAD undergoing coronary artery bypass grafting and 120 patients undergoing aortic or mitral valve replacement. Adipocytes were isolated from subcutaneous (SAT), epicardial (EAT), and perivascular AT (PVAT) samples, and cultured for 24 h, after which gene expression of adipocytokines in the culture medium was determined; (3) Results: men showed reduced ADIPOQ expression in EAT and PVAT, LEP expression in PVAT, and LEPR expression in SAT and PVAT compared to women. Men also exhibited higher SAT and lower PVAT IL6 than women. Meanwhile, dyslipidemia associated with decreased ADIPOQ expression in EAT and PVAT, LEPR in EAT, and IL6 in PVAT. Arterial hypertension (AH) associated with low EAT and PVAT ADIPOQ, and high EAT LEP, SAT, as well as PVAT LEPR, and IL6 in SAT and EAT. ADIPOQ expression decreased with increased AH duration over 20 years against an increased LEP background in ATs. Smoking increased ADIPOQ expression in all ATs and increased LEP in SAT and EAT, however, decreased LEPR in PVAT. Patients 51-59 years old exhibited the highest EAT and PVAT LEP, IL-6, and LEPR expression compared to other age groups; (4) Conclusions: decreased EAT ADIPOQ expression against an increased pro-inflammatory IL6 background may increase atherogenesis and contribute to CAD progression in combination with risk factors including male sex, dyslipidemia, and AH.
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Thoracic Visceral Adipose Tissue Area and Pulmonary Hypertension in Lung Transplant Candidates. The Lung Transplant Body Composition Study. Ann Am Thorac Soc 2021; 17:1393-1400. [PMID: 32530703 DOI: 10.1513/annalsats.202003-247oc] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rationale: Obesity is associated with an increased risk of pulmonary hypertension (PH); however, regional adipose tissue deposition is heterogeneous with distinct cardiovascular phenotypes.Objectives: To determine the association of body mass index (BMI) and thoracic visceral and subcutaneous adipose tissue areas (VAT and SAT, respectively) with PH in patients with advanced lung disease referred for lung transplantation.Methods: We studied patients undergoing evaluation for lung transplantation at three centers from the Lung Transplant Body Composition Study. PH was defined as mean pulmonary artery pressure >20 mm Hg and pulmonary vascular resistance ≥3 Wood units. VAT and SAT were measured on chest computed tomography and normalized to height squared.Results: One hundred thirty-seven (34%) of 399 patients included in our study had PH. Doubling of thoracic VAT was associated with significantly lower pulmonary vascular resistance (β, -0.24; 95% confidence interval [95% CI], -0.46 to -0.02; P = 0.04), higher pulmonary arterial wedge pressure (β, 0.79; 95% CI, 0.32 to 1.26; P = 0.001), and decreased risk of PH (relative risk, 0.86; 95% CI, 0.74 to 0.99; P = 0.04) after multivariate adjustment. Vaspin levels were higher in patients without PH (median, 101.8 vs. 92.0 pg/ml; P < 0.001) but did not mediate the association between VAT and the risk of PH. SAT and BMI were not independently associated with risk of PH.Conclusions: Lower thoracic VAT was associated with a higher risk of PH in patients with advanced lung disease undergoing evaluation for lung transplantation. The role of adipokines in the pulmonary vascular disease remains to be evaluated.
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SADOUNI M, DURAND M, BOLDEANU I, DANIELI C, BODSON-CLERMONT P, MANSOUR S, BARIL JG, TROTTIER B, TREMBLAY C, CHARTRAND-LEFEBVRE C. Association of epicardial fat with noncalcified coronary plaque volume and with low attenuation plaque in people with HIV. AIDS 2021; 35:1575-1584. [PMID: 33831908 PMCID: PMC8286299 DOI: 10.1097/qad.0000000000002911] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES People with HIV are exposed to a higher risk of coronary artery disease (CAD) compared with the general population. Epicardial fat may play a unique role in promoting coronary atherosclerosis. We measured epicardial fat in participants living with HIV and controls and investigated its association with coronary plaque volume and low attenuation plaque, a marker of plaque vulnerability. DESIGN This is a cross-sectional study, nested in the Canadian HIV and Aging Cohort Study, a large prospective cohort actively following participants with HIV and controls. Participants with low/intermediate cardiovascular risk without symptoms/history of CAD were invited to undergo cardiac computed tomography (CT). METHODS Volume of epicardial fat, coronary plaque and low attenuation component of the plaque were measured. Association between epicardial fat, coronary plaque volume and low attenuation component was tested using adjusted regression analysis. RESULTS A total of 169 participants with HIV and 81 controls underwent cardiac CT. Participants with HIV had a greater epicardial fat volume compared with controls (P = 0.019). In participants with HIV, epicardial fat volume was positively associated with duration of nonnucleoside reverse transcriptase inhibitors (NNRTI) (β=2.19, P = 0.004). After adjustment for cardiovascular risk factors, epicardial fat volume was positively associated to noncalcified plaque volume [odds ratio (OR) = 1.09, P = 0.028] and to the low-attenuation plaque component portion (β=0.38, P = 0.026). CONCLUSION The association of epicardial fat volume to noncalcified plaque volume and to low attenuation component plaque may suggest a potential mechanism by which epicardial fat could be a silent driver of CAD in the HIV population.
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Affiliation(s)
- Manel SADOUNI
- Centre hospitalier de l’Université de Montréal (CHUM) Research Center, Montreal, Canada
- Université de Montréal, Montreal, Canada
| | - Madeleine DURAND
- Centre hospitalier de l’Université de Montréal (CHUM) Research Center, Montreal, Canada
- Université de Montréal, Montreal, Canada
- Internal Medicine, CHUM, Montreal, Canada
| | | | | | - Paule BODSON-CLERMONT
- Centre hospitalier de l’Université de Montréal (CHUM) Research Center, Montreal, Canada
| | | | - Jean-Guy BARIL
- Centre hospitalier de l’Université de Montréal (CHUM) Research Center, Montreal, Canada
- Université de Montréal, Montreal, Canada
- Medical Clinic Quartier Latin, Montreal, Canada
| | | | - Cécile TREMBLAY
- Centre hospitalier de l’Université de Montréal (CHUM) Research Center, Montreal, Canada
- Université de Montréal, Montreal, Canada
- Microbiology, CHUM, Montreal, Canada
| | - Carl CHARTRAND-LEFEBVRE
- Centre hospitalier de l’Université de Montréal (CHUM) Research Center, Montreal, Canada
- Université de Montréal, Montreal, Canada
- Radiology, CHUM, Montreal, Canada
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Li X, Ma Z, Zhu YZ. Regional Heterogeneity of Perivascular Adipose Tissue: Morphology, Origin, and Secretome. Front Pharmacol 2021; 12:697720. [PMID: 34239444 PMCID: PMC8259882 DOI: 10.3389/fphar.2021.697720] [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: 04/20/2021] [Accepted: 06/10/2021] [Indexed: 12/11/2022] Open
Abstract
Perivascular adipose tissue (PVAT) is a unique fat depot with local and systemic impacts. PVATs are anatomically, developmentally, and functionally different from classical adipose tissues and they are also different from each other. PVAT adipocytes originate from different progenitors and precursors. They can produce and secrete a wide range of autocrine and paracrine factors, many of which are vasoactive modulators. In the context of obesity-associated low-grade inflammation, these phenotypic and functional differences become more evident. In this review, we focus on the recent findings of PVAT’s heterogeneity by comparing commonly studied adipose tissues around the thoracic aorta (tPVAT), abdominal aorta (aPVAT), and mesenteric artery (mPVAT). Distinct origins and developmental trajectory of PVAT adipocyte potentially contribute to regional heterogeneity. Regional differences also exist in ways how PVAT communicates with its neighboring vasculature by producing specific adipokines, vascular tone regulators, and extracellular vesicles in a given microenvironment. These insights may inspire new therapeutic strategies targeting the PVAT.
