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Yin R, Tang X, Wang T, Shi H, Wang X, Wang X, Pan C. Cardiac CT scanning in coronary artery disease: Epicardial fat volume and its correlation with coronary artery lesions and left ventricular function. Exp Ther Med 2020; 20:2961-2968. [PMID: 32855661 PMCID: PMC7444410 DOI: 10.3892/etm.2020.9064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/23/2019] [Indexed: 11/25/2022] Open
Abstract
Coronary artery disease (CAD) is a major and common disease that poses a threat to human health. Recent studies suggested that epicardial fat may have an important role in the pathogenesis of CAD. Therefore, the association between epicardial fat volume (EFV) and left ventricular function with CAD was investigated in the present study. A total of 61 patients with suspected CAD who underwent CT scanning were enrolled. Baseline data, parameters of left heart function and EFV of the subjects were collected and analyzed. The degree of coronary artery lesions was assessed using the Gensini score. Pearson's correlation analysis and a logistic regression model were applied to assess the association between EFV and risk factors for CAD, the Gensini score and left ventricular function index. A total of 29 female and 32 male subjects with a median age of 63 years were enrolled. The median body mass index (BMI) of the subjects was 23.37 kg/m2 and the median EFV was 86.41 cm3. It was revealed that risk factors of CAD, specially hypertension, diabetes mellitus, dyslipidemia, history of myocardial infarction and smoking, had no significant association with the EFV (P>0.05); however, the EFV was significantly positively correlated with the BMI (r=0.479, P<0.0001), interventricular septal thickness (r=0.436, P=0.004), left ventricular posterior wall thickness (r=0.350, P=0.0058), left ventricular end diastolic diameter (r=0.265, P=0.0388), left ventricular mass (r=0.445, P=0.0003) and left ventricular mass index (r=0.371, P=0.0035). However, no correlation was identified between the EFV and the Gensini score (r=0.131, P=0.3137). In conclusion, the EFV measured by cardiac CT scanning was positively correlated with the BMI and left ventricular function, but was not associated with the presence of CAD according to the Gensini scores.
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Affiliation(s)
- Ruohan Yin
- Department of Radiology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu 213164, P.R. China
| | - Xiaoqiang Tang
- Department of Radiology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu 213164, P.R. China
| | - Tao Wang
- Department of Radiology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu 213164, P.R. China
| | - Haifeng Shi
- Department of Radiology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu 213164, P.R. China
| | - Xiang Wang
- Department of Radiology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu 213164, P.R. China
| | - Xiaoqin Wang
- Department of Radiology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu 213164, P.R. China
| | - Changjie Pan
- Department of Radiology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu 213164, P.R. China
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The predictive value of the epicardial adipose thickness in the rate of expansion of the aortic root. Herz 2019; 46:48-53. [PMID: 31728554 DOI: 10.1007/s00059-019-04865-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/14/2019] [Accepted: 10/10/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Epicardial adipose tissue (ECAT) is metabolically active and is involved in the development of atherosclerosis. The thickness of ECAT has been positively correlated with the dimensions of the ascending aorta. We aimed to examine whether ECAT thickness predicted the expansion of the aortic dimensions. METHODS The imaging results of patients who had undergone transthoracic echocardiographic (TTE) examinations more than twice during the period 2005-2015 were surveyed. We included adult patients who had undergone TTE examinations at least 1 year apart. The ECAT was measured in the parasternal long-axis view from the index TTE study. End-diastolic dimensions in three consecutive beats were averaged for all measurements. The annulus, root, and sinotubular junction (STJ) were also measured. The amount of increase (if any) in aortic dimensions per year was calculated and the correlation of this increase with the initial thickness of the ECAT was analyzed. RESULTS In total, 429 examinations were performed with 197 patients (17 females), from which 394 examinations were analyzed. The ECAT thickness was 8.6 ± 3.6 mm. In the initial examinations, the annulus, STJ, and root measured 23 ± 4, 28 ± 4, and 34 ± 4 mm, respectively. In univariate analysis, for every 1 mm of ECAT thickness, the STJ expanded 0.056 (95% CI: 0.001-0.112 mm/year; p = 0.030) and the aortic root expanded 0.088 mm/year (p < 0.001). In multivariate analysis, ECAT thickness remained an independent predictor of the aortic root expansion. For every 1‑mm increase in ECAT thickness, the aortic root expanded by 0.036 mm (95% CI: 0.010-0.062) per year (p = 0.007). CONCLUSION The thickness of the ECAT is a predictor of more rapid increases in the dimensions of the aortic root. Further studies of patients with established aortic aneurysm are warranted.
