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Ahmed B, Farb MG, Karki S, D'Alessandro S, Edwards NM, Gokce N. Pericardial Adipose Tissue Thrombospondin-1 Associates With Antiangiogenesis in Ischemic Heart Disease. Am J Cardiol 2024; 210:201-207. [PMID: 37863116 PMCID: PMC10842123 DOI: 10.1016/j.amjcard.2023.09.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/15/2023] [Accepted: 09/24/2023] [Indexed: 10/22/2023]
Abstract
Accumulation of ectopic pericardial adipose tissue has been associated with cardiovascular complications which, in part, may relate to adipose-derived factors that regulate vascular responses and angiogenesis. We sought to characterize adipose tissue microvascular angiogenic capacity in subjects who underwent elective cardiac surgeries including aortic, valvular, and coronary artery bypass grafting. Pericardial adipose tissue was collected intraoperatively and examined for angiogenic capacity. Capillary sprouting was significantly blunted (twofold, p <0.001) in subjects with coronary artery disease (CAD) (age 60 ± 9 years, body mass index [BMI] 32 ± 4 kg/m2, low-density lipoprotein cholesterol [LDL-C] 95 ± 46 mg/100 ml, n = 29) compared with age-, BMI-, and LDL-C matched subjects without angiographic obstructive CAD (age 59 ± 10 y, BMI 35 ± 9 kg/m2, LDL-C 101 ± 40 mg/100 ml, n = 12). For potential mechanistic insight, we performed mRNA expression analyses using quantitative real-time polymerase chain reaction and observed no significant differences in pericardial fat gene expression of proangiogenic mediators vascular endothelial growth factor-A (VEGF-A), fibroblast growth factor-2 (FGF-2), and angiopoietin-1 (angpt1), or anti-angiogenic factors soluble fms-like tyrosine kinase-1 (sFlt-1) and endostatin. In contrast, mRNA expression of anti-angiogenic thrombospondin-1 (TSP-1) was significantly upregulated (twofold, p = 0.008) in CAD compared with non-CAD subjects, which was confirmed by protein western-immunoblot analysis. TSP-1 gene knockdown using short hairpin RNA lentiviral delivery significantly improved angiogenic deficiency in CAD (p <0.05). In conclusion, pericardial fat in subjects with CAD may be associated with an antiangiogenic profile linked to functional defects in vascularization capacity. Local paracrine actions of TSP-1 in adipose depots surrounding the heart may play a role in mechanisms of ischemic heart disease.
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Affiliation(s)
- Bulbul Ahmed
- Evans Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Melissa G Farb
- Evans Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Shakun Karki
- Evans Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Sophia D'Alessandro
- Evans Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Niloo M Edwards
- Division of Cardiac Surgery, Boston Medical Center, Boston, Massachusetts
| | - Noyan Gokce
- Evans Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts.
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Cheng X, Feng Z, Pan B, Liu Q, Han Y, Zou L, Rong P, Meng J. Establishment and application of the BRP prognosis model for idiopathic pulmonary fibrosis. J Transl Med 2023; 21:805. [PMID: 37951977 PMCID: PMC10638707 DOI: 10.1186/s12967-023-04668-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/27/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is the most common idiopathic interstitial lung disease. Clinical models to accurately evaluate the prognosis of IPF are currently lacking. This study aimed to construct an easy-to-use and robust prediction model for transplant-free survival (TFS) of IPF based on clinical and radiological information. METHODS A multicenter prognostic study was conducted involving 166 IPF patients who were followed up for 3 years. The end point of follow-up was death or lung transplantation. Clinical information, lung function tests, and chest computed tomography (CT) scans were collected. Body composition quantification on CT was performed using 3D Slicer software. Risk factors in blood routine examination-radiology-pulmonary function (BRP) were identified by Cox regression and utilized to construct the "BRP Prognosis Model". The performance of the BRP model and the gender-age-physiology variables (GAP) model was compared using time-ROC curves, calibration curves, and decision curve analysis (DCA). Furthermore, histopathology fibrosis scores in clinical specimens were compared between the different risk stratifications identified by the BRP model. The correlations among body composition, lung function, serum inflammatory factors, and profibrotic factors were analyzed. RESULTS Neutrophil percentage > 68.3%, pericardial adipose tissue (PAT) > 94.91 cm3, pectoralis muscle radiodensity (PMD) ≤ 36.24 HU, diffusing capacity of the lung for carbon monoxide/alveolar ventilation (DLCO/VA) ≤ 56.03%, and maximum vital capacity (VCmax) < 90.5% were identified as independent risk factors for poor TFS among patients with IPF. We constructed a BRP model, which showed superior accuracy, discrimination, and clinical practicability to the GAP model. Median TFS differed significantly among patients at different risk levels identified by the BRP model (low risk: TFS > 3 years; intermediate risk: TFS = 2-3 years; high risk: TFS ≈ 1 year). Patients with a high-risk stratification according to the BRP model had a higher fibrosis score on histopathology. Additionally, serum proinflammatory markers were positively correlated with visceral fat volume and infiltration. CONCLUSIONS In this study, the BRP prognostic model of IPF was successfully constructed and validated. Compared with the commonly used GAP model, the BRP model had better performance and generalization with easily obtainable indicators. The BRP model is suitable for clinical promotion.
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Affiliation(s)
- Xiaoyun Cheng
- Department of Pulmonary and Critical Care Medicine, The Third Xiangya Hospital of Central South University, Tongzipo Road 138, Yuelu District, Changsha, 410000, Hunan, China
- Hunan Key Laboratory of Organ Fibrosis, Tongzipo Road 138, Yuelu District, Changsha, 410000, China
| | - Zhichao Feng
- Departments of Radiology, The Third Xiangya Hospital of Central South University, Tongzipo Road 138, Yuelu District, Changsha, 410000, Hunan, China
| | - Boyu Pan
- Departments of Orthopedics, The Third Xiangya Hospital of Central South University, Tongzipo Road 138, Yuelu District, Changsha, 410000, Hunan, China
| | - Qingxiang Liu
- Hunan Key Laboratory of Organ Fibrosis, Tongzipo Road 138, Yuelu District, Changsha, 410000, China
| | - Yuanyuan Han
- Department of Pulmonary and Critical Care Medicine, The Third Xiangya Hospital of Central South University, Tongzipo Road 138, Yuelu District, Changsha, 410000, Hunan, China
- Hunan Key Laboratory of Organ Fibrosis, Tongzipo Road 138, Yuelu District, Changsha, 410000, China
| | - Lijun Zou
- Department of Pulmonary and Critical Care Medicine, The Third Xiangya Hospital of Central South University, Tongzipo Road 138, Yuelu District, Changsha, 410000, Hunan, China
- Hunan Key Laboratory of Organ Fibrosis, Tongzipo Road 138, Yuelu District, Changsha, 410000, China
| | - Pengfei Rong
- Departments of Radiology, The Third Xiangya Hospital of Central South University, Tongzipo Road 138, Yuelu District, Changsha, 410000, Hunan, China.
| | - Jie Meng
- Department of Pulmonary and Critical Care Medicine, The Third Xiangya Hospital of Central South University, Tongzipo Road 138, Yuelu District, Changsha, 410000, Hunan, China.
- Hunan Key Laboratory of Organ Fibrosis, Tongzipo Road 138, Yuelu District, Changsha, 410000, China.
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Mukherjee AG, Renu K, Gopalakrishnan AV, Jayaraj R, Dey A, Vellingiri B, Ganesan R. Epicardial adipose tissue and cardiac lipotoxicity: A review. Life Sci 2023; 328:121913. [PMID: 37414140 DOI: 10.1016/j.lfs.2023.121913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/21/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023]
Abstract
Epicardial adipose tissue (EAT) has morphological and physiological contiguity with the myocardium and coronary arteries, making it a visceral fat deposit with some unique properties. Under normal circumstances, EAT exhibits biochemical, mechanical, and thermogenic cardioprotective characteristics. Under clinical processes, epicardial fat can directly impact the heart and coronary arteries by secreting proinflammatory cytokines via vasocrine or paracrine mechanisms. It is still not apparent what factors affect this equilibrium. Returning epicardial fat to its physiological purpose may be possible by enhanced local vascularization, weight loss, and focused pharmacological therapies. This review centers on EAT's developing physiological and pathophysiological dimensions and its various and pioneering clinical utilities.
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Affiliation(s)
- Anirban Goutam Mukherjee
- Department of Biomedical Sciences, School of Bio-Sciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, India
| | - Kaviyarasi Renu
- Centre of Molecular Medicine and Diagnostics (COMManD), Department of Biochemistry, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India
| | - Abilash Valsala Gopalakrishnan
- Department of Biomedical Sciences, School of Bio-Sciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, India.
| | - Rama Jayaraj
- Jindal Institute of Behavioral Sciences (JIBS), Jindal Global Institution of Eminence Deemed to Be University, 28, Sonipat 131001, India; Director of Clinical Sciences, Northern Territory Institute of Research and Training, Darwin, NT 0909, Australia
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata, West Bengal 700073, India
| | - Balachandar Vellingiri
- Stem cell and Regenerative Medicine/Translational Research, Department of Zoology, School of Basic Sciences, Central University of Punjab (CUPB), Bathinda 151401, Punjab, India
| | - Raja Ganesan
- Institute for Liver and Digestive Diseases, Hallym University, Chuncheon 24252, Republic of Korea
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Oduah MT, Sundaram V, Reddy YNV. Epicardial Fat in Heart Failure with Preserved Ejection Fraction: Bad Actor or Just Lying Around? Card Fail Rev 2023; 9:e06. [PMID: 37397241 PMCID: PMC10311396 DOI: 10.15420/cfr.2022.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/04/2022] [Indexed: 07/04/2023] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is increasingly recognised to be strongly associated with obesity and abnormalities in fat distribution. Epicardial fat has been associated with abnormal haemodynamics in HFpEF, with potential for direct mechanical effects on the heart causing constriction-like physiology and local myocardial remodelling effects from secretion of inflammatory and profibrotic mediators. However, patients with epicardial fat generally have more systemic and visceral adipose tissue making determination of causality between epicardial fat and HFpEF complex. In this review, we will summarise the evidence for epicardial fat being either directly causal in HFpEF pathogenesis or merely being a correlate of worse systemic inflammatory and generalised adiposity. We will also discuss therapies that directly target epicardial fat and may have potential for treating HFpEF and elucidating the independent role of epicardial fat in its pathogenesis.