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Affiliation(s)
- Xinzhi Li
- School of Pharmacy and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Zhongyuan Ma
- Department of Cardiothoracic Surgery, Zhuhai People's Hospital, Jinan University Medical School, Guangzhou, China
| | - Yi Zhun Zhu
- School of Pharmacy and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
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20
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Ferreira J, Martins R, Monteiro S, Teixeira R, Gonçalves L. Alternative sites of echocardiographic epicardial fat assessment and coronary artery disease. J Ultrasound 2021; 25:177-184. [PMID: 34105055 DOI: 10.1007/s40477-021-00598-4] [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: 01/25/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022] Open
Abstract
AIMS Increasing evidence points towards the use of epicardial fat (EF) as a reliable biomarker of coronary artery disease extent and severity. We aim to assess the different locations of echocardiographic EF thickness measurement and their relation with the presence, extent, and severity of coronary artery disease (CAD) in patients admitted with acute coronary syndromes (ACS). METHODS Prospective cohort study including patients admitted for ACS. EF was assessed by transthoracic echocardiography and compared with coronary angiography findings. Spearmen correlation analysis was used to search for EF correlations. Receiver-operating characteristic curve analysis was performed to assess the predictive value of the different sites of measurement of EF thickness for the presence of CAD. To evaluate other potential variables independently associated with CAD, we performed multivariate analysis employing logistic regression. RESULTS 196 patients were included. Significant CAD was diagnosed in 83.7% of patients. In all views, EF thickness was greater in patients with CAD (p < 0.001). We found a moderate correlation between EF thickness and CAD extent and severity. EF thickness measured at RV basal level showed a good performance in predicting significant CAD in patients with ACS (AUC = 0.885, 95% CI 0.80-0.97, p < 0.001). For a value of mean RV basal region EF thickness ≥ 12.57 mm, sensitivity was 85% and specificity was 80.8%. CONCLUSION In patients admitted with ACS, echocardiographic EF thickness predicted the presence of CAD, as well as its extent and severity. We found EF thickness measured at the RV basal region to be the best predictor of significant CAD.
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Affiliation(s)
- João Ferreira
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Praceta, R. Prof. Mota Pinto, 3004-561, Coimbra, Portugal.
| | - Rui Martins
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Praceta, R. Prof. Mota Pinto, 3004-561, Coimbra, Portugal
| | - Sílvia Monteiro
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Praceta, R. Prof. Mota Pinto, 3004-561, Coimbra, Portugal
| | - Rogério Teixeira
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Praceta, R. Prof. Mota Pinto, 3004-561, Coimbra, Portugal.,Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
| | - Lino Gonçalves
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Praceta, R. Prof. Mota Pinto, 3004-561, Coimbra, Portugal.,Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
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21
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Gui C, Parson J, Meyer GA. Harnessing adipose stem cell diversity in regenerative medicine. APL Bioeng 2021; 5:021501. [PMID: 33834153 PMCID: PMC8018797 DOI: 10.1063/5.0038101] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/26/2021] [Indexed: 12/20/2022] Open
Abstract
Since the first isolation of mesenchymal stem cells from lipoaspirate in the early 2000s, adipose tissue has been a darling of regenerative medicine. It is abundant, easy to access, and contains high concentrations of stem cells (ADSCs) exhibiting multipotency, proregenerative paracrine signaling, and immunomodulation-a winning combination for stem cell-based therapeutics. While basic science, preclinical and clinical findings back up the translational potential of ADSCs, the vast majority of these used cells from a single location-subcutaneous abdominal fat. New data highlight incredible diversity in the adipose morphology and function in different anatomical locations or depots. Even in isolation, ADSCs retain a memory of this diversity, suggesting that the optimal adipose source material for ADSC isolation may be application specific. This review discusses our current understanding of the heterogeneity in the adipose organ, how that heterogeneity translates into depot-specific ADSC characteristics, and how atypical ADSC populations might be harnessed for regenerative medicine applications. While our understanding of the breadth of ADSC heterogeneity is still in its infancy, clear trends are emerging for application-specific sourcing to improve regenerative outcomes.
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Affiliation(s)
- Chang Gui
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri 63110, USA
| | - Jacob Parson
- Program in Physical Therapy, Washington University in St. Louis, St. Louis, Missouri 63110, USA
| | - Gretchen A. Meyer
- Author to whom correspondence should be addressed:. Tel.: (314) 286-1425. Fax: (314) 747-0674
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22
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Iacobellis G. Aging Effects on Epicardial Adipose Tissue. FRONTIERS IN AGING 2021; 2:666260. [PMID: 35822028 PMCID: PMC9261330 DOI: 10.3389/fragi.2021.666260] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/28/2021] [Indexed: 01/01/2023]
Abstract
Epicardial fat is the visceral fat of the heart. Epicardial fat is a white adipose tissue, but it displays also brown-fat like or beige fat features. Under physiological conditions, epicardial fat has cardioprotective functions such as free fatty acids supply and thermoregulation of the adjacent myocardium. Epicardial adipose tissue encounters changes in the transition from embryological to childhood and then to adult life. Aging can affect the function and morphology of epicardial fat, more likely in women than in men. The effect of aging on the brown fat properties of the epicardial fat is the most prominent and with the greatest clinical implications. It is promising to know that epicardial fat responds to newer pharmaceutical drugs modulating the adipose tissue and potentially restoring its browning effects. Epicardial fat pro-inflammatory secretome is down-regulated in end-stage coronary artery disease. Chronic ischemia and adverse hemodynamic conditions can also affect the regulatory component of the epicardial fat. Epicardial fat may incur in apoptotic and fibrotic changes that alter its transcriptome and proteasome. In conclusion, aging and advanced stage of chronic diseases are likely to influence and affect epicardial fat genes and function. Whether the downregulation of the epicardial fat tissue is due more to aging than advancing stages of coronary artery disease, or more likely to the combination of both, would be object of future investigations.
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Galangin Resolves Cardiometabolic Disorders through Modulation of AdipoR1, COX-2, and NF-κB Expression in Rats Fed a High-Fat Diet. Antioxidants (Basel) 2021; 10:antiox10050769. [PMID: 34066039 PMCID: PMC8150752 DOI: 10.3390/antiox10050769] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/11/2021] [Accepted: 05/11/2021] [Indexed: 12/11/2022] Open
Abstract
Galangin is a natural flavonoid. In this study, we evaluated whether galangin could alleviate signs of metabolic syndrome (MS) and cardiac abnormalities in rats receiving a high-fat (HF) diet. Male Sprague–Dawley rats were given an HF diet plus 15% fructose for four months, and they were fed with galangin (25 or 50 mg/kg), metformin (100 mg/kg), or a vehicle for the last four weeks. The MS rats exhibited signs of MS, hypertrophy of adipocytes, impaired liver function, and cardiac dysfunction and remodeling. These abnormalities were alleviated by galangin (p < 0.05). Interleukin-6 and tumor necrosis factor-α concentrations and expression were high in the plasma and cardiac tissue in the MS rats, and these markers were suppressed by galangin (p < 0.05). These treatments also alleviated the low levels of adiponectin and oxidative stress induced by an HF diet in rats. The downregulation of adiponectin receptor 1 (AdipoR1) and cyclooxygenase-2 (COX-2) and the upregulation of nuclear factor kappa B (NF-κB) expression were recovered in the galangin-treated groups. Metformin produced similar effects to galangin. In conclusion, galangin reduced cardiometabolic disorders in MS rats. These effects might be linked to the suppression of inflammation and oxidative stress and the restoration of AdipoR1, COX-2, and NF-κB expression.
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Frohlich J, Chaldakov GN, Vinciguerra M. Cardio- and Neurometabolic Adipobiology: Consequences and Implications for Therapy. Int J Mol Sci 2021; 22:ijms22084137. [PMID: 33923652 PMCID: PMC8072708 DOI: 10.3390/ijms22084137] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 12/12/2022] Open
Abstract
Studies over the past 30 years have revealed that adipose tissue is the major endocrine and paracrine organ of the human body. Arguably, adiopobiology has taken its reasonable place in studying obesity and related cardiometabolic diseases (CMDs), including Alzheimer's disease (AD), which is viewed herein as a neurometabolic disorder. The pathogenesis and therapy of these diseases are multiplex at basic, clinical and translational levels. Our present goal is to describe new developments in cardiometabolic and neurometabolic adipobiology. Accordingly, we focus on adipose- and/or skeletal muscle-derived signaling proteins (adipsin, adiponectin, nerve growth factor, brain-derived neuroptrophic factor, neurotrophin-3, irisin, sirtuins, Klotho, neprilysin, follistatin-like protein-1, meteorin-like (metrnl), as well as growth differentiation factor 11) as examples of metabotrophic factors (MTFs) implicated in the pathogenesis and therapy of obesity and related CMDs. We argue that these pathologies are MTF-deficient diseases. In 1993 the "vascular hypothesis of AD" was published and in the present review we propose the "vasculometabolic hypothesis of AD." We discuss how MTFs could bridge CMDs and neurodegenerative diseases, such as AD. Greater insights on how to manage the MTF network would provide benefits to the quality of human life.