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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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RPS3A positively regulates the mitochondrial function of human periaortic adipose tissue and is associated with coronary artery diseases. Cell Discov 2018; 4:52. [PMID: 30131868 PMCID: PMC6102269 DOI: 10.1038/s41421-018-0041-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 05/27/2018] [Accepted: 05/29/2018] [Indexed: 02/07/2023] Open
Abstract
Pericardial adipose tissue, which comprises both epicardial adipose tissue (EAT) and paracardial adipose tissue (PAT), has recently been recognized as a novel factor in the pathophysiology of cardiovascular diseases, especially coronary artery disease (CAD). The goal of this study was to evaluate differences in the brown-like characteristic and proteome among human EAT, PAT, and subcutaneous adipose tissue (SAT) to identify candidate molecules causing CAD. Uncoupling protein 1 (UCP-1) and other brown-related proteins were highly expressed in pericardial adipose tissue but was weakly expressed in SAT from the same non-CAD patient. Moreover, pericardial adipose tissues displayed a higher thermogenesis than SAT. However, brown-related genes were lower in CAD pericardial fat. Remarkably, there were lower levels of metabolic enzymes involved in glycolysis, tricarboxylic acid cycle, and fatty acid metabolism in pericardial adipose tissues of CAD. EAT is an organ adjacent to aortic root without anatomy barriers, which differs from PAT. We found that the expression of ribosomal protein S3A (RPS3A) was decreased in human EAT as well as in mouse perivascular adipose tissue (PVAT). Knockdown of RPS3A significantly inhibited adipocyte differentiation in preadipocytes and impaired the function of mitochondria in mature adipocytes. Moreover, RPS3A knockdown in mouse periaortic adipose tissue impaired browning of PVAT, accelerated vascular inflammation, and atherosclerosis progression. Mechanistically, RPS3A can migrate to the mitochondria to maintain the function of brown adipocytes. These findings provide compelling evidence that RPS3A was a key factor for modulating the brown fat-specific gene UCP-1 and carbon metabolic enzymes in EAT for preventing CAD.
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Mahaney MC, Karere GM, Rainwater DL, Voruganti VS, Dick EJ, Owston MA, Rice KS, Cox LA, Comuzzie AG, VandeBerg JL. Diet-induced early-stage atherosclerosis in baboons: Lipoproteins, atherogenesis, and arterial compliance. J Med Primatol 2017. [PMID: 28620920 DOI: 10.1111/jmp.12283] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The purpose of this study was to determine whether dietary manipulation can reliably induce early-stage atherosclerosis and clinically relevant changes in vascular function in an established, well-characterized non-human primate model. METHODS We fed 112 baboons a high-cholesterol, high-fat challenge diet for two years. We assayed circulating biomarkers of cardiovascular disease (CVD) risk, at 0, 7, and 104 weeks into the challenge; assessed arterial compliance noninvasively at 104 weeks; and measured atherosclerotic lesions in three major arteries at necropsy. RESULTS We observed evidence of atherosclerosis in all but one baboon fed the two-year challenge diet. CVD risk biomarkers, the prevalence, size, and complexity of arterial lesions, plus consequent arterial stiffness, were increased in comparison with dietary control animals. CONCLUSIONS Feeding baboons a high-cholesterol, high-fat diet for two years reliably induces atherosclerosis, with risk factor profiles, arterial lesions, and changes in vascular function also seen in humans.
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Affiliation(s)
- Michael C Mahaney
- South Texas Diabetes and Obesity Institute, School of Medicine, The University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Genesio M Karere
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - David L Rainwater
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Venkata S Voruganti
- Department of Nutrition and UNC Nutrition Research Institute, University of North Carolina, Kannapolis, NC, USA
| | - Edward J Dick
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Michael A Owston
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Karen S Rice
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Laura A Cox
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX, USA.,Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Anthony G Comuzzie
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX, USA.,Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - John L VandeBerg
- South Texas Diabetes and Obesity Institute, School of Medicine, The University of Texas Rio Grande Valley, Brownsville, TX, USA
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Ittermann T, Lorbeer R, Dörr M, Schneider T, Quadrat A, Heßelbarth L, Wenzel M, Lehmphul I, Köhrle J, Mensel B, Völzke H. High levels of thyroid-stimulating hormone are associated with aortic wall thickness in the general population. Eur Radiol 2016; 26:4490-4496. [PMID: 26973144 DOI: 10.1007/s00330-016-4316-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 02/26/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Our aim was to investigate the association of thyroid function defined by serum concentrations of thyroid-stimulating hormone (TSH) with thoracic aortic wall thickness (AWT) as a marker of atherosclerotic processes. METHODS We pooled data of 2,679 individuals from two independent population-based surveys of the Study of Health in Pomerania. Aortic diameter and AWT measurements were performed on a 1.5-T MRI scanner at the concentration of the right pulmonary artery displaying the ascending and the descending aorta. RESULTS TSH, treated as continuous variable, was significantly associated with descending AWT (β = 0.11; 95 % confidence interval (CI) 0.02-0.21), while the association with ascending AWT was not statistically significant (β = 0.20; 95 % CI -0.01-0.21). High TSH (>3.29 mIU/L) was significantly associated with ascending (β = 0.12; 95 % CI 0.02-0.23) but not with descending AWT (β = 0.06; 95 % CI -0.04-0.16). There was no consistent association between TSH and aortic diameters. CONCLUSIONS Our study demonstrated that AWT values increase with increasing serum TSH concentrations. Thus, a hypothyroid state may be indicative for aortic atherosclerosis. These results fit very well to the findings of previous studies pointing towards increased atherosclerotic risk in the hypothyroid state. KEY POINTS • Serum TSH concentrations are positively associated with aortic wall thickness. • Serum TSH concentrations are not associated with the aortic diameters. • Serum 3,5-diiodothyronine concentrations may be positively associated with aortic wall thickness.