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Affiliation(s)
| | - Varun Sundaram
- Division of Cardiovascular Diseases, Louis Stokes Cleveland Department of Veterans Affairs Medical CenterCleveland, OH, US
| | - Yogesh NV Reddy
- Department of Cardiovascular Disease, Mayo ClinicRochester, MN, US
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Miller NE, Steptoe A. Pericardial Fat, Socioeconomic Status, and Biological Responses to Acute Mental Stress. Psychosom Med 2023; 85:280-288. [PMID: 36705572 PMCID: PMC10082067 DOI: 10.1097/psy.0000000000001169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/14/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Central adiposity is associated with impaired biological responses to mental stress, and socioeconomic status (SES) might moderate this relationship. However, evidence for associations between pericardial fat, a fat depot implicated in the pathogenesis of cardiovascular disease (CVD), with cardiovascular and inflammatory responses to mental stress is lacking, and moderation by SES is unknown. METHODS The sample was 473 healthy men and women (mean age = 62.8 years) from the Whitehall II study. Cardiovascular and inflammatory responses to laboratory-induced mental stress, consisting of a 5-minute Stroop task and 5-minute mirror tracing task, were assessed. Pericardial fat volume was measured using electron bean computed tomography and adjusted for body surface area. SES was defined by grade of employment within the British civil service (higher/intermediate/lower). RESULTS Pericardial fat was associated with lower heart rate variability, raised heart rate, plasma interleukin-6, fibrinogen, and C-reactive protein at baseline. Furthermore, greater pericardial fat was associated with lower systolic blood pressure reactivity to mental stress, independent of sociodemographics, smoking status, waist-to-hip ratio, and baseline systolic blood pressure. There were no interactions between pericardial fat and SES for any outcome. CONCLUSIONS Greater pericardial fat was associated with numerous cardiovascular and inflammatory factors implicated in CVD. It was also related to reduced systolic blood pressure reactivity to acute mental stress, independent of central adiposity and baseline systolic blood pressure. This association did not vary by SES. Reduced systolic blood pressure reactivity to mental stress might contribute to the association between greater pericardial fat and CVD.
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Chow BHN, Dimarakis I. Extrapericardial fat: friend or foe in lung transplantation. BMJ Case Rep 2022; 15:e251460. [PMID: 36319042 PMCID: PMC9628653 DOI: 10.1136/bcr-2022-251460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Affiliation(s)
- Bobby Hiu Nam Chow
- Medical School, The University of Manchester, Manchester, UK
- Undergraduate department, Wythenshawe Hospital, Manchester, UK
| | - Ioannis Dimarakis
- Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Wythenshawe Hospital, Manchester, UK
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Association between depressive symptoms and pericardial fat in healthy older men and women. Sci Rep 2022; 12:13959. [PMID: 35978037 PMCID: PMC9385858 DOI: 10.1038/s41598-022-17888-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/02/2022] [Indexed: 12/02/2022] Open
Abstract
Depressive symptoms are associated with increased risk for cardiovascular disease (CVD), and inflammation may contribute to this relationship. Pericardial fat, a highly metabolically active fat depot, is implicated in the pathogenesis of CVD, but its association with depressive symptoms is unclear. This study examined the cross-sectional and longitudinal association between depressive symptoms and pericardial fat over a three-year period. Participants were 543 healthy men and women (mean age = 62.9 years) without history or objective signs of coronary heart disease from the Whitehall II cohort. In men, depressive symptoms were positively associated with pericardial fat at baseline after adjustment for sociodemographics, waist to hip ratio and conventional cardiovascular risk factors. Inflammation, indexed by plasma interleukin 6 concentration, accounted for 17% of this association. Longitudinally, depressive symptoms did not predict pericardial fat three years later in men once baseline levels of pericardial fat were accounted for. No significant associations between depressive symptoms and pericardial fat were found in women. Overall, our findings suggest that greater pericardial fat might be a mechanism by which depressive symptoms are associated with increased risk for CVD in men, and inflammation may also lie on this pathway.
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Kawai Y, Banno H, Sato T, Ikeda S, Tsuruoka T, Sugimoto M, Niimi K, Kodama A, Matsui K, Matsui S, Komori K. Epicardial adipose tissue volume is associated with abdominal aortic aneurysm expansion. J Vasc Surg 2022; 76:1253-1260. [PMID: 35661742 DOI: 10.1016/j.jvs.2022.04.032] [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: 12/15/2021] [Accepted: 04/08/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Epicardial adipose tissue volume (EATV) is associated with cardiovascular diseases such as coronary artery disease. However, no information is available regarding the relationship between EATV and abdominal aortic aneurysm (AAA) expansion. This study aimed to evaluate the association between EATV and the growth of AAA, and to identify predictors of AAA expansion. METHODS Between June 2009 and December 2019, a total of 906 patients underwent endovascular or open repair of AAA at our institution. Patients with previous cardiac surgery, previous ascending thoracic aortic surgery, ruptured AAA, infected AAA, inflammatory AAA, saccular aneurysm, solitary iliac aneurysm, or reintervention after treatment for AAA were excluded. Two hundred and thirty-seven patients with at least two preoperative computed tomography (CT) scans performed more than 180 days apart were included in this study. EATV within the pericardium was retrospectively quantified from preoperative non-contrast CT images using a 3D workstation. The EATV index was defined as EATV divided by body surface area. The AAA expansion rate was defined as the increase in AAA diameter per year, and patients were divided into the slow-expansion group, with an expansion rate < 5 mm/year, and the fast-expansion group, with an expansion rate ≥ 5 mm/year. The correlation between expansion rate and the EATV index was analyzed, and the cut-off value of the EATV index was determined using a receiver operating characteristics curve. Multivariate analysis was used to assess predictors of the AAA expansion rate. RESULTS The expansion rate of AAA was positively correlated with the EATV index (R = .237, P < .001). The initial aneurysm diameter (P < .001) and EATV index (P = .009) differed significantly between the two groups. The cut-off value of the EATV index was 60.3 cm3/m2 (area under the curve, .658; 95% confidence interval [CI], .568-.749; sensitivity, 1.000; specificity, .309). Multivariate analysis revealed that the initial aneurysm diameter and an EATV index > 60.3 cm3/m2 were significantly associated with the AAA expansion rate. CONCLUSIONS This study demonstrated that the EATV index was associated with AAA expansion.
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Affiliation(s)
- Yohei Kawai
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Hiroshi Banno
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomohiro Sato
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shuta Ikeda
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takuya Tsuruoka
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masayuki Sugimoto
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kiyoaki Niimi
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akio Kodama
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kota Matsui
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigeyuki Matsui
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kimihiro Komori
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Greco F, Salgado R, Van Hecke W, Del Buono R, Parizel PM, Mallio CA. Epicardial and pericardial fat analysis on CT images and artificial intelligence: a literature review. Quant Imaging Med Surg 2022; 12:2075-2089. [PMID: 35284252 PMCID: PMC8899943 DOI: 10.21037/qims-21-945] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/03/2021] [Indexed: 07/24/2023]
Abstract
The present review summarizes the available evidence on artificial intelligence (AI) algorithms aimed to the segmentation of epicardial and pericardial adipose tissues on computed tomography (CT) images. Body composition imaging is a novel concept based on quantitative analysis of body tissues. Manual segmentation of medical images allows to obtain quantitative and qualitative data on several tissues including epicardial and pericardial fat. However, since manual segmentation requires a considerable amount of time, the analysis of adipose tissue compartments based on AI has been proposed as an automatic, reliable, accurate and fast tool. The literature research was performed on March 2021 using MEDLINE PubMed Central and "adipose tissue artificial intelligence", "adipose tissue deep learning" or "adipose tissue machine learning" as keywords for articles search. Relevant articles concerning epicardial adipose tissue, pericardial adipose tissue and AI were selected. The evaluation of adipose tissue compartments can provide additional information on the pathogenesis and prognosis of several diseases, including cardiovascular. AI can assist physicians to obtain important information, possibly improving the patient's quality of life and identifying patients at risk of developing variable disorders.
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Affiliation(s)
- Federico Greco
- U.O.C. Diagnostica per Immagini Territoriale Aziendale, Cittadella della Salute Azienda Sanitaria Locale di Lecce, Lecce, Italy
| | - Rodrigo Salgado
- Department of Radiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Wim Van Hecke
- AI Supported Modelling in Clinical Sciences (AIMS), Vrije Universiteit Brussel, 1050 Brussels, Belgium and founder of icoMetrix, Leuven, Belgium
| | - Romualdo Del Buono
- Unit of Anesthesia, Resuscitation, Intensive Care and Pain Management, ASST Gaetano Pini, Milano, Italy
| | - Paul M. Parizel
- Royal Perth Hospital & University of Western Australia, Perth, Western Australia, Australia
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Pericardial fat, thoracic peri-aortic adipose tissue, and systemic inflammatory marker in nonalcoholic fatty liver and abdominal obesity phenotype. Sci Rep 2022; 12:1958. [PMID: 35121786 PMCID: PMC8816900 DOI: 10.1038/s41598-022-06030-z] [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: 06/28/2021] [Accepted: 01/17/2022] [Indexed: 12/24/2022] Open
Abstract
Researchers have conducted many studies about the relationships between peri-cardiovascular fat, nonalcoholic fatty liver disease (NAFLD), waist circumference, and cardiovascular disease (CVD). Nevertheless, the relationship between NAFLD and pericardial fat (PCF)/thoracic peri-aortic adipose tissue (TAT) phenotypes was still unknown. This study aimed to explore whether PCF/TAT was associated with NAFLD/abdominal obesity (AO) phenotypes in different high-sensitivity C-reactive protein (hs-CRP) levels. We consecutively studied 1655 individuals (mean age, 49.44 ± 9.76 years) who underwent a health-screening program. We showed a significant association between PCF/TAT and NAFLD/AO phenotypes in the cross-sectional study. We observed that the highest risk occurred in both abnormalities' groups, and the second highest risk occurred in the AO-only group. Subjects with AO had a significantly increased risk of PCF or TAT compared to those with NAFLD. Notably, the magnitude of the associations between PCF/TAT and NAFLD/AO varied by the level of systemic inflammatory marker (hs-CRP level). We suggested that people with AO and NAFLD must be more careful about changes in PCF and TAT. Regular measurement of waist circumference (or AO) can be a more accessible way to monitor peri-cardiovascular fat (PCF and TAT), which may serve as a novel and rapid way to screen CVD in the future.