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Affiliation(s)
- Jan Frohlich
- International Clinical Research Center, St. Anne’s University Hospital, 656 91 Brno, Czech Republic;
| | - George N. Chaldakov
- Department of Anatomy and Cell Biology and Research Institute of the Medical University, 9002 Varna, Bulgaria;
- Department of Translational Stem Cell Biology, Research Institute of the Medical University, 9002 Varna, Bulgaria
| | - Manlio Vinciguerra
- International Clinical Research Center, St. Anne’s University Hospital, 656 91 Brno, Czech Republic;
- Department of Translational Stem Cell Biology, Research Institute of the Medical University, 9002 Varna, Bulgaria
- Correspondence: or
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Shan D, Dou G, Yang J, Wang X, Wang J, Zhang W, He B, Liu Y, Chen Y, Li Y. Epicardial Adipose Tissue Volume Is Associated with High Risk Plaque Profiles in Suspect CAD Patients. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6663948. [PMID: 33953836 PMCID: PMC8057896 DOI: 10.1155/2021/6663948] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/14/2021] [Accepted: 04/02/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To explore the association between EAT volume and plaque precise composition and high risk plaque detected by coronary computed tomography angiography (CCTA). METHODS 101 patients with suspected coronary artery disease (CAD) underwent CCTA examination from March to July 2019 were enrolled, including 70 cases acute coronary syndrome (ACS) and 31 cases stable angina pectoris (SAP). Based on CCTA image, atherosclerotic plaque precise compositions were analyzed using dedicated quantitative software. High risk plaque was defined as plaque with more than 2 high risk features (spotty calcium, positive remolding, low attenuation plaque, napkin-ring sign) on CCTA image. The association between EAT volume and plaque composition was assessed as well as the different of correlation between ACS and SAP was analyzed. Multivariable logistic regression analysis was used to explore whether EAT volume was independent risk factors of high risk plaque (HRP). RESULTS EAT volume in the ACS group was significantly higher than that of the SAP group (143.7 ± 49.8 cm3 vs. 123.3 ± 39.2 cm3, P = 0.046). EAT volume demonstrated a significant positive correlation with total plaque burden (r = 0.298, P = 0.003), noncalcified plaque burden (r = 0.245, P = 0.013), lipid plaque burden (r = 0.250, P = 0.012), and homocysteine (r = 0.413, P ≤ 0.001). In ACS, EAT volume was positively correlated with total plaque burden (r = 0.309, P = 0.009), noncalcified plaque burden (r = 0.242, P = 0.044), and lipid plaque burden (r = 0.240, P = 0.045); however, no correlation was observed in SAP. Patients with HRP have larger EAT volume than those without HRP (169 ± 6.2 cm3 vs. 130.6 ± 5.3 cm3, P = 0.002). After adjustment by traditional risk factors and coronary artery calcium score (CACS), EAT volume was an independent risk predictor of presence of HRP (OR: 1.018 (95% CI: 1.006-1.030), P = 0.004). CONCLUSIONS With the increasing EAT volume, more dangerous plaque composition burdens increase significantly. EAT volume is a risk predictor of HRP independent of convention cardiovascular risk factors and CACS, which supports the potential impact of EAT on progression of coronary atherosclerotic plaque.
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Affiliation(s)
- Dongkai Shan
- Department of Cardiovascular Medicine, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Guanhua Dou
- Department of Cardiology, Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Junjie Yang
- Department of Cardiovascular Medicine, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xi Wang
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jingjing Wang
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wei Zhang
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bai He
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yuqi Liu
- Department of Cardiovascular Medicine, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yundai Chen
- Department of Cardiovascular Medicine, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yang Li
- Department of Cardiovascular Medicine, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
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A new approach to cardiac fat volume assessment and the correlation with coronary artery calcification. ACTA ACUST UNITED AC 2021; 58:81-91. [PMID: 32097122 DOI: 10.2478/rjim-2020-0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Coronary artery disease (CAD) is the foremost cause of death in the most developed societies. Plaque formation in epicardial coronary arteries and ensuing inflammation are a known pathophysiologic factor of CAD. OBJECTIVES We aimed to separately and simultaneously evaluate the correlation between pericardial fat pad volume and overall peri-coronary epicardial adipose tissue (EAT) thickness with coronary calcium score (CCS) to improve risk stratification of CAD. METHODS We retrospectively reviewed patients who underwent a non-invasive contrast-enhanced coronary multidetector CT (MDCT) angiography. Peri-coronary EAT thickness, pericardial fat pad volume and CCS were obtained by an expert radiologist from the patients coronary multidetector CT (MDCT) angiography. RESULTS We included 141 symptomatic patients (86 men, 55 women) with an average age of 53.53 ± 12.92. An increment of overall peri-coronary EAT thickness (1/3 × (left anterior descending artery (LAD) + left circumflex artery (LCx) + right coronary artery (RCA)) was associated with a 49% increase in the odds for the presence of coronary artery calcification (CAC) (P = 0.004). Significant predictability of peri-coronary EAT-average was seen in diagnosing calcified plaque. Pericardial fat pad volume was positively correlated with overall peri-coronary EAT thickness in age and body mass index (BMI)-adjusted linear regression models, (P < 0.001). CONCLUSION Our results amplify previous idea that peri-coronary EAT and pericardial fat pad volume might act as useful markers and better indicators of CCS based on Agatston score in comparison with BMI or body weight in order to reveal subsequent CADs.
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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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Suzuki T, Ogita H, Sato A, Minamidate N, Hachiro K. Differences Between Patients with and without Atherosclerosis in Expression Levels of Inflammatory Mediators in the Adipose Tissue Around the Coronary Artery. Int Heart J 2021; 62:390-395. [PMID: 33731531 DOI: 10.1536/ihj.20-585] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Perivascular adipose tissue (PVAT) secretes large amounts of inflammatory mediators and plays a certain role in atherosclerosis formation from the exterior of the vessel. In the present study, we examined the expression level of inflammation-related mediators using adipose tissue samples harvested from patients with and without coronary artery disease (CAD). The subjects were 23 patients who underwent elective coronary bypass surgery (CAD group) and 17 patients who underwent elective mitral valve surgery (non-CAD group) between January 2017 and March 2018. The adipose tissue was harvested from three sites: the ascending aorta (AO), subcutaneous fat (SC), and pericoronary artery (CO) for the measurement of the expression levels of interleukin (IL) -1β, IL-6, IL-10, tumor necrosis factor (TNF) -α, interferon (INF) -γ, and arginase (Arg) -1. In both the non-CAD and CAD groups, the expression levels of all mediators, except Agr-1, which showed a tendency to have higher levels in the SC than in the AO and CO, tended to upregulate in the AO than in the SC and CO. The CAD group had higher values of almost all mediators, except Arg-1. Most importantly, the expression levels of IL-1β, IL-6, and IL-10 in the coronary artery were significantly higher in the CAD group. The expression levels of inflammatory mediators in the pericoronary adipose tissue were significantly higher in the CAD than in the non-CAD group. The adipose tissue appears to influence atherosclerosis formation from the exterior of the coronary artery.