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Affiliation(s)
- Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Walther Rathenau Str. 48, D-17475, Greifswald, Germany.
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald, Germany.
| | - Roberto Lorbeer
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Marcus Dörr
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany
| | - Tobias Schneider
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Alexander Quadrat
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Lydia Heßelbarth
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Michael Wenzel
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Ina Lehmphul
- Institut für Experimentelle Endokrinologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Josef Köhrle
- Institut für Experimentelle Endokrinologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Birger Mensel
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Walther Rathenau Str. 48, D-17475, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
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Erkan AF, Tanindi A, Kocaman SA, Ugurlu M, Tore HF. Epicardial Adipose Tissue Thickness Is an Independent Predictor of Critical and Complex Coronary Artery Disease by Gensini and Syntax Scores. Tex Heart Inst J 2016; 43:29-37. [PMID: 27047282 DOI: 10.14503/thij-14-4850] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Epicardial adipose tissue thickness is associated with the severity and extent of atherosclerotic coronary artery disease. We prospectively investigated whether epicardial adipose tissue thickness is related to coronary artery disease extent and complexity as denoted by Gensini and Syntax scores, and whether the thickness predicts critical disease. After performing coronary angiography in 183 patients who had angina or acute myocardial infarction, we divided them into 3 groups: normal coronary arteries, noncritical disease (≥1 coronary lesion with <70% stenosis), and critical disease (≥1 coronary lesion with <70% stenosis). We used transthoracic echocardiography to measure epicardial adipose tissue thickness, then calculated Gensini and Syntax scores by reviewing the angiograms. Mean thicknesses were 4.3 ± 0.9, 5.2 ± 1.5, and 7.5 ± 1.9 mm in patients with normal coronary arteries, noncritical disease, and critical disease, respectively (P <0.001). At progressive thicknesses (<5, 5-7, and >7 mm), mean Gensini scores were 4.1 ± 5.5, 19.8 ± 15.6, and 64.9 ± 32.4, and mean Syntax scores were 4.7 ± 5.9, 16.6 ± 8.5, and 31.7 ± 8.7, respectively (both P <0.001). Thickness had strong and positive correlations with both scores (Gensini, r =0.82, P <0.001; and Syntax, r =0.825, P <0.001). The cutoff thickness value to predict critical disease was 5.75 mm (area under the curve, 0.875; 95% confidence interval, 0.825-0.926; P <0.001). Epicardial adipose tissue thickness is independently related to coronary artery disease extent and complexity as denoted by Gensini and Syntax scores, and it predicts critical coronary artery disease.
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Kong Q, Ma X. Contributing Mechanisms of Aortic Atheroma in Ischemic Cerebrovascular Disease. J Stroke Cerebrovasc Dis 2015; 24:2653-9. [PMID: 26522269 DOI: 10.1016/j.jstrokecerebrovasdis.2015.09.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 09/23/2015] [Accepted: 09/28/2015] [Indexed: 11/17/2022] Open
Abstract
In recent years, the correlation between aortic atheroma (AA) and the occurrence and recurrence of ischemic cerebrovascular disease (ICVD) has attracted much attention, but the contributory mechanisms remain controversial. This review analyzes related research on the roles of AA in ICVD, and demonstrates the correlation between the formation and development of AA and abnormal metabolism, inflammation, hemodynamic changes, and other contributory factors. The presence of complex aortic plaque (CAP) in the ascending aorta and aortic arch increases the risk of cerebral embolism and degree of injury, while the association between CAP in the descending aorta and cerebral embolism remains ambiguous. AA also functions as an indicator of atherosclerosis burden as well as hypercoagulability, which may further increase the risk of ICVD. Further study on the relationship of AA to ICVD will improve diagnosis and treatment in clinical practice.
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Affiliation(s)
- Qi Kong
- Department of Neurology, Xuanwu Hospital, the Capital Medical University, Beijing, China
| | - Xin Ma
- Department of Neurology, Xuanwu Hospital, the Capital Medical University, Beijing, China.
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