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Rasmussen IKB, Zobel EH, Ripa RS, von Scholten BJ, Curovic VR, Jensen JK, Kjaer A, Hansen TW, Rossing P. Liraglutide reduces cardiac adipose tissue in type 2 diabetes: A secondary analysis of the LIRAFLAME randomized placebo-controlled trial. Diabetes Obes Metab 2021; 23:2651-2659. [PMID: 34387408 DOI: 10.1111/dom.14516] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/13/2021] [Accepted: 07/28/2021] [Indexed: 01/13/2023]
Abstract
AIM To test the hypothesis that treatment with liraglutide can reduce cardiac adipose tissue. MATERIALS AND METHODS LIRAFLAME is a randomized placebo-controlled, double-blind, parallel clinical study. Participants with type 2 diabetes were randomized to treatment with liraglutide 1.8 mg/d or placebo for 26 weeks. Computed tomography was performed at baseline and at end of treatment to evaluate the cardiac adipose tissue volume, quantified automatically. We report the results of a secondary endpoint evaluating changes in cardiac adipose tissue. RESULTS A total of 102 participants were randomly assigned to liraglutide (n = 51) or placebo (n = 51). At baseline, the mean (SD) cardiac adipose tissue volume was comparable between the liraglutide and the placebo group (232.6 [112.8] vs. 227.0 [103.2] mL; P = 0.80). The mean change in body weight was -3.7 (-4.8, -2.6) kg in the liraglutide and -0.18 (-0.76, 0.40) kg in the placebo group. From baseline to end of treatment the mean cardiac adipose tissue change was -11.5 (95% confidence interval -17.6, -5.4) mL in the liraglutide (P < 0.001) and -0.01 (-5.3, 5.3) mL in the placebo (P = 1.00) groups. The reduction in cardiac adipose tissue was significantly greater in the liraglutide compared to the placebo group (mean difference -11.4 [-19.4, -3.3] mL; P = 0.006), but significance was lost after adjustment for changes in body mass index (P = 0.46). CONCLUSION Treatment with liraglutide for 26 weeks was associated with a reduction in cardiac adipose tissue compared to placebo. The reduction was not independent of weight loss, suggesting that this is not a drug-specific effect.
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Affiliation(s)
| | | | - Rasmus S Ripa
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, Kobenhavn, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Bernt J von Scholten
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
- Novo Nordisk A/S, Søborg, Denmark
| | | | - Jacob K Jensen
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, Kobenhavn, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Andreas Kjaer
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, Kobenhavn, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | | | - Peter Rossing
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
- University of Copenhagen, Copenhagen, Denmark
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Baritussio A, Williams MC. Gaining evidence on coronary inflammation. J Cardiovasc Comput Tomogr 2021; 15:455-456. [PMID: 33952437 DOI: 10.1016/j.jcct.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Anna Baritussio
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Azienda Ospedale-Università, University of Padua, Padua, Italy.
| | - Michelle C Williams
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; Edinburgh Imaging Facility QMRI, University of Edinburgh, Edinburgh, UK
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Sousa JA, Mendonça MI, Serrão M, Borges S, Henriques E, Freitas S, Tentem M, Santos M, Freitas P, Ferreira A, Guerra G, Drumond A, Palma Reis R. Epicardial Adipose Tissue: The Genetics Behind an Emerging Cardiovascular Risk Marker. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2021; 15:11795468211029244. [PMID: 34276231 PMCID: PMC8255575 DOI: 10.1177/11795468211029244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 06/07/2021] [Indexed: 12/16/2022]
Abstract
Evidence points epicardial adipose tissue (EAT) as an emerging cardiovascular risk marker. Whether genetic polymorphisms linked with atherosclerosis are associated with higher EAT is still unknown. We aim to assess the role of genetic burden of atherosclerosis and its association to EAT in a cohort of asymptomatic individuals without coronary disease. A total of 996 participants were prospectively enrolled in a single Portuguese center. EAT volume was measured by Cardiac Computed Tomography and participants were distributed into 2 groups, above and below median EAT. SNPs were genotyped and linked to their respective pathophysiological axes. A multiplicative genetic risk score (mGRS) was constructed, representing the genetic burden of the studied SNPs. To evaluate the association between genetics and EAT, we compared both groups by global mGRS, mGRS by functional axes, and SNPs individually. Individuals above-median EAT were older, had a higher body mass index (BMI) and higher prevalence of hypertension, metabolic syndrome, diabetes, and dyslipidemia. They presented higher GRS, that remained an independent predictor of higher EAT volumes. The group with more EAT consistently presented higher polymorphic burden across numerous pathways. After adjustment, age, BMI, and mGRS of each functional axis emerged as independently related to higher EAT volumes. Amongst the 33 SNPs, MTHFR677 polymorphism emerged as the only significant and independent predictor of higher EAT volumes. Patients with higher polymorphism burden for atherosclerosis present higher EAT volumes. We present the first study in a Portuguese population, evaluating the genetic profile of EAT through GWAS and GRS, casting further insight into this complicated matter.
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Affiliation(s)
- João Adriano Sousa
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Maria Isabel Mendonça
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Marco Serrão
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Sofia Borges
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Eva Henriques
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Sónia Freitas
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Margarida Tentem
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Marina Santos
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Pedro Freitas
- Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, CHLO, Carnaxide, Portugal
| | - António Ferreira
- Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, CHLO, Carnaxide, Portugal
| | - Graça Guerra
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - António Drumond
- Centro de Investigação Dra Maria Isabel Mendonça, Hospital Dr Nélio Mendonça, SESARAM, EPERAM, Funchal, Madeira, Portugal
| | - Roberto Palma Reis
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
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14
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Kang JH, Kim H, Kim J, Seo JH, Cha S, Oh H, Kim K, Park SJ, Kim E, Kong S, Lee JH, Bae JS, Won HH, Joung JG, Yang YJ, Kim J, Park WY. Interaction of genetic and environmental factors for body fat mass control: observational study for lifestyle modification and genotyping. Sci Rep 2021; 11:13180. [PMID: 34162918 PMCID: PMC8222320 DOI: 10.1038/s41598-021-92229-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 06/01/2021] [Indexed: 01/22/2023] Open
Abstract
Previous studies suggested that genetic, environmental factors and their interactions could affect body fat mass (BFM). However, studies describing these effects were performed at a single time point in a population. In this study, we investigated the interaction between genetic and environmental factors in affecting BFM and implicate the healthcare utilization of lifestyle modifications from a personalized and genomic perspective. We examined how nutritional intake or physical activity changes in the individuals affect BFM concerning the genetic composition. We conducted an observational study including 259 adult participants with single nucleotide polymorphism (SNP) genotyping and longitudinal lifestyle monitoring, including food consumption and physical activities, by following lifestyle modification guidance. The participants’ lifelog data on exercise and diet were collected through a wearable device for 3 months. Moreover, we measured anthropometric and serologic markers to monitor their potential changes through lifestyle modification. We examined the influence of genetic composition on body fat reduction induced by lifestyle changes using genetic risk scores (GRSs) of three phenotypes: GRS-carbohydrate (GRS-C), GRS-fat (GRS-F), and GRS-exercise (GRS-E). Our results showed that lifestyle modifications affected BFM more significantly in the high GRS class compared to the low GRS class, indicating the role of genetic factors affecting the efficiency of the lifestyle modification-induced BFM changes. Interestingly, the influence of exercise modification in the low GRS class with active lifestyle change was lower than that in the high GRS class with inactive lifestyle change (P = 0.022), suggesting the implication of genetic factors for efficient body fat control.
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Affiliation(s)
- Joon Ho Kang
- Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, 16419, South Korea.,Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University, Ilwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Heewon Kim
- Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University, Ilwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Jinki Kim
- AI&SW Center, SAIT, SEC, 130, Samsung-ro, Yeongtong-gu, Suwon, Gyeonggi, 16678, South Korea
| | - Jong-Hwa Seo
- AI&SW Center, SAIT, SEC, 130, Samsung-ro, Yeongtong-gu, Suwon, Gyeonggi, 16678, South Korea
| | - Soyeon Cha
- Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University, Ilwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Hyunjung Oh
- Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University, Ilwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Kyunga Kim
- Samsung Medical Center, Gangnam-gu, Seoul, 06351, South Korea
| | - Seong-Jin Park
- AI&SW Center, SAIT, SEC, 130, Samsung-ro, Yeongtong-gu, Suwon, Gyeonggi, 16678, South Korea
| | - Eunbin Kim
- Department of Clinical Nutrition, School of Public Health, Dongduk Women's University, Seoul, 02748, Korea
| | - Sunga Kong
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Jae-Hak Lee
- Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University, Ilwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Joon Seol Bae
- Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University, Ilwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University of Medicine, Seoul, 06351, South Korea
| | - Je-Gun Joung
- Samsung Medical Center, Gangnam-gu, Seoul, 06351, South Korea
| | - Yoon Jung Yang
- Department of Foods and Nutrition, College of Natural Sciences, Dongduk Women's University, 60, Hwarang-ro 13-gil, Seongbuk-gu, Seoul, 02748, Korea.
| | - Jinho Kim
- Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University, Ilwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea.
| | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University, Ilwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea.