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Affiliation(s)
- Tomoaki Suzuki
- Division of Cardiovascular Surgery, Shiga University of Medical Science
| | - Hisakazu Ogita
- Division of Molecular Medical Biochemistry, Department of Biochemistry and Molecular Biology, Shiga University of Medical Science
| | - Akira Sato
- Division of Molecular Medical Biochemistry, Department of Biochemistry and Molecular Biology, Shiga University of Medical Science
| | - Naoshi Minamidate
- Division of Cardiovascular Surgery, Shiga University of Medical Science
| | - Kohei Hachiro
- Division of Cardiovascular Surgery, Shiga University of Medical Science
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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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Mazzotta C, Basu S, Gower AC, Karki S, Farb MG, Sroczynski E, Zizza E, Sarhan A, Pande AN, Walsh K, Dobrilovic N, Gokce N. Perivascular Adipose Tissue Inflammation in Ischemic Heart Disease. Arterioscler Thromb Vasc Biol 2021; 41:1239-1250. [PMID: 33504180 DOI: 10.1161/atvbaha.120.315865] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE There is growing recognition that adipose tissue-derived proatherogenic mediators contribute to obesity-related cardiovascular disease. We sought to characterize regional differences in perivascular adipose tissue (PVAT) phenotype in relation to atherosclerosis susceptibility. Approach and Results: We examined thoracic PVAT samples in 34 subjects (body mass index 32±6 kg/m2, age 59±11 years) undergoing valvular, aortic, or coronary artery bypass graft surgeries and performed transcriptomic characterization using whole-genome expression profiling and quantitative polymerase chain reaction analyses. We identified a highly inflamed region of PVAT surrounding the human aortic root in close proximity to coronary takeoff and adjoining epicardial fat. In subjects undergoing coronary artery bypass graft, we found 300 genes significantly upregulated (false discovery rate Q<0.1) in paired samples of PVAT surrounding the aortic root compared with nonatherosclerotic left internal mammary artery. Genes encoding proteins mechanistically implicated in atherogenesis were enriched in aortic PVAT consisting of signaling pathways linked to inflammation, WNT (wingless-related integration site) signaling, matrix remodeling, coagulation, and angiogenesis. Overexpression of several proatherogenic transcripts, including IL1β, CCL2 (MCP-1), and IL6, were confirmed by quantitative polymerase chain reaction and significantly bolstered in coronary artery disease subjects. Angiographic coronary artery disease burden quantified by the Gensini score positively correlated with the expression of inflammatory genes in PVAT. Moreover, periaortic adipose inflammation was markedly higher in obese subjects with striking upregulation (≈8-fold) of IL1β expression compared to nonobese individuals. CONCLUSIONS Proatherogenic mediators that originate from dysfunctional PVAT may contribute to vascular disease mechanisms in human vessels. Moreover, PVAT may adopt detrimental properties under obese conditions that play a key role in the pathophysiology of ischemic heart disease. Graphic Abstract: A graphic abstract is available for this article.
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Affiliation(s)
- Celestina Mazzotta
- Evans Department of Medicine and Whitaker Cardiovascular Institute (C.M., S.B., S.K., M.G.F., E.S., E.Z., A.S., A.N.P., N.G.), Boston University School of Medicine, MA
| | - Sanchita Basu
- Evans Department of Medicine and Whitaker Cardiovascular Institute (C.M., S.B., S.K., M.G.F., E.S., E.Z., A.S., A.N.P., N.G.), Boston University School of Medicine, MA
| | - Adam C Gower
- Clinical and Translational Science Institute (A.C.G.), Boston University School of Medicine, MA
| | | | - Melissa G Farb
- Evans Department of Medicine and Whitaker Cardiovascular Institute (C.M., S.B., S.K., M.G.F., E.S., E.Z., A.S., A.N.P., N.G.), Boston University School of Medicine, MA
| | - Emily Sroczynski
- Evans Department of Medicine and Whitaker Cardiovascular Institute (C.M., S.B., S.K., M.G.F., E.S., E.Z., A.S., A.N.P., N.G.), Boston University School of Medicine, MA
| | - Elaina Zizza
- Evans Department of Medicine and Whitaker Cardiovascular Institute (C.M., S.B., S.K., M.G.F., E.S., E.Z., A.S., A.N.P., N.G.), Boston University School of Medicine, MA
| | - Anas Sarhan
- Evans Department of Medicine and Whitaker Cardiovascular Institute (C.M., S.B., S.K., M.G.F., E.S., E.Z., A.S., A.N.P., N.G.), Boston University School of Medicine, MA
| | - Ashvin N Pande
- Evans Department of Medicine and Whitaker Cardiovascular Institute (C.M., S.B., S.K., M.G.F., E.S., E.Z., A.S., A.N.P., N.G.), Boston University School of Medicine, MA
| | - Kenneth Walsh
- Hematovascular Biology Center and the Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville (K.W.)
| | - Nikola Dobrilovic
- Division of Cardiac Surgery, Department of Surgery, Boston Medical Center, MA (N.D.)
| | - Noyan Gokce
- Evans Department of Medicine and Whitaker Cardiovascular Institute (C.M., S.B., S.K., M.G.F., E.S., E.Z., A.S., A.N.P., N.G.), Boston University School of Medicine, MA
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Chen Y, Qin Z, Wang Y, Li X, Zheng Y, Liu Y. Role of Inflammation in Vascular Disease-Related Perivascular Adipose Tissue Dysfunction. Front Endocrinol (Lausanne) 2021; 12:710842. [PMID: 34456867 PMCID: PMC8385491 DOI: 10.3389/fendo.2021.710842] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/21/2021] [Indexed: 12/12/2022] Open
Abstract
Perivascular adipose tissue (PVAT) is the connective tissue around most blood vessels throughout the body. It provides mechanical support and maintains vascular homeostasis in a paracrine/endocrine manner. Under physiological conditions, PVAT has anti-inflammatory effects, improves free fatty acid metabolism, and regulates vasodilation. In pathological conditions, PVAT is dysfunctional, secretes many anti-vasodilator factors, and participates in vascular inflammation through various cells and mediators; thus, it causes dysfunction involving vascular smooth muscle cells and endothelial cells. Inflammation is an important pathophysiological event in many vascular diseases, such as vascular aging, atherosclerosis, and hypertension. Therefore, the pro-inflammatory crosstalk between PVAT and blood vessels may comprise a novel therapeutic target for the prevention and treatment of vascular diseases. In this review, we summarize findings concerning PVAT function and inflammation in different pathophysiological backgrounds, focusing on the secretory functions of PVAT and the crosstalk between PVAT and vascular inflammation in terms of vascular aging, atherosclerosis, hypertension, diabetes mellitus, and other diseases. We also discuss anti-inflammatory treatment for potential vascular diseases involving PVAT.
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Affiliation(s)
- Yaozhi Chen
- Center for Cardiovascular Medicine, First Hospital of Jilin University, Changchun, China
| | - Zeyu Qin
- Department of Respiratory Medicine, First Hospital of Jilin University, Changchun, China
| | - Yaqiong Wang
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, China
| | - Xin Li
- Center for Cardiovascular Medicine, First Hospital of Jilin University, Changchun, China
| | - Yang Zheng
- Center for Cardiovascular Medicine, First Hospital of Jilin University, Changchun, China
- *Correspondence: Yunxia Liu, ; Yang Zheng,
| | - Yunxia Liu
- Center for Cardiovascular Medicine, First Hospital of Jilin University, Changchun, China
- *Correspondence: Yunxia Liu, ; Yang Zheng,
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Khanahmadi M, Manafi B, Tayebinia H, Karimi J, Khodadadi I. Downregulation of Sirt1 is correlated to upregulation of p53 and increased apoptosis in epicardial adipose tissue of patients with coronary artery disease. EXCLI JOURNAL 2020; 19:1387-1398. [PMID: 33250679 PMCID: PMC7689241 DOI: 10.17179/excli2020-2423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 10/01/2020] [Indexed: 12/31/2022]
Abstract
The higher expression level of p53 in epithelial adipose tissue (EAT) has previously been reported in atherosclerosis. Since we hypothesized that the expression of p53 is modulated by Sirt1, the aim of this study was to determine the expression levels of Sirt1 and p53 and to investigate their correlation to apoptosis in EAT of patients with coronary artery disease (CAD). Thirty-five patients with more than 50 % stenosis in at least one of the main coronary arteries were considered as CAD group while 29 patients with no clinical signs of atherosclerosis who underwent open-heart surgery for valve replacement were classified as control group. EAT biopsy samples were collected from all participants during surgery. Sirt1, p53, Bax, and Bcl-2 gene expression levels were determined in EAT by qRT-PCR and Western blotting was carried out to assess Sirt1 and p53 protein levels. Hematoxylin and eosin staining was used for histopathological analysis. mRNA and protein levels of Sirt1 in EAT were significantly lower in patients with CAD compared with control group, whereas CAD patients showed greater p53 gene and protein expressions. In addition, inverse correlations were observed between Sirt1 and p53 at both mRNA and protein levels. The Bax and ratio of Bax/Bcl-2 gene expressions were higher in CAD group, but no difference was observed in Bcl-2 expression. Histopathological analysis showed apoptotic bodies and infiltrated immune cells in EAT of CAD group. Our results suggest that the Sirt1-p53 axis may involve in atherosclerosis by promotion of apoptosis.
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Affiliation(s)
- Mahdieh Khanahmadi
- Department of Clinical Biochemistry, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Babak Manafi
- Department of Surgery, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Heidar Tayebinia
- Department of Clinical Biochemistry, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jamshid Karimi
- Department of Clinical Biochemistry, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Iraj Khodadadi
- Department of Clinical Biochemistry, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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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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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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Potential role of perivascular adipose tissue in modulating atherosclerosis. Clin Sci (Lond) 2020; 134:3-13. [PMID: 31898749 PMCID: PMC6944729 DOI: 10.1042/cs20190577] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/16/2019] [Accepted: 12/23/2019] [Indexed: 02/06/2023]
Abstract
Perivascular adipose tissue (PVAT) directly juxtaposes the vascular adventitia and contains a distinct mixture of mature adipocytes, preadipocytes, stem cells, and inflammatory cells that communicate via adipocytokines and other signaling mediators with the nearby vessel wall to regulate vascular function. Cross-talk between perivascular adipocytes and the cells in the blood vessel wall is vital for normal vascular function and becomes perturbed in diseases such as atherosclerosis. Perivascular adipocytes surrounding coronary arteries may be primed to promote inflammation and angiogenesis, and PVAT phenotypic changes occurring in the setting of obesity, hyperlipidemia etc., are fundamentally important in determining a pathogenic versus protective role of PVAT in vascular disease. Recent discoveries have advanced our understanding of the role of perivascular adipocytes in modulating vascular function. However, their impact on cardiovascular disease (CVD), particularly in humans, is yet to be fully elucidated. This review will highlight the complex mechanisms whereby PVAT regulates atherosclerosis, with an emphasis on clinical implications of PVAT and emerging strategies for evaluation and treatment of CVD based on PVAT biology.
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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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Pobozheva IA, Razgildina ND, Polyakova EA, Panteleeva AA, Belyaeva OD, Nifontov SE, Galkina OV, Kolodina DA, Berkovich OA, Baranova EI, Pchelina SN, Miroshnikova VV. [Epicardial and subcutenious adipose tissue adiponectin gene expression in coronary artery disease patients]. KARDIOLOGIYA 2020; 60:62-69. [PMID: 32394859 DOI: 10.18087/cardio.2020.4.n517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 11/01/2019] [Accepted: 01/23/2020] [Indexed: 11/18/2022]
Abstract
Aim To determine the expression of adiponectin gene (ADIPOQ) and the content of high-molecular-weight adiponectin (HMWA) in epicardial (EAT) and subcutaneous adipose tissue (SCAT) in patients with ischemic heart disease (IHD).Material and methods Paired samples of EAT and SCAT and blood serum were withdrawn from patients with IHD after bypass surgery and 16 subjects without IHD (comparison group). Matrix RNA (mRNA) level was measured using real-time polymerase chain reaction. HMWA levels in EAT and SCAT were evaluated by Western blotting. Serum adiponectin concentration was measured immunoenzymatically. For all patients, echocardiography was performed to measure the EAT thickness; coronarography was performed to determine severity of coronary atherosclerosis.Results Serum adiponectin concentration was lower in IHD patients than in the comparison group (p<0.001). Levels of ADIPOO gene mRNA and HMWA in SCAT were lower in IHD patients than in the comparison group (р=0.020 and p=0.003, respectively). The HMWA level in EAT was lower with the EAT thickness of 8 mm compared to the HMWA level in IHD patients with EAT ≤8 mm (p=0.034).Conclusion The decreased serum concentration of antiatherogenic adiponectin and the reduced expression of ADIPOQ gene in SCAT (mRNA, HMWA) are associated with IHD.
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Affiliation(s)
- I A Pobozheva
- NRC «Kurchatov Institute» - PNPI Acad. I.P. Pavlov First St.-Petersburg State Medical University
| | | | - E A Polyakova
- Acad. I.P. Pavlov First St.-Petersburg State Medical University
| | - A A Panteleeva
- NRC «Kurchatov Institute» - PNPI Acad. I.P. Pavlov First St.-Petersburg State Medical University
| | - O D Belyaeva
- Acad. I.P. Pavlov First St.-Petersburg State Medical University
| | - S E Nifontov
- Acad. I.P. Pavlov First St.-Petersburg State Medical University
| | - O V Galkina
- Acad. I.P. Pavlov First St.-Petersburg State Medical University
| | - D A Kolodina
- Acad. I.P. Pavlov First St.-Petersburg State Medical University
| | - O A Berkovich
- Acad. I.P. Pavlov First St.-Petersburg State Medical University
| | - E I Baranova
- Acad. I.P. Pavlov First St.-Petersburg State Medical University
| | - S N Pchelina
- NRC «Kurchatov Institute» - PNPI Acad. I.P. Pavlov First St.-Petersburg State Medical University
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Ragino YI, Stakhneva EM, Polonskaya YV, Kashtanova EV. The Role of Secretory Activity Molecules of Visceral Adipocytes in Abdominal Obesity in the Development of Cardiovascular Disease: A Review. Biomolecules 2020; 10:biom10030374. [PMID: 32121175 PMCID: PMC7175189 DOI: 10.3390/biom10030374] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 12/11/2022] Open
Abstract
Adipose tissue is considered one of the endocrine organs in the body because of its ability to synthesize and release a large number of hormones, cytokines, and growth and vasoactive factors that influence a variety of physiological and pathophysiological processes, such as vascular tone, inflammation, vascular smooth muscle cell migration, endothelial function, and vascular redox state. Moreover, genetic factors substantially contribute to the risk of obesity. Research into the biochemical effects of molecules secreted by visceral adipocytes as well as their molecular genetic characteristics is actively conducted around the world mostly in relation to pathologies of the cardiovascular system, metabolic syndrome, and diabetes mellitus. Adipokines could be developed into biomarkers for diagnosis, prognosis, and therapeutic targets in different diseases. This review describes the relevance of secretory activity molecules of visceral adipocytes in cardiovascular disease associated abdominal obesity.
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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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D’Marco L, Puchades MJ, Gorriz JL, Romero-Parra M, Lima-Martínez M, Soto C, Bermúdez V, Raggi P. Epicardial Adipose Tissue, Adiponectin and Leptin: A Potential Source of Cardiovascular Risk in Chronic Kidney Disease. Int J Mol Sci 2020; 21:ijms21030978. [PMID: 32024124 PMCID: PMC7037723 DOI: 10.3390/ijms21030978] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/21/2020] [Accepted: 01/29/2020] [Indexed: 12/18/2022] Open
Abstract
The importance of cardiometabolic factors in the inception and progression of atherosclerotic cardiovascular disease is increasingly being recognized. Beyond diabetes mellitus and metabolic syndrome, other factors may be responsible in patients with chronic kidney disease (CKD) for the high prevalence of cardiovascular disease, which is estimated to be 5- to 20-fold higher than in the general population. Although undefined uremic toxins are often blamed for part of the increased risk, visceral adipose tissue, and in particular epicardial adipose tissue (EAT), have been the focus of intense research in the past two decades. In fact, several lines of evidence suggest their involvement in atherosclerosis development and its complications. EAT may promote atherosclerosis through paracrine and endocrine pathways exerted via the secretion of adipocytokines such as adiponectin and leptin. In this article we review the current knowledge of the impact of EAT on cardiovascular outcomes in the general population and in patients with CKD. Special reference will be made to adiponectin and leptin as possible mediators of the increased cardiovascular risk linked with EAT.