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15
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Yuan H, Medina-Inojosa JR, Lopez-Jimenez F, Miranda WR, Collazo-Clavell ML, Sarr MG, Chamberlain AM, Hodge DO, Bailey KR, Wang Y, Chen Y, Cha YM. The Long-Term Impact of Bariatric Surgery on Development of Atrial Fibrillation and Cardiovascular Events in Obese Patients: An Historical Cohort Study. Front Cardiovasc Med 2021; 8:647118. [PMID: 33928133 PMCID: PMC8076511 DOI: 10.3389/fcvm.2021.647118] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/02/2021] [Indexed: 12/18/2022] Open
Abstract
Objective: To determine whether early Roux-en-Y gastric bypass surgery (RYGB) reduces the risk of Major adverse cardiovascular events (MACE) in patients with obesity. Patients and Methods: We conducted a study of patients with class II and III obesity [body mass index (BMI) > 35 kg/m2] from Olmsted County, Minnesota, who underwent obesity clinic consultation between the years 1993-2012, and had either RYGB surgery within 1 year (RYGB-1Y group), or medically managed (No-RYGB group). The composite endpoint of MACE (all-cause mortality, stroke, heart failure admission and acute myocardial infarction) was the primary endpoint, with new-onset AF as the secondary endpoint. Results: Of the 1,009 study patients, 308 had RYGB-1Y and 701 were medically managed (No-RYGB). Overall, the age was 44.0 ± 12.4 (mean ± SD) years; BMI was 45.0 ± 6.8 kg/m2. The RYGB-1Y group had a lower rate of MACE (adjusted hazard ratio (HR), 0.62; 95% CI, 0.44-0.88; P = 0.008) and lower mortality (adjusted HR, 0.51; 95% CI, 0.26-0.96; P = 0.04) than the No-RYGB group. The RYGB-1Y surgery was not associated with lower AF occurrence (HR, 0.66; 95% CI, 0.40-1.10; P = 0.11). Conclusion: An early RYGB approach for BMI reduction was associated with lower rates of MACE.
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Affiliation(s)
- Hongtao Yuan
- Department of Cardiology, Chinese People's Liberation Army General Hospital (PLAGH), Beijing, China
| | | | | | - William R Miranda
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Maria L Collazo-Clavell
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, United States
| | - Michael G Sarr
- Department of Surgery, Mayo Clinic, Rochester, MN, United States
| | - Alanna M Chamberlain
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - David O Hodge
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, United States
| | - Kent R Bailey
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Yutang Wang
- Department of Cardiology, Chinese People's Liberation Army General Hospital (PLAGH), Beijing, China
| | - Yundai Chen
- Department of Cardiology, Chinese People's Liberation Army General Hospital (PLAGH), Beijing, China
| | - Yong-Mei Cha
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
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16
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Philip C, Seifried R, Peterson PG, Liotta R, Steel K, Bittencourt MS, Hulten EA. Cardiac MRI for Patients with Increased Cardiometabolic Risk. Radiol Cardiothorac Imaging 2021; 3:e200575. [PMID: 33969314 DOI: 10.1148/ryct.2021200575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/07/2021] [Accepted: 02/12/2021] [Indexed: 11/11/2022]
Abstract
Cardiac MRI (CMR) has rich potential for future cardiovascular screening even though not approved clinically for routine screening for cardiovascular disease among patients with increased cardiometabolic risk. Patients with increased cardiometabolic risk include those with abnormal blood pressure, body mass, cholesterol level, or fasting glucose level, which may be related to dietary and exercise habits. However, CMR does accurately evaluate cardiac structure and function. CMR allows for effective tissue characterization with a variety of sequences that provide unique insights as to fibrosis, infiltration, inflammation, edema, presence of fat, strain, and other potential pathologic features that influence future cardiovascular risk. Ongoing epidemiologic and clinical research may demonstrate clinical benefit leading to increased future use. © RSNA, 2021.
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Affiliation(s)
- Cynthia Philip
- Department of Medicine, Cardiology Service (C.P., R.S., E.A.H.) and Department of Radiology (P.G.P., R.L.), Walter Reed National Military Medical Center, Bethesda, Md; Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (C.P., R.S., P.G.P., R.L., E.A.H.); PeaceHealth Medical Group, Bellingham, Wash (K.S.); University Hospital, University of São Paulo School of Medicine, São Paulo, Brazil (M.S.B.); Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil (M.S.B.); and DASA São Paulo, São Paulo, Brazil (M.S.B.)
| | - Rebecca Seifried
- Department of Medicine, Cardiology Service (C.P., R.S., E.A.H.) and Department of Radiology (P.G.P., R.L.), Walter Reed National Military Medical Center, Bethesda, Md; Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (C.P., R.S., P.G.P., R.L., E.A.H.); PeaceHealth Medical Group, Bellingham, Wash (K.S.); University Hospital, University of São Paulo School of Medicine, São Paulo, Brazil (M.S.B.); Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil (M.S.B.); and DASA São Paulo, São Paulo, Brazil (M.S.B.)
| | - P Gabriel Peterson
- Department of Medicine, Cardiology Service (C.P., R.S., E.A.H.) and Department of Radiology (P.G.P., R.L.), Walter Reed National Military Medical Center, Bethesda, Md; Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (C.P., R.S., P.G.P., R.L., E.A.H.); PeaceHealth Medical Group, Bellingham, Wash (K.S.); University Hospital, University of São Paulo School of Medicine, São Paulo, Brazil (M.S.B.); Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil (M.S.B.); and DASA São Paulo, São Paulo, Brazil (M.S.B.)
| | - Robert Liotta
- Department of Medicine, Cardiology Service (C.P., R.S., E.A.H.) and Department of Radiology (P.G.P., R.L.), Walter Reed National Military Medical Center, Bethesda, Md; Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (C.P., R.S., P.G.P., R.L., E.A.H.); PeaceHealth Medical Group, Bellingham, Wash (K.S.); University Hospital, University of São Paulo School of Medicine, São Paulo, Brazil (M.S.B.); Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil (M.S.B.); and DASA São Paulo, São Paulo, Brazil (M.S.B.)
| | - Kevin Steel
- Department of Medicine, Cardiology Service (C.P., R.S., E.A.H.) and Department of Radiology (P.G.P., R.L.), Walter Reed National Military Medical Center, Bethesda, Md; Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (C.P., R.S., P.G.P., R.L., E.A.H.); PeaceHealth Medical Group, Bellingham, Wash (K.S.); University Hospital, University of São Paulo School of Medicine, São Paulo, Brazil (M.S.B.); Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil (M.S.B.); and DASA São Paulo, São Paulo, Brazil (M.S.B.)
| | - Marcio S Bittencourt
- Department of Medicine, Cardiology Service (C.P., R.S., E.A.H.) and Department of Radiology (P.G.P., R.L.), Walter Reed National Military Medical Center, Bethesda, Md; Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (C.P., R.S., P.G.P., R.L., E.A.H.); PeaceHealth Medical Group, Bellingham, Wash (K.S.); University Hospital, University of São Paulo School of Medicine, São Paulo, Brazil (M.S.B.); Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil (M.S.B.); and DASA São Paulo, São Paulo, Brazil (M.S.B.)
| | - Edward A Hulten
- Department of Medicine, Cardiology Service (C.P., R.S., E.A.H.) and Department of Radiology (P.G.P., R.L.), Walter Reed National Military Medical Center, Bethesda, Md; Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (C.P., R.S., P.G.P., R.L., E.A.H.); PeaceHealth Medical Group, Bellingham, Wash (K.S.); University Hospital, University of São Paulo School of Medicine, São Paulo, Brazil (M.S.B.); Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil (M.S.B.); and DASA São Paulo, São Paulo, Brazil (M.S.B.)
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Steffen BT, Guan W, Ding J, Nomura SO, Weir NL, Tsai MY. Plasma omega-3 and saturated fatty acids are differentially related to pericardial adipose tissue volume across race/ethnicity: the Multi-ethnic Study of Atherosclerosis. Eur J Clin Nutr 2021; 75:1237-1244. [PMID: 33398103 PMCID: PMC8254815 DOI: 10.1038/s41430-020-00833-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 11/02/2020] [Accepted: 12/02/2020] [Indexed: 11/13/2022]
Abstract
BACKGROUND: Pericardial adipose tissue (PAT) is a cardiometabolic risk factor influenced by race/ethnicity, inflammation, and metabolic dysfunction. Omega-3 fatty acids (FAs) and saturated FAs (SFAs) are known to affect these latter phenomena and may influence PAT accumulation. We aimed to determine whether plasma levels of these FAs are related to PAT volume and its rate of change over a median 3-year follow-up. METHODS: Cardiac computed tomography assessed PAT in 6,785 Multi-Ethnic Study of Atherosclerosis participants. Gas chromatography flame-ionization estimated plasma phospholipid fatty acids. Regression analyses estimated associations of FAs with PAT volume and its rate of change with adjustments for other risk factors. Race-interactions were tested. RESULTS: In cross-section, top tertiles of omega-3 FAs and odd-chained SFAs were associated with 2.8 and 4.93 cm3 lower PAT volumes, respectively; race/ethnicity was a significant modifying variable (p<0.002). Even-chained SFAs were associated with 3.5 cm3 greater PAT volume. With stratification by race/ethnicity, Chinese Americans in the top tertile of omega-3 FAs showed 10.5 cm3 greater PAT volume than those in the referent tertile. Black individuals in the top tertile of odd-chained SFAs showed 5.0 cm3 lower PAT compared to referents. Black and Chinese Americans in top tertiles of even-chained SFAs showed respective 3.7 and 5.9 cm3 greater PAT volumes compared to referents. Two associations were observed in prospective analyses among Caucasians; race interactions were non-significant. CONCLUSIONS: Cross-sectional and prospective findings provide inconclusive evidence as to whether plasma FAs are related to PAT in healthy individuals. Cohort studies with longer follow-up periods are warranted.
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Affiliation(s)
- Brian T Steffen
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Weihua Guan
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Jingzhong Ding
- Department of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Sarah O Nomura
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Natalie L Weir
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Michael Y Tsai
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN, USA.
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Miller VM, Naftolin F, Asthana S, Black DM, Brinton EA, Budoff MJ, Cedars MI, Dowling NM, Gleason CE, Hodis HN, Jayachandran M, Kantarci K, Lobo RA, Manson JE, Pal L, Santoro NF, Taylor HS, Harman SM. The Kronos Early Estrogen Prevention Study (KEEPS): what have we learned? Menopause 2019; 26:1071-1084. [PMID: 31453973 PMCID: PMC6738629 DOI: 10.1097/gme.0000000000001326] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/20/2018] [Accepted: 12/20/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The Kronos Early Estrogen Prevention Study (KEEPS) was designed to address gaps in understanding the effects of timely menopausal hormone treatments (HT) on cardiovascular health and other effects of menopause after the premature termination of the Women's Health Initiative. METHOD The KEEPS was a randomized, double-blinded, placebo-controlled trial to test the hypothesis that initiation of HT (oral conjugated equine estrogens [o-CEE] or transdermal 17β-estradiol [t-E2]) in healthy, recently postmenopausal women (n = 727) would slow the progression of atherosclerosis as measured by changes in carotid artery intima-media thickness (CIMT). RESULTS After 4 years, neither HT affected the rate of increase in CIMT. There was a trend for reduced accumulation of coronary artery calcium with o-CEE. There were no severe adverse effects, including venous thrombosis. Several ancillary studies demonstrated a positive effect on mood with o-CEE, and reduced hot flashes, improved sleep, and maintenance of bone mineral density with both treatments. Sexual function improved with t-E2. There were no significant effects of either treatment on cognition, breast pain, or skin wrinkling. Variants of genes associated with estrogen metabolism influenced the age of menopause and variability in effects of the HT on CIMT. Platelet activation associated with the development of white matter hyperintensities in the brain. CONCLUSIONS KEEPS and its ancillary studies have supported the value and safety of the use of HT in recently postmenopausal women and provide a perspective for future research to optimize HT and health of postmenopausal women. The KEEPS continuation study continues to pursue these issues.
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Affiliation(s)
- Virginia M. Miller
- Departments of Surgery and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN
| | - Fredrick Naftolin
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY
| | - Sanjay Asthana
- Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, University of Wisconsin School of Medicine and Public Health and the Geriatric Research, Madison, WI
| | - Dennis M. Black
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA
| | | | - Matthew J. Budoff
- Department of Medicine, Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles, Torrance, CA
| | - Marcelle I. Cedars
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
| | - N. Maritza Dowling
- Departments of Acute and Chronic Care, Epidemiology and Biostatistics, George Washington University School of Nursing and Milken Institute School of Public Health, Washington, DC
| | - Carey E. Gleason
- Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health and the William S. Middleton Memorial VA, Geriatric Research, Education and Clinical Center, Madison, WI
| | - Howard N. Hodis
- Atherosclerosis Research Unit, University of Southern California, Los Angeles, CA
| | - Muthuvel Jayachandran
- Department of Physiology and Biomedical Engineering, Division of Nephrology and Hypertension, Division of Hematology Research, Mayo Clinic, Rochester, MN
| | | | - Rogerio A. Lobo
- Department of Obstetrics and Gynecology, Columbia University, New York, NY
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Lubna Pal
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT
| | - Nanette F. Santoro
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO
| | - Hugh S. Taylor
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT
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Reinhardt M, Cushman TR, Thearle MS, Krakoff J. Epicardial adipose tissue is a predictor of decreased kidney function and coronary artery calcification in youth- and early adult onset type 2 diabetes mellitus. J Endocrinol Invest 2019; 42:979-986. [PMID: 30674009 DOI: 10.1007/s40618-019-1011-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 01/16/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE To examine the association of epicardial and pericardial fat volume (EFV, PFV) with cardiovascular risk factors and kidney function in Native Americans of southwestern heritage with youth and early adult onset type 2 diabetes mellitus (T2DM) versus healthy controls. METHODS Using computed tomography, we quantified EFV and PFV in 149 Native Americans (92 women, 57 men), 95 of which had T2DM (38 diagnosed prior to age 20 years). Duration of T2DM, mean carotid arterial mass (AM), coronary artery calcification (CAC), IL-6, and estimated glomerular filtration rate eGFRcr(CKD-EPI) were measured. RESULTS EFV and PFV were associated with BMI (r = 0.37, p < 0.0001; r = 0.26, p = 0.001) and did not differ between onset age-groups and controls (p > 0.05). EFV was associated with AM only in controls (r = 0.51, p < 0.0001). After adjustment for BMI, T2DM duration, HbA1C, age, and sex, EFV was a predictor of CAC and IL-6 concentrations in early adult onset T2DM (β = 0.05 ± 0.02 cm3, p = 0.03; β = 0.05 ± 0.01 pg/ml/cm3, p = 0.002). EFV and PFV were independent predictors of reduced eGFRcr(CKD-EPI) in the youth onset T2DM group (β = -0.3 ± 0.08 ml/min/cm3, p = 0.001; β = -0.25 ± 0.05 ml/min/cm3, p < 0.0001). CONCLUSIONS Epicardial fat volume may be a risk factor for heart disease in individuals with early adult onset T2DM and a predictor of decreased kidney function in individuals with youth onset T2DM.
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Affiliation(s)
- M Reinhardt
- Obesity and Diabetes Clinical Research Section, Department of Health and Human Services, Phoenix Epidemiology and Clinical Research Branch National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 N. 16th Street, Phoenix, AZ, 85016, USA.
- Department of Diagnostic and Interventional Radiology, University of Leipzig Medical Center, Liebigstraße 20, 04103, Leipzig, Germany.
| | - T R Cushman
- Obesity and Diabetes Clinical Research Section, Department of Health and Human Services, Phoenix Epidemiology and Clinical Research Branch National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 N. 16th Street, Phoenix, AZ, 85016, USA
| | - M S Thearle
- Obesity and Diabetes Clinical Research Section, Department of Health and Human Services, Phoenix Epidemiology and Clinical Research Branch National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 N. 16th Street, Phoenix, AZ, 85016, USA
| | - J Krakoff
- Obesity and Diabetes Clinical Research Section, Department of Health and Human Services, Phoenix Epidemiology and Clinical Research Branch National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 N. 16th Street, Phoenix, AZ, 85016, USA
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Ruppert J, Hartung D, Westhoff-Bleck M, Herrmann J, Stubbs B, Cordes J, Krüger THC, Lichtinghagen R, Kahl KG. Increased pericardial adipose tissue and cardiometabolic risk in patients with schizophrenia versus healthy controls. Eur Arch Psychiatry Clin Neurosci 2018; 268:719-725. [PMID: 29170826 DOI: 10.1007/s00406-017-0858-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 11/14/2017] [Indexed: 02/07/2023]
Abstract
Patients with schizophrenia are at increased risk of diabetes, cardiovascular disease (CVD) and associated mortality versus the general population. Increased intra-abdominal and pericardial adipose tissue are associated with elevated CVD and mortality in the general population, but little is known about these in patients with schizophrenia. This study examined pericardial and intra-abdominal adipose tissue in schizophrenia and compared this to healthy controls. Thirty-one patients with schizophrenia (mean age 41.2 years, 76% males) and 30 healthy volunteers (CTRL) were examined in this study. The primary outcomes were the volumes of pericardial adipose tissue and intra-abdominal adipose tissue, measured using magnetic resonance imaging. Secondary outcomes included diabetes and cardiac event risk assessed by established instruments. Volumes of pericardial adipose tissue were increased in male and female patients with schizophrenia compared to healthy controls after the adjustment of age, sex and body mass index (P < 0.005). The 10-year risk of a cardiac event was significantly higher in patients with schizophrenia. Furthermore, the risk for developing type-2 diabetes mellitus was slightly increased in schizophrenia. Volumes of intra-abdominal adipose tissue were slightly increased in male and female patients with schizophrenia, albeit not statistically significant. This study demonstrates that patients with schizophrenia have increased pericardial adipose tissue versus controls. This increased fat deposit around the heart is highly relevant for understanding the comorbidity between heart disease and schizophrenia. Interventions aiming to reduce pericardial and intra-abdominal adipose tissue, such as exercise, may be essential to reduce the burden of heart disease in schizophrenia.
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Affiliation(s)
- J Ruppert
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Str. 1, 30625, Hannover, Germany
| | - D Hartung
- Institute for Diagnostic and Interventional Radiology, MHH, Hannover, Germany
| | - M Westhoff-Bleck
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - J Herrmann
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Str. 1, 30625, Hannover, Germany
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK.,Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
| | - J Cordes
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University, Düsseldorf, Germany
| | - T H C Krüger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Str. 1, 30625, Hannover, Germany
| | - R Lichtinghagen
- Institute for Clinical Chemistry, Hannover Medical School, Hannover, Germany
| | - K G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Carl-Neuberg. Str. 1, 30625, Hannover, Germany.
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21
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Lovric A, Granér M, Bjornson E, Arif M, Benfeitas R, Nyman K, Ståhlman M, Pentikäinen MO, Lundbom J, Hakkarainen A, Sirén R, Nieminen MS, Lundbom N, Lauerma K, Taskinen MR, Mardinoglu A, Boren J. Characterization of different fat depots in NAFLD using inflammation-associated proteome, lipidome and metabolome. Sci Rep 2018; 8:14200. [PMID: 30242179 PMCID: PMC6155005 DOI: 10.1038/s41598-018-31865-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 08/21/2018] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is recognized as a liver manifestation of metabolic syndrome, accompanied with excessive fat accumulation in the liver and other vital organs. Ectopic fat accumulation was previously associated with negative effects at the systemic and local level in the human body. Thus, we aimed to identify and assess the predictive capability of novel potential metabolic biomarkers for ectopic fat depots in non-diabetic men with NAFLD, using the inflammation-associated proteome, lipidome and metabolome. Myocardial and hepatic triglycerides were measured with magnetic spectroscopy while function of left ventricle, pericardial and epicardial fat, subcutaneous and visceral adipose tissue were measured with magnetic resonance imaging. Measured ectopic fat depots were profiled and predicted using a Random Forest algorithm, and by estimating the Area Under the Receiver Operating Characteristic curves. We have identified distinct metabolic signatures of fat depots in the liver (TAG50:1, glutamate, diSM18:0 and CE20:3), pericardium (N-palmitoyl-sphinganine, HGF, diSM18:0, glutamate, and TNFSF14), epicardium (sphingomyelin, CE20:3, PC38:3 and TNFSF14), and myocardium (CE20:3, LAPTGF-β1, glutamate and glucose). Our analyses highlighted non-invasive biomarkers that accurately predict ectopic fat depots, and reflect their distinct metabolic signatures in subjects with NAFLD.