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Affiliation(s)
- Luis D’Marco
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, University of Valencia, 46010 Valencia, Spain; (L.D.); (M.J.P.); (J.L.G.); (M.R.-P.)
| | - Maria Jesús Puchades
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, University of Valencia, 46010 Valencia, Spain; (L.D.); (M.J.P.); (J.L.G.); (M.R.-P.)
| | - Jose Luis Gorriz
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, University of Valencia, 46010 Valencia, Spain; (L.D.); (M.J.P.); (J.L.G.); (M.R.-P.)
| | - Maria Romero-Parra
- Nephrology Department, Hospital Clínico Universitario, INCLIVA, University of Valencia, 46010 Valencia, Spain; (L.D.); (M.J.P.); (J.L.G.); (M.R.-P.)
| | - Marcos Lima-Martínez
- Physiologic Sciences Department, School of Health Sciences, Universidad de Oriente, Bolívar 5110, Venezuela;
| | - Carlos Soto
- Nephrology Department, Consorci Sanitari del Alt Penedes-Garraf, 08800 Barcelona, Spain;
| | - Valmore Bermúdez
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 080005, Colombia;
| | - Paolo Raggi
- Mazankowski Alberta Heart Institute, School of Medicine, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Correspondence: ; Tel.: +1-780-407-8006; Fax: +1-780-407-6452
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Christensen RH, von Scholten BJ, Lehrskov LL, Rossing P, Jørgensen PG. Epicardial adipose tissue: an emerging biomarker of cardiovascular complications in type 2 diabetes? Ther Adv Endocrinol Metab 2020; 11:2042018820928824. [PMID: 32518616 PMCID: PMC7252363 DOI: 10.1177/2042018820928824] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 05/03/2020] [Indexed: 12/13/2022] Open
Abstract
Type 2 diabetes (T2D) is associated with an increased risk of cardiovascular disease and heart failure, which highlights the need for improved understanding of factors contributing to the pathophysiology of these complications as they are the leading cause of mortality in T2D. Patients with T2D have high levels of epicardial adipose tissue (EAT). EAT is known to secrete inflammatory factors, lipid metabolites, and has been proposed to apply mechanical stress on the cardiac muscle that may accelerate atherosclerosis, cardiac remodeling, and heart failure. High levels of EAT in patients with T2D have been associated with atherosclerosis, diastolic dysfunction, and incident cardiovascular events, and this fat depot has been suggested as an important link coupling diabetes, obesity, and cardiovascular disease. Despite this, the predictive potential of EAT in general, and in patients with diabetes, is yet to be established, and, up until now, the clinical relevance of EAT is therefore limited. Should this link be established, importantly, studies show that this fat depot can be modified both by pharmacological and lifestyle interventions. In this review, we first introduce the role of adipose tissue in T2D and present mechanisms involved in the pathophysiology of EAT and pericardial adipose tissue (PAT) in general, and in patients with T2D. Next, we summarize the evidence that these fat depots are elevated in patients with T2D, and discuss whether they might drive the high cardiometabolic risk in patients with T2D. Finally, we discuss the clinical potential of cardiac adipose tissues, address means to target this depot, and briefly touch upon underlying mechanisms and future research questions.
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Affiliation(s)
| | | | - Louise Lang Lehrskov
- Center for Inflammation and Metabolism/Center for Physical Activity Research, Rigshospitalet, Denmark
| | - Peter Rossing
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Corica D, Oreto L, Pepe G, Calabrò MP, Longobardo L, Morabito L, Pajno GB, Alibrandi A, Aversa T, Wasniewska M. Precocious Preclinical Cardiovascular Sonographic Markers in Metabolically Healthy and Unhealthy Childhood Obesity. Front Endocrinol (Lausanne) 2020; 11:56. [PMID: 32194501 PMCID: PMC7062712 DOI: 10.3389/fendo.2020.00056] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/29/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Childhood obesity is related to a wide spectrum of cardiovascular and metabolic comorbidities. Objectives: (1) To identify precocious, preclinical, cardiovascular sonographic modifications, in a cohort of overweight (OW) and obese (OB) children and adolescents compared to lean controls; (2) to investigate the association between clinical and metabolic variables and cardiovascular sonographic parameters; (3) to evaluate their relation with two different phenotypes of obesity: metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). Materials and Methods: Fifty-nine OW and OB children and adolescents (9.8 ± 2.9 years) and 20 matched lean controls underwent anthropometric, biochemical, echocardiography assessment, and sonographic evaluation of carotid artery and ascending aorta (AA). OW and OB subjects were divided in MHO and MUO, according to the Camhi et al. definition. Results: OW and OB children showed significantly higher left ventricular (LV) dimensions and mass, carotid artery intima-media thickness (CIMT), carotid stiffness [β-index, pulse wave velocity (PWV)], significantly lower mitral peak early (E) and late (A) velocity ratio (E/A ratio), and significantly impaired global longitudinal strain (GLS) compared to controls. BMI SD and HOMA-IR were positively significantly related to LV dimensions, LA volume and epicardial adipose tissue (EAT), and negative to E/A ratio. Waist circumference (WC) was positively correlated to LV dimensions, LA volume, CIMT, PWV, AA diameter, and EAT. Furthermore, WC was a strong predictor of LV dimensions, LA volume and strain, AA stiffness and diameter; BMI SD was significantly associated with EAT, LVM index, and E/A ratio; HOMA-IR and triglycerides were significant predictors of GLS. MUO patients showed higher BMI SD (p = 0.02), WC (p = 0.001), WHtR (p = 0.001), HOMA-IR (p = 0.004), triglycerides (p = 0.01), SBP (p = 0.001), as well as LV dimensions, EAT (p = 0.03), CIMT (p = 0.01), AA diameter (p = 0.02), β-index (p = 0.03) and PWV (p = 0.002), AA stiffness (p = 0.006), and significantly impaired GLS (p = 0.042) compared to MHO. Conclusions: Severity of overweight, abdominal obesity, insulin resistance, and MUO phenotype negatively affect cardiovascular remodeling and subclinical myocardial dysfunction in OW and OB children. MUO phenotype is likely to increase the risk of developing cardiometabolic complications since the pediatric age. Distinction between MHO and MUO phenotypes might be useful in planning a personalized follow-up approach in obese children.
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Affiliation(s)
- Domenico Corica
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
- *Correspondence: Domenico Corica
| | - Lilia Oreto
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giorgia Pepe
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | - Maria Pia Calabrò
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | - Luca Longobardo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Letteria Morabito
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | - Giovanni Battista Pajno
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | | | - Tommaso Aversa
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
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Mirdamadi A, Mirmohammadsadeghi M, Banazade Dardashty A, Arabi Z. The value of epicardial adipose tissue thickness for outcome prediction of patients undergoing coronary artery bypass grafting surgery. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2019; 24:93. [PMID: 31741665 PMCID: PMC6856538 DOI: 10.4103/jrms.jrms_1024_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 09/26/2018] [Accepted: 10/03/2019] [Indexed: 12/02/2022]
Abstract
Background: The significant association between epicardial adipose tissue and cardiovascular risk factors as well as outcome of ischemic heart diseases has been recently proposed. We determined the association between epicardial adipose tissue thickness and in-hospital as well as 3-month outcome after coronary artery bypass grafting surgery (CABG). Materials and Methods: This cross-sectional study was performed on 78 consecutive patients who underwent CABG in our heart center. Associations between epicardial adipose tissue thickness and in-hospital as well as 3-month outcome after CABG were measured by logistic regression and value of epicardial fat thickness evaluated by receiver operating characteristic (ROC) curve analysis. Results: Patients in-intensive care unit (ICU) suffered a variety of events, which many of them were insignificant, but 23 events (29.4%) of 78 were considered as important. The most frequent complication occurred in ICU was atrial fibrillation (9%). The frequency of 3-month complications was 6.4%, including 3.8% rehospitalization, 1.3% reoperation, and 1.3% cardiac death. Ninety-day mortality rate was 1.3%. Mean epicardial adipose tissue thickness was significantly higher in those with in-ICU complications than those without complication (7.64 ± 2.80 mm vs. 6.16 ± 2.29 mm, P = 0.015); however, the difference for 90-day complications was statistically nonsignificant. According to ROC curve analysis, measuring epicardial adipose tissue thickness could moderately predict in-ICU complication (area under the curve = 0.65 8, 95% confidence interval: 0.536–0.779, P = 0.017). The best cut-off point of this adipose tissue thickness for predicting in-ICU complication was 6.5 mm with sensitivity of 65.9% and specificity of 58.8%. Conclusion: Epicardial adipose tissue thickness is a useful predicting parameter for in-ICU complications after CABG.