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Affiliation(s)
- Alen Lovric
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Marit Granér
- Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Elias Bjornson
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden.,Department of Molecular and Clinical Medicine/Wallenberg Lab, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Muhammad Arif
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Rui Benfeitas
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Kristofer Nyman
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Marcus Ståhlman
- Department of Molecular and Clinical Medicine/Wallenberg Lab, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Markku O Pentikäinen
- Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Jesper Lundbom
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Antti Hakkarainen
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Reijo Sirén
- Department of General Practice and Primary Health Care, Health Care Centre of City of Helsinki and University of Helsinki, Helsinki, Finland
| | - Markku S Nieminen
- Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Nina Lundbom
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Kirsi Lauerma
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Marja-Riitta Taskinen
- Heart and Lung Center, Division of Cardiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
| | - Adil Mardinoglu
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden. .,Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden.
| | - Jan Boren
- Department of Molecular and Clinical Medicine/Wallenberg Lab, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden.
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22
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Faight E, Verdelis K, Ahearn JM, Shields KJ. 3D MicroCT spatial and temporal characterization of thoracic aorta perivascular adipose tissue and plaque volumes in the ApoE-/- mouse model. Adipocyte 2018; 7:156-165. [PMID: 29956579 DOI: 10.1080/21623945.2018.1493900] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Perivascular adipose tissue (PVAT) influences vascular function and pathology. We present a protocol using micro-computed tomography (microCT), a novel imaging technique typically used for hard biological tissue, to characterize the temporal and spatial development of aorta PVAT and luminal plaque soft tissue. Apolipoprotein E deficient (ApoE) and C57Bl/6J (control) mice were fed a high fat western diet up to 30 weeks. 3D microCT reconstructions were used to quantify: 1) vascular wall volume, a surrogate measure of remodeling, was greater in ApoE, 2) aorta PVAT volume was reduced in ApoE, 3) plaque volumes increased over time in ApoE, 4) plaque development co-localized with luminal ostia, origins of branching arteries, which traveled through areas of greatest PVAT volume, 5) qualitatively, the same arteries showed evidence of increased tortuosity in ApoE. This study reflects the potential of microCT analyses to assess vascular wall, PVAT and arterial trajectory modifications in relevant animal models. Abbreviations: PVAT: perivascular adipose tissue; ApoE: apolipoprotein E deficient mouse strain; Control: C57Bl/6J mouse strain; PTA: 0.3% phosphotungstic acid; microCT: micro-computed tomography; CV: cardiovascular; CVD: cardiovascular disease; IQR: interquartile range; PPARγ: peroxisome proliferator activated receptor - gamma; VV: vasa vasorum; 3D: three dimensional.
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Affiliation(s)
- Erin Faight
- Lupus Center of Excellence, Autoimmunity Institute, Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA
| | - Kostas Verdelis
- Division of Endodontics at the Department of Restorative Dentistry and Comprehensive Care and the Department of Oral Biology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joseph M. Ahearn
- Lupus Center of Excellence, Autoimmunity Institute, Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA
| | - Kelly J. Shields
- Lupus Center of Excellence, Autoimmunity Institute, Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA
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23
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Epicardial adipose tissue is related to arterial stiffness and inflammation in patients with cardiovascular disease and type 2 diabetes. BMC Cardiovasc Disord 2018; 18:31. [PMID: 29433433 PMCID: PMC5809843 DOI: 10.1186/s12872-018-0770-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 02/02/2018] [Indexed: 11/10/2022] Open
Abstract
Background Epicardial adipose tissue (EAT) is an emerging cardio-metabolic risk factor and has been shown to correlate with adverse cardiovascular (CV) outcome; however the underlying pathophysiology of this link is not well understood. The aim of this study was to evaluate the relationship between EAT and a comprehensive panel of cardiovascular risk biomarkers and pulse wave velocity (PWV) and indexed left ventricular mass (LVMI) in a cohort of patients with cardiovascular disease (CVD) and diabetes compared to controls. Methods One hundred forty-five participants (mean age 63.9 ± 8.1 years; 61% male) were evaluated. All patients underwent cardiovascular magnetic resonance (CMR) examination and PWV. EAT measurements from CMR were performed on the 4-chamber view. Blood samples were taken and a range of CV biomarkers was evaluated. Results EAT measurements were significantly higher in the groups with CVD, with or without T2DM compared to patients without CVD or T2DM (group 1 EAT 15.9 ± 5.5 cm2 vs. group 4 EAT 11.8 ± 4.1 cm2, p = 0.001; group 3 EAT 15.1 ± 4.3 cm2 vs. group 4 EAT 11.8 ± 4.1 cm2, p = 0.024). EAT was independently associated with IL-6 (beta 0.2, p = 0.019). When added to clinical variables, both EAT (beta 0.16, p = 0.035) and IL-6 (beta 0.26, p = 0.003) were independently associated with PWV. EAT was significantly associated with LVMI in a univariable analysis but not when added to significant clinical variables. Conclusions In patients with cardio-metabolic disease, EAT was independently associated with PWV. EAT may be associated with CVD risk due to an increase in systemic vascular inflammation. Whether targeting EAT may reduce inflammation and/or cardiovascular risk should be evaluated in prospective studies. Electronic supplementary material The online version of this article (10.1186/s12872-018-0770-z) contains supplementary material, which is available to authorized users.
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24
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Lee JJ, Pedley A, Hoffmann U, Massaro JM, O'Donnell CJ, Benjamin EJ, Long MT. Longitudinal Associations of Pericardial and Intrathoracic Fat With Progression of Coronary Artery Calcium (from the Framingham Heart Study). Am J Cardiol 2018; 121:162-167. [PMID: 29146023 DOI: 10.1016/j.amjcard.2017.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 09/22/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
Abstract
Cross-sectional studies have shown that pericardial fat is associated with atherosclerotic burden above and beyond generalized and central adiposity. Whether pericardial fat is longitudinally associated with coronary artery calcium (CAC) has not been firmly established. We examined the associations between cardiac ectopic fat including pericardial and intrathoracic fat with CAC progression and incidence in a community-based study setting. Study participants were from the Framingham Heart Study Offspring and Third Generation Cohorts who underwent multidetector computed tomography at 2 consecutive examinations (2002 to 2005 and 2008 to 2011) for the assessment of CAC. Multivariable-adjusted regression models were used to evaluate the associations between cardiac ectopic fat with CAC. Nonlinear associations were also examined. We included 1,732 participants (49.6% women, mean age 49.9 years). Of the 1,024 participants with a CAC score = 0 at baseline, 197 individuals developed a CAC score > 0 (19.2%) during 6.1 years of follow-up. The remaining 708 participants with a CAC score > 0 at baseline were eligible for CAC progression analysis. We identified nonlinear association between pericardial fat and CAC progression. Higher pericardial fat was associated with higher CAC progression only for those participants with pericardial fat higher than the median value (β = 56.0, p = 0.04). Intrathoracic fat was linearly associated with CAC progression (β = 23.0, p = 0.02). However, all of these associations did not persist after additional adjustment for body mass index, abdominal visceral adipose tissue, or waist circumference (all p ≥ 0.14). Neither pericardial nor intrathoracic fat were associated with CAC incidence (all p ≥ 0.33). Overall, both of the cardiac ectopic fat measures were longitudinally associated with CAC progression.
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25
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Goeller M, Achenbach S, Marwan M, Doris MK, Cadet S, Commandeur F, Chen X, Slomka PJ, Gransar H, Cao JJ, Wong ND, Albrecht MH, Rozanski A, Tamarappoo BK, Berman DS, Dey D. Epicardial adipose tissue density and volume are related to subclinical atherosclerosis, inflammation and major adverse cardiac events in asymptomatic subjects. J Cardiovasc Comput Tomogr 2017; 12:67-73. [PMID: 29233634 DOI: 10.1016/j.jcct.2017.11.007] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 11/07/2017] [Accepted: 11/20/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND We investigated whether epicardial adipose tissue (EAT) volume and density are related to early atherosclerosis, plaque inflammation and major adverse cardiac events (MACE, cardiac death and myocardial infarction) in asymptomatic subjects. METHODS EAT volume and density were quantified from non-contrast cardiac CT in 456 asymptomatic individuals (age 60.3 ± 8.3; 68% with CCS>0) from the prospective EISNER trial. EAT volume and density were examined in relation to coronary calcium score (CCS), inflammatory biomarkers and MACE. RESULTS EAT volume was higher and EAT density lower in subjects with coronary calcium compared to subjects without [89 vs 74 cm3, p < 0.001] [-76.9 vs -75.7 HU,p = 0.024]. EAT volume was lowest in individuals with no coronary calcium and was significant higher in subjects with early atherosclerosis (CCS 1-99) [74 vs 87 cm3,p = 0.016] and in subjects with more advanced atherosclerosis (CCS≥100) [89 cm3,p = 0.002]). EAT volume was independently related to serum levels of PAI-1, and MCP-1 and inversely related to adiponectin and HDL-cholesterol (p < 0.05). EAT density was inversely related to PAI-1 and LDL-cholesterol and positively associated to adiponectin, sICAM-1 and HDL-cholesterol (p < 0.05). EAT density was more significantly associated with MACE [(HR 0.8, 95%CI:0.7-0.98), p = 0.029] than EAT volume or CCS. CONCLUSION EAT volume was higher and density lower in subjects with coronary calcium compared to subjects with CCS = 0, with similar EAT volume in CCS<100 and CCS≥100. Lower EAT density and increased EAT volume were associated with coronary calcification, serum levels of plaque inflammatory markers and MACE, suggesting that dysfunctional EAT may be linked to early plaque formation and inflammation.