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Affiliation(s)
- Ahmad Mirdamadi
- Department of Heart, Najafabad Branch, Islamic Azad University, Najafabad, Isfahan, Iran
| | | | - Amir Banazade Dardashty
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Arabi
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Munoz C, Cruz G, Neji R, Botnar RM, Prieto C. Motion corrected water/fat whole-heart coronary MR angiography with 100% respiratory efficiency. Magn Reson Med 2019; 82:732-742. [PMID: 30927310 PMCID: PMC6563440 DOI: 10.1002/mrm.27732] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 12/23/2022]
Abstract
PURPOSE To develop a framework for respiratory motion-corrected 3D whole-heart water/fat coronary MR angiography (CMRA) at 3T with reduced and predictable scan time. METHODS A 3D dual-echo acquisition and respiratory motion-corrected reconstruction framework for water/fat CMRA imaging was developed. The acquisition sequence integrates a 2D dual-echo image navigator (iNAV), enabling 100% respiratory scan efficiency. Respiratory motion estimated from both the 2D iNAVs and the 3D data itself is used to produce nonrigid motion-corrected water/fat CMRA images. A first study to investigate which iNAV (water, fat, in-phase or out-of-phase) provides the best translational motion estimation was performed in 10 healthy subjects. Subsequently, nonrigid motion-corrected water/fat images were compared to a diaphragmatic navigator gated and tracked water/fat CMRA acquisition. Image quality metrics included visible vessel length and vessel sharpness for both the left anterior descending and right coronary arteries. RESULTS Average vessel sharpness achieved with water, fat, in-phase and out-of-phase iNAVs was 33.8%, 29.6%, 32.2%, and 38.5%, respectively. Out-of-phase iNAVs were therefore used for estimating translational respiratory motion for the remainder of the study. No statistically significant differences in vessel length and sharpness (P > 0.01) were observed between the proposed nonrigid motion correction approach and the reference images, although data acquisition was significantly shorter (P < 2.6×10-4 ). Motion correction improved vessel sharpness by 60.4% and vessel length by 47.7%, on average, in water CMRA images in comparison with no motion correction. CONCLUSION The feasibility of a novel motion-corrected water/fat CMRA approach has been demonstrated at 3T, producing images comparable to a reference gated acquisition, but in a shorter and predictable scan time.
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Affiliation(s)
- Camila Munoz
- King’s College LondonSchool of Biomedical Engineering and Imaging SciencesLondonUnited Kingdom
| | - Gastão Cruz
- King’s College LondonSchool of Biomedical Engineering and Imaging SciencesLondonUnited Kingdom
| | - Radhouene Neji
- King’s College LondonSchool of Biomedical Engineering and Imaging SciencesLondonUnited Kingdom
- Siemens Healthcare, MR Research CollaborationsFrimleyUnited Kingdom
| | - Rene M. Botnar
- King’s College LondonSchool of Biomedical Engineering and Imaging SciencesLondonUnited Kingdom
- Pontificia Universidad Católica de ChileEscuela de IngenieríaSantiagoChile
| | - Claudia Prieto
- King’s College LondonSchool of Biomedical Engineering and Imaging SciencesLondonUnited Kingdom
- Pontificia Universidad Católica de ChileEscuela de IngenieríaSantiagoChile
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Demir E, Harmankaya NÖ, Kıraç Utku İ, Açıksarı G, Uygun T, Özkan H, Demir B. The Relationship between Epicardial Adipose Tissue Thickness and Serum Interleukin-17a Level in Patients with Isolated Metabolic Syndrome. Biomolecules 2019; 9:biom9030097. [PMID: 30862094 PMCID: PMC6468684 DOI: 10.3390/biom9030097] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 02/26/2019] [Accepted: 03/05/2019] [Indexed: 12/25/2022] Open
Abstract
In this study, it was aimed to investigate the relationship between the epicardial adipose tissue thickness (EATT) and serum IL-17A level insulin resistance in metabolic syndrome patients. This study enrolled a total of 160 subjects, of whom 80 were consecutive patients who applied to our outpatient clinic and were diagnosed with metabolic syndrome, and the other 80 were consecutive patients who were part of the control group with similar age and demographics in whom the metabolic syndrome was excluded. The metabolic syndrome diagnosis was made according to International Diabetes Federation (IDF)-2005 criteria. EATT was measured with transthoracic echocardiography (TTE) in the subjects. IL-17A serum levels were determined using the ELISA method. Fasting blood glucose, HDL, triglyceride, and fasting insulin levels were significantly higher in the metabolic syndrome group compared to the control group. In addition, the metabolic syndrome group had significantly higher high-sensitivity C-reactive protein (hs-CRP) and Homeostatic Model Assessment Insulin Resistance (HOMA-IR) levels than the control group. Similarly, serum IL-17A levels were significantly elevated in the metabolic syndrome group compared to the control group statistically (p < 0.001). As well, EATT was higher in the metabolic syndrome than the control group. Conclusion: By virtue of their proinflammatory properties, EATT and IL-17 may play an important role in the pathogenesis of the metabolic syndrome.
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Affiliation(s)
- Esra Demir
- Department of İnternal Medicine, Kanuni Sultan Süleyman Education and Research Hospital, 34103 İstanbul, Turkey.
| | - Nazmiye Özlem Harmankaya
- Department of İnternal Medicine, Bakırköy Dr Sadi Konuk Education and Research Hospital, 34147 İstanbul, Turkey.
| | - İrem Kıraç Utku
- Department of İnternal Medicine, Kanuni Sultan Süleyman Education and Research Hospital, 34103 İstanbul, Turkey.
| | - Gönül Açıksarı
- Department of Cardiology, Medeniyet University Medical Faculty, 34722 İstanbul, Turkey.
| | - Turgut Uygun
- Department of Cardiology, Konya Education and Research Hospital, 42040 Konya, Turkey.
| | - Hanise Özkan
- Department of İnternal Medicine, Kanuni Sultan Süleyman Education and Research Hospital, 34103 İstanbul, Turkey.
| | - Bülent Demir
- Department of Cardiology, Bakırköy Dr Sadi Konuk Education and Research Hospital, 34147 İstanbul, Turkey.
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Nakajima T, Yokota T, Shingu Y, Yamada A, Iba Y, Ujihira K, Wakasa S, Ooka T, Takada S, Shirakawa R, Katayama T, Furihata T, Fukushima A, Matsuoka R, Nishihara H, Dela F, Nakanishi K, Matsui Y, Kinugawa S. Impaired mitochondrial oxidative phosphorylation capacity in epicardial adipose tissue is associated with decreased concentration of adiponectin and severity of coronary atherosclerosis. Sci Rep 2019; 9:3535. [PMID: 30837669 PMCID: PMC6401184 DOI: 10.1038/s41598-019-40419-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/14/2019] [Indexed: 11/09/2022] Open
Abstract
Epicardial adipose tissue (EAT), a source of adipokines, is metabolically active, but the role of EAT mitochondria in coronary artery disease (CAD) has not been established. We investigated the association between EAT mitochondrial respiratory capacity, adiponectin concentration in the EAT, and coronary atherosclerosis. EAT samples were obtained from 25 patients who underwent elective cardiac surgery. Based on the coronary angiographycal findings, the patients were divided into two groups; coronary artery disease (CAD; n = 14) and non-CAD (n = 11) groups. The mitochondrial respiratory capacities including oxidative phosphorylation (OXPHOS) capacity with non-fatty acid (complex I and complex I + II-linked) substrates and fatty acids in the EAT were significantly lowered in CAD patients. The EAT mitochondrial OXPHOS capacities had a close and inverse correlation with the severity of coronary artery stenosis evaluated by the Gensini score. Intriguingly, the protein level of adiponectin, an anti-atherogenic adipokine, in the EAT was significantly reduced in CAD patients, and it was positively correlated with the mitochondrial OXPHOS capacities in the EAT and inversely correlated with the Gensini score. Our study showed that impaired mitochondrial OXPHOS capacity in the EAT was closely linked to decreased concentration of adiponectin in the EAT and severity of coronary atherosclerosis.