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Affiliation(s)
- Markus Goeller
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Internal Medicine 2, University of Erlangen, Erlangen, Germany.
| | - Stephan Achenbach
- Department of Internal Medicine 2, University of Erlangen, Erlangen, Germany.
| | - Mohamed Marwan
- Department of Internal Medicine 2, University of Erlangen, Erlangen, Germany.
| | - Mhairi K Doris
- Department of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Sebastien Cadet
- Department of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Frederic Commandeur
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Xi Chen
- Department of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Piotr J Slomka
- Department of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Heidi Gransar
- Department of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - J Jane Cao
- Department of Cardiology, St Francis Hospital, New York, NY, USA.
| | - Nathan D Wong
- Department of Medicine, University of California at Irvine, Irvine, USA.
| | - Moritz H Albrecht
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
| | - Alan Rozanski
- Division of Cardiology, Mount Sinai St Lukes Hospital, New York, NY, USA.
| | - Balaji K Tamarappoo
- Department of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Daniel S Berman
- Department of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Damini Dey
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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26
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Fernandes-Cardoso A, Santos-Furtado M, Grindler J, Ferreira LA, Andrade JL, Santo MA. Epicardial fat thickness correlates with P-wave duration, left atrial size and decreased left ventricular systolic function in morbid obesity. Nutr Metab Cardiovasc Dis 2017; 27:731-738. [PMID: 28739186 DOI: 10.1016/j.numecd.2017.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/20/2017] [Accepted: 05/22/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND AIM Epicardial fat (EF) is increased in obesity and has important interactions with atrial and ventricular myocardium. Most of the evidence in this scenario can be confused by the presence of comorbidities such as hypertension, diabetes and dyslipidemia, which are very common in this population. The influence of EF on atrial remodeling and cardiac function demands further investigation on morbidly obese without these comorbidities. METHODS AND RESULTS We prospectively recruited 20 metabolically healthy morbidly obese and 20 normo-weights controls. The maximum P-wave duration (PWD) was analyzed by 12-lead electrocardiogram. Left atrial diameter (LAD), left ventricular ejection fraction (LVEF) and EF thickness (EFT) were evaluated by two-dimensional echocardiography. The mean of maximum PWD and LAD were significantly larger in the obese group as compared to the control group: 109.55 ± 11.52 ms × 89.38 ± 11.19 ms and 36.12 ± 3.46 mm × 31.45 ± 2.64 mm, (p < 0.0001). The mean LVEF was lower in the obese group: 63.15 ± 4.25% × 66.17 ± 3.37% (p < 0.017). The mean EFT was higher in the obese group: 7.72 ± 1.60 mm × 3.10 ± 0.85 mm (p < 0.0001). A positive correlation was found between EFT and PWD (r = 0.70; p = 0.001) and LAD (r = 0.667; p = 0.001). An inverse correlation was found between EFT and LVEF (r = -0.523; p = 0.001). In a multiple multivariate regression analysis the EFT remains correlated with LAD and LVEF. CONCLUSIONS In a select group of morbidly obese, the excess of EF had a significant impact on atrial remodeling and cardiac function.
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MESH Headings
- Adipose Tissue/diagnostic imaging
- Adipose Tissue/physiopathology
- Adiposity
- Adult
- Arrhythmias, Cardiac/diagnosis
- Arrhythmias, Cardiac/etiology
- Arrhythmias, Cardiac/physiopathology
- Atrial Function, Left
- Atrial Remodeling
- Cross-Sectional Studies
- Echocardiography
- Electrocardiography
- Female
- Heart Atria/diagnostic imaging
- Heart Atria/physiopathology
- Humans
- Linear Models
- Male
- Middle Aged
- Multivariate Analysis
- Obesity, Metabolically Benign/complications
- Obesity, Metabolically Benign/diagnosis
- Obesity, Metabolically Benign/physiopathology
- Obesity, Morbid/complications
- Obesity, Morbid/diagnosis
- Obesity, Morbid/physiopathology
- Pericardium/diagnostic imaging
- Pericardium/physiopathology
- Predictive Value of Tests
- Prospective Studies
- Risk Factors
- Stroke Volume
- Systole
- Ventricular Dysfunction, Left/diagnosis
- Ventricular Dysfunction, Left/etiology
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Function, Left
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Affiliation(s)
- A Fernandes-Cardoso
- Electrocardiology Service, Medical Clinic Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil.
| | - M Santos-Furtado
- Echocardiography Laboratory, Radiology Institute (InRad), HCFMUSP, Brazil
| | - J Grindler
- Electrocardiology Service, Medical Clinic Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - L A Ferreira
- Institute of Mathematics and Statistics, Department of Statistics, IMEUSP, Brazil
| | - J L Andrade
- Echocardiography Laboratory, Radiology Institute (InRad), HCFMUSP, Brazil
| | - M A Santo
- Bariatric Surgery Unit, Gastroenterology Department, HCFMUSP, Brazil
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27
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Epoxyeicosatrienoic Acid as Therapy for Diabetic and Ischemic Cardiomyopathy. Trends Pharmacol Sci 2016; 37:945-962. [DOI: 10.1016/j.tips.2016.08.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/12/2016] [Accepted: 08/17/2016] [Indexed: 12/19/2022]
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28
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Inoue J, Skanes AC, Gula LJ, Drangova M. Effect of Left Atrial Wall Thickness on Radiofrequency Ablation Success. J Cardiovasc Electrophysiol 2016; 27:1298-1303. [PMID: 27510229 DOI: 10.1111/jce.13065] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 06/29/2016] [Accepted: 08/09/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Radiofrequency (RF) ablation in thicker regions of the left atrium (LA) may require increased ablation energy in order to achieve effective transmural lesions. Consequently, many cases of recurrent atrial fibrillation (AF) postablation may be due to thicker-than-normal atrial tissue. The aim of this study was to test the hypotheses that patients with recurrent AF have thicker tissue overall and that electrical reconnection is more likely in regions of thicker tissue. METHODS AND RESULTS Retrospective analysis was performed on 86 CT images acquired preoperatively from a cohort of 119 patients who had undergone RF ablation for AF. Of these, 33 patients experienced recurrence of AF within 1 year of initial treatment and 29 returned for a repeat ablation. For each patient, LA wall thickness (LAWT) was measured from the images in 12 anatomical regions using custom software. Patients with recurrent AF had larger LAWT compared to successfully treated patients (1.6 ± 0.6 mm vs. 1.5 ± 0.5 mm, P < 0.001) and reconnection was found to be at regions of thicker tissue (1.6 ± 0.6 mm, P = 0.038) compared to nonreconnected regions (1.5 ± 0.5 mm). The superior right posterior wall of the LA was significantly related to both recurrence (P = 0.048) and reconnection (P = 0.014). CONCLUSION Increased LAWT has a small but significant effect on postablation recurrence and reconnection. Measures of LAWT may facilitate appropriate dosing of RF energy, but other factors will be critical in transmural lesion formation and ablation success.
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Affiliation(s)
- Jiro Inoue
- Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada
| | - Allan C Skanes
- Division of Cardiology, Department of Medicine, The University of Western Ontario, London, Ontario, Canada
| | - Lorne J Gula
- Division of Cardiology, Department of Medicine, The University of Western Ontario, London, Ontario, Canada
| | - Maria Drangova
- Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada.,Department of Medical Biophysics, The University of Western Ontario, London, Ontario, Canada
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29
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Soufer R, Fernandez AB, Meadows J, Collins D, Burg MM. Body Mass Index and Risk for Mental Stress Induced Ischemia in Coronary Artery Disease. Mol Med 2016; 22:286-291. [PMID: 27261777 DOI: 10.2119/molmed.2016.00128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 05/12/2016] [Indexed: 11/06/2022] Open
Abstract
Acute emotionally reactive mental stress (MS) can provoke prognostically relevant deficits in cardiac function and myocardial perfusion, and chronic inflammation increases risk for this ischemic phenomenon. We have described parasympathetic withdrawal and generation of inflammatory factors in MS. Adiposity is also associated with elevated markers of chronic inflammation. High body mass index (BMI) is frequently used as a surrogate for assessment of excess adiposity, and associated with traditional CAD risk factors, and CAD mortality. BMI is also associated with autonomic dysregulation, adipose tissue derived proinflammatory cytokines, which are also attendant to emotion provoked myocardial ischemia. Thus, we sought to determine if body mass index (BMI) contributes to risk of developing myocardial ischemia provoked by mental stress. We performed a prospective interventional study in a cohort of 161 patients with stable CAD. They completed an assessment of myocardial blood flow with single photon emission computed tomography (SPECT) simultaneously during 2 conditions: laboratory mental stress and at rest. Multivariate logistic regression determined the independent contribution of BMI to the occurrence of mental-stress induced ischemia. Mean age was 65.6 ±9.0 years; 87.0% had a history of hypertension, and 28.6% had diabetes. Mean BMI was 30.4 ± 4.7. Prevalence of mental stress ischemia was 39.8%. BMI was an independent predictor of mental stress ischemia, OR=1.10, 95% CI [1.01-1.18] for one-point increase in BMI and OR=1.53, 95% CI [1.06-2.21] for a 4.7 point increase in BMI (one standard deviation beyond the cohort BMI mean), p=0.025 for all. These data suggest that BMI may serve as an independent risk marker for mental stress ischemia. The factors attendant with greater BMI, which include autonomic dysregulation and inflammation, may represent pathways by which high BMI contribute to this risk and serve as a conceptual construct to replicate these findings in larger CAD populations.