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Affiliation(s)
- Takayuki Nakajima
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takashi Yokota
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
| | - Yasushige Shingu
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Akira Yamada
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yutaka Iba
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Kosuke Ujihira
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Satoru Wakasa
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Tomonori Ooka
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shingo Takada
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ryosuke Shirakawa
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takashi Katayama
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takaaki Furihata
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Arata Fukushima
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ryosuke Matsuoka
- Division of Clinical Cancer Genomics, Hokkaido University Hospital, Sapporo, Japan
| | - Hiroshi Nishihara
- Division of Clinical Cancer Genomics, Hokkaido Cancer Center, Sapporo, Japan
| | - Flemming Dela
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Geriatrics, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark
| | - Katsuhiko Nakanishi
- Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yoshiro Matsui
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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47
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Guler S, Varol E. The relation between echocardiographic epicardial fat thickness and mitral annular calcification. Afr Health Sci 2019; 19:1657-1664. [PMID: 31148995 PMCID: PMC6531966 DOI: 10.4314/ahs.v19i1.41] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background Mitral annular calcification (MAC) is associated with several cardiovascular disorders including coronary artery disease (CAD), atrial fibrillation, heart failure, ischemic stroke and increased mortality. Epicardial fat thickness (EFT) has strong correlation with obesity, CAD, insulin resistance, metabolic syndrome, hypertension, diabetes mellitus, and atherosclerosis. There are strong similarities between EFT and MAC from the aspect of risk factors and pathogenesis. Objective In this study we aimed to investigate the EFT in patients with MAC. Methods The study group consisted of 78 patients with MAC. An age, gender and body mass index matched control group consisted of 47 subjects who admitted to echocardiography laboratory due to suspicion of organic heart disease and eventually found to be free of MAC. We measured EFT in patients with MAC and control subjects. Results EFT was significantly higher in patients with MAC than in control subjects (5.7±0.9 vs. 4.4±0.6 mm respectively; P< 0.001). Correlation analysis indicated that EFT was positively correlated with presence of MAC (p<0.001, r=0.597). Conclusion We showed that EFT was significantly elevated in patients with MAC and it was positively correlated with MAC.
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Affiliation(s)
- Serdar Guler
- Department of Cardiology, Suleyman Demirel University, Medical School, Isparta, Turkey
| | - Ercan Varol
- Department of Cardiology, Suleyman Demirel University, Medical School, Isparta, Turkey
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48
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Pabon MA, Manocha K, Cheung JW, Lo JC. Linking Arrhythmias and Adipocytes: Insights, Mechanisms, and Future Directions. Front Physiol 2018; 9:1752. [PMID: 30568603 PMCID: PMC6290087 DOI: 10.3389/fphys.2018.01752] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/20/2018] [Indexed: 01/14/2023] Open
Abstract
Obesity and atrial fibrillation have risen to epidemic levels worldwide and may continue to grow over the next decades. Emerging evidence suggests that obesity promotes atrial and ventricular arrhythmias. This has led to trials employing various strategies with the ultimate goal of decreasing the atrial arrhythmic burden in obese patients. The effectiveness of these interventions remains to be determined. Obesity is defined by the expansion of adipose mass, making adipocytes a prime candidate to mediate the pro-arrhythmogenic effects of obesity. The molecular mechanisms linking obesity and adipocytes to increased arrhythmogenicity in both the atria and ventricles remain poorly understood. In this focused review, we highlight areas of potential molecular interplay between adipocytes and cardiomyocytes. The effects of adipocytes may be direct, local or remote. Direct effect refers to adipocyte or fatty infiltration of the atrial and ventricular myocardium itself, possibly causing increased dispersion of normal myocardial electrical signals and fibrotic substrate of adipocytes that promote reentry or adipocytes serving as a direct source of aberrant signals. Local effects may originate from nearby adipose depots, specifically epicardial adipose tissue (EAT) and pericardial adipose tissue, which may play a role in the secretion of adipokines and chemokines that can incite inflammation given the direct contact and disrupt the conduction system. Adipocytes can also have a remote effect on the myocardium arising from their systemic secretion of adipokines, cytokines and metabolites. These factors may lead to mitochondrial dysfunction, oxidative stress, autophagy, mitophagy, autonomic dysfunction, and cardiomyocyte death to ultimately produce a pro-arrhythmogenic state. By better understanding the molecular mechanisms connecting dysfunctional adipocytes and arrhythmias, novel therapies may be developed to sever the link between obesity and arrhythmias.
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Affiliation(s)
- Maria A Pabon
- Joan and Sanford I. Weill, Department of Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, United States
| | - Kevin Manocha
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, United States
| | - Jim W Cheung
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, United States
| | - James C Lo
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, United States.,Metabolic Health Center, Weill Cornell Medicine, New York, NY, United States.,Department of Pharmacology, Weill Cornell Medicine, New York, NY, United States
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49
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Tekin I, Edem E. Association of Epicardial Fat Tissue with Coronary Artery Disease and Left Ventricle Diastolic Function Indicators. Med Sci Monit 2018; 24:6367-6374. [PMID: 30205415 PMCID: PMC6144741 DOI: 10.12659/msm.910989] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background Epicardial fat tissue (EAT) acts as brown adipose tissue and protects the heart and coronary arteries against hypothermia. Recent studies demonstrated that EAT is a source of both anti-inflammatory and atherogenic cytokines. In this study, our aim was to investigate the association of vertical, horizontal, and area measurements of EAT thickness and their association with coronary artery disease, diastolic function, and myocardial performance index in patients who underwent coronary angiography. Material/Methods The study population consisted of patients who presented to our outpatient clinic with chest pain and whose non-invasive stress tests were positive between June 2015 and July 2017. Echocardiographic examinations were performed prior to the angiography. Coronary angiograms were performed using Judkins method from the femoral artery. Results Mean vertical thickness of EAT was 0.6 cm in patients with CAD and 0.46 cm in those without CAD (p=0.0001). Mean horizontal length of EAT was 2.91 cm in patients with CAD and was 2.41 cm in the subjects without CAD (p=0.001). ROC analysis showed 81% sensitivity and 53% specificity for a cut-off value of 0.45, and 67% sensitivity and 71% specificity for a cut-off value of 0.55 for EAT vertical (cm). Multivariate analysis showed that EAT is an independent risk factor for coronary artery disease. Conclusions Echocardiography is an inexpensive routine assessment for most patients. EAT thickness determined by echocardiography may be a useful indicator of increased CAD risk, but not diastolic dysfunction, of the left ventricle.
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Affiliation(s)
- Işık Tekin
- Department of Cardiology, Tarsus State Hospital, Mersin, Turkey
| | - Efe Edem
- Department of Cardiology, Tınaztepe Hospital, Izmir, Turkey
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Ansari MA, Mohebati M, Poursadegh F, Foroughian M, Shamloo AS. Is echocardiographic epicardial fat thickness increased in patients with coronary artery disease? A systematic review and meta-analysis. Electron Physician 2018; 10:7249-7258. [PMID: 30258557 PMCID: PMC6140987 DOI: 10.19082/7249] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/04/2018] [Indexed: 01/16/2023] Open
Abstract
Background The relation of epicardial fat thickness (EFT) to coronary artery disease (CAD) has recently been reported in multiple studies. Echocardiography is a safe and relatively inexpensive and accessible approach to assess regional EFT, which can be performed easily in many centers. Objective To determine the association between echocardiographic EFT and the presence or the absence of CAD. Methods This was a systematic review and meta-analysis conducted on literature available in electronic databases up to March 2018. The articles measuring EFT by echocardiography in the right ventricular (RV) free wall were included in the study. The quality of the enrolled items was assessed using the Methodological Index for Non-Randomized Studies (MINORS) checklist. The analyses were performed using the Comprehensive Meta-Analysis version 2 software. Cochran’s Q test and I2 index were used to evaluate heterogeneity. Results This meta-analysis was performed on 13 studies involving 2,436 patients (1,622 with CAD, and 814 without CAD). The maximum EFT reported by echocardiography was 12.9±2.7 mm in the CAD group and 8.4±2.5 mm in the non-CAD group. The minimum EFT reported by echocardiography was 2.2±1.8 mm in the CAD group and 1.8±1.4 mm in the non-CAD group. The heterogeneity was found among the researched studies (I2=91.8%, p=0.000, Q-value=146.43, df [Q] =12) using the random effect model. The patients with CAD had a significantly higher echocardiographic EFT than those without CAD (SMD=1.03, 95% CI= 0.70–1.37, p=0.000). Conclusion According to the findings of this meta-analysis, the echocardiographic EFT in the subjects with CAD was significantly higher than that of those without CAD. The measurement of echocardiographic EFT seems to be an acceptable strategy for risk stratification of heart diseases considering ease of use, cost-effectiveness and non-exposure characteristics, compared to other imaging interventions.
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Affiliation(s)
- Mohammad Ali Ansari
- Atherosclerosis Prevention Research Center, Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Mohebati
- Associate Professor, Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farid Poursadegh
- Internal Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Foroughian
- Emergency Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Sepehri Shamloo
- Atherosclerosis Prevention Research Center, Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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