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Affiliation(s)
- Robert Soufer
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA.,VA Connecticut Healthcare System, West Haven Campus, West Haven, CT, USA
| | - Antonio B Fernandez
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Judith Meadows
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA.,VA Connecticut Healthcare System, West Haven Campus, West Haven, CT, USA
| | - Dorothea Collins
- VA Connecticut Healthcare System, West Haven Campus, West Haven, CT, USA
| | - Matthew M Burg
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA.,VA Connecticut Healthcare System, West Haven Campus, West Haven, CT, USA
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Epicardial and paracardial adipose tissue volume and attenuation - Association with high-risk coronary plaque on computed tomographic angiography in the ROMICAT II trial. Atherosclerosis 2016; 251:47-54. [PMID: 27266821 DOI: 10.1016/j.atherosclerosis.2016.05.033] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/27/2016] [Accepted: 05/18/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND AIMS To determine whether epicardial (EAT) and paracardial adipose tissue (PAT) volume and attenuation are associated with high-risk coronary plaque features. METHODS In subjects with suspected acute coronary syndrome (ACS) enrolled in the ROMICAT II trial, EAT and PAT volumes indexed to body surface area (BSA) and attenuation were measured on non-contrast coronary artery calcium score (CACS) CT. High-risk plaque features (napkin-ring sign, positive remodeling, low density plaque, spotty calcium) and stenosis were assessed on coronary CT angiography (CTA). The association of EAT and PAT volume and attenuation with high-risk plaque and whether this was independent of clinical risk assessment, CACS and significant coronary artery disease (CAD) was determined. RESULTS Of 467 (mean 54 ± 8 yrs, 53% male) with CACS and CTA, 167 (36%) had high-risk plaque features. Those with high-risk plaque had significantly higher indexed EAT (median 59 (Q1-Q3:45-75) cc/m(2) vs. 49 (35-65) cc/m(2), p < 0.001) and PAT volume (median:51 (36-73) cc/m(2) vs. 33 (22-52) cc/m(2), p < 0.001). Higher indexed EAT volume was associated with high-risk plaque [univariate OR 1.02 (95%-CI:1.01-1.03) per cc/m(2) of EAT, p < 0.001], which remained significant [univariate OR 1.04 (95%-CI:1.00-1.08) per cc/m(2) of EAT, p = 0.040] after adjustment for risk factors, CACS, and stenosis ≥50%. Higher indexed PAT volume was associated with high-risk plaque in univariate analysis [OR 1.02 (1.01-1.03) per cc/m(2) of PAT, p < 0.001], though this was not significant in multivariate analysis. At a threshold of >62.3 cc/m(2), EAT volume was associated with high-risk plaque [univariate OR 2.50 (95%-CI:1.69-3.72), p < 0.001)], which remained significant [OR 1.83 (95%-CI:1.10-3.05), p = 0.020] after adjustment. Subjects with high-risk plaque had lower mean attenuation EAT (-88.1 vs. -86.9 HU, p = 0.008) and PAT (-106 vs. -103 HU, p < 0.001), though this was not significant in multivariable analysis. CONCLUSIONS Greater volumes of EAT are associated with high-risk plaque independent of risk factors, CACS and obstructive CAD. This observation supports possible local influence of EAT on development of high-risk coronary plaque.
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Christoph MJ, Allison MA, Pankow JS, Decker PA, Kirsch PS, Tsai MY, Sale MM, de Andrade M, Sicotte H, Tang W, Hanson NQ, Berardi C, Wassel CL, Larson NB, Bielinski SJ. Impact of adiposity on cellular adhesion: The Multi-Ethnic Study of atherosclerosis (MESA). Obesity (Silver Spring) 2016; 24:223-30. [PMID: 26638193 PMCID: PMC4688228 DOI: 10.1002/oby.21245] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 07/13/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE At the cellular level, how excess adiposity promotes atherogenesis is not fully understood. One pathway involves secretion of adipokines that stimulate endothelial dysfunction through increased expression of adhesion molecules. However, the relationship of adiposity to adhesion molecules that promote atherosclerosis is largely unknown. METHODS Linear regression models were used to assess the sex-specific associations of soluble cellular adhesion molecules (sP- and sL-selectin, sICAM-1, sVCAM-1, and sHGF) and adiposity in 5,974 adults examined as part of the Multi-Ethnic Study of Atherosclerosis (MESA). Adiposity measures included body mass index (BMI), waist-to-hip-ratio (WHR), and computed tomography measures of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). RESULTS The mean age was 64 years and 52% were female. In multivariable models adjusting for traditional cardiovascular risk factors, sHGF was positively associated with BMI, WHR, and VAT in both males and females, and sP-selectin with WHR and VAT in males. sVCAM-1 was inversely associated with VAT in females only. CONCLUSIONS Our results showed the relation of adiposity to soluble cellular adhesion proteins was similar across adiposity measures and for both sexes. However, the relationship between adiposity and sVCAM-1 and P-selectin may be modified by sex and the measure used to assess adiposity.
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Affiliation(s)
- Mary J. Christoph
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Matthew A. Allison
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA
| | - James S. Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Paul A. Decker
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Phillip S. Kirsch
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Michael Y. Tsai
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Michele M. Sale
- Center for Public Health Genomics, University of Virginia, VA, USA
| | - Mariza de Andrade
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Hugues Sicotte
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Weihong Tang
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Naomi Q. Hanson
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Cecilia Berardi
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Montefiore Medical Center, Bronx, NY, USA
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Impact of Nonalcoholic Fatty Liver Disease on Myocardial Perfusion in Nondiabetic Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction. Am J Cardiol 2015; 116:1810-4. [PMID: 26506122 DOI: 10.1016/j.amjcard.2015.09.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 09/19/2015] [Accepted: 09/19/2015] [Indexed: 12/13/2022]
Abstract
Limited data exist on the role of nonalcoholic fatty liver disease (FLD) as a potential independent risk factor in the setting of acute coronary syndromes. The aim of this study was to evaluate the impact of FLD on myocardial perfusion and inhospital major adverse cardiac events (MACE) in the setting of ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). We examined 186 consecutive nondiabetic patients (mean age 58 ± 11 years and 76% men) who underwent primary PCI for STEMI by ultrasound within 72 hours of admission. FLD was graded according to a semiquantitative severity score as mild (score <3) or moderate to severe (score ≥3). Myocardial perfusion was determined by measuring myocardial blush grade (MBG) and ST-segment resolution (STR) analysis. Patients were divided into 2 groups according to FLD score (<3 or ≥3). There were no differences with regard to postprocedural Thrombolysis In Myocardial Infarction 3 flow grade between the 2 groups (89% vs 83%, p = 0.201). Patients with FLD score ≥3 were more likely to have absent myocardial perfusion (MBG 0/1, 37% vs 12%, p <0.0001), absent STR (27% vs 9%, p = 0.001), and higher inhospital MACE rate (31% vs 8%, p <0.0001). By multivariate analysis, FLD ≥3 score was found to be an independent predictor of absent MBG 0/1 (odds ratio [OR] 2.856, 95% confidence interval [CI] 1.214 to 6.225, p = 0.033), absent STR (OR 2.862, 95% CI 1.242 to 6.342, p = 0.031), and inhospital MACE (OR 2.454, 95% CI 1.072 to 4.872, p = 0.048). In conclusion, we found that despite similar high rates of Thrombolysis In Myocardial Infarction 3 after primary PCI, patients with FLD score ≥3 are more likely to have impaired myocardial perfusion which may contribute to adverse inhospital outcome.
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Hong HC, Hwang SY, Park S, Ryu JY, Choi HY, Yoo HJ, Seo JA, Kim SG, Kim NH, Baik SH, Choi DS, Kim S, Choi KM. Implications of Pericardial, Visceral and Subcutaneous Adipose Tissue on Vascular Inflammation Measured Using 18FDG-PET/CT. PLoS One 2015; 10:e0135294. [PMID: 26270050 PMCID: PMC4536214 DOI: 10.1371/journal.pone.0135294] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 07/20/2015] [Indexed: 02/06/2023] Open
Abstract
Objective Pericardial adipose tissue (PAT) is associated with adverse cardiometabolic risk factors and cardiovascular disease (CVD). However, the relative implications of PAT, abdominal visceral and subcutaneous adipose tissue on vascular inflammation have not been explored. Method and Results We compared the association of PAT, abdominal visceral fat area (VFA), and subcutaneous fat area (SFA) with vascular inflammation, represented as the target-to-background ratio (TBR), the blood-normalized standardized uptake value measured using 18F-Fluorodeoxyglucose Positron Emission Tomography (18FDG-PET) in 93 men and women without diabetes or CVD. Age- and sex-adjusted correlation analysis showed that PAT, VFA, and SFA were positively associated with most cardiometabolic risk factors, including systolic blood pressure, LDL-cholesterol, triglycerides, glucose, insulin resistance and high sensitive C-reactive proteins (hsCRP), whereas they were negatively associated with HDL-cholesterol. In particular, the maximum TBR (maxTBR) values were positively correlated with PAT and VFA (r = 0.48 and r = 0.45, respectively; both P <0.001), whereas SFA showed a relatively weak positive relationship with maxTBR level (r = 0.31, P = 0.003). Conclusion This study demonstrated that both PAT and VFA are significantly and similarly associated with vascular inflammation and various cardiometabolic risk profiles.
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Affiliation(s)
- Ho Cheol Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Soon Young Hwang
- Department of Biostatistics, College of Medicine, Korea University, Seoul, Korea
| | - Soyeon Park
- Department of Nuclear Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Ja Young Ryu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Hae Yoon Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Ji-A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Dong Seop Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Sungeun Kim
- Department of Nuclear Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
- * E-mail:
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Thermogenic potential and physiological relevance of human epicardial adipose tissue. INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2015; 5:S28-34. [PMID: 27152172 DOI: 10.1038/ijosup.2015.8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Epicardial adipose tissue is a unique fat depot around the heart that shares a close anatomic proximity and vascular supply with the myocardium and coronary arteries. Its accumulation around the heart, measured using various imaging modalities, has been associated with the onset and progression of coronary artery disease in humans. Epicardial adipose tissue is also the only fat depot around the heart that is known to express uncoupling protein 1 at both mRNA and protein levels in the detectable range. Recent advances have further indicated that human epicardial fat exhibits beige fat-like features. Here we provide an overview of the physiological and pathophysiological relevance of human epicardial fat, and further discuss whether its thermogenic properties can serve as a target for the therapeutic management of coronary heart disease in humans.
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Romijn MA, Danad I, Bakkum MJ, Stuijfzand WJ, Tulevski II, Somsen GA, Lammertsma AA, van Kuijk C, van de Ven PM, Min JK, Leipsic J, van Rossum AC, Raijmakers PG, Knaapen P. Incremental diagnostic value of epicardial adipose tissue for the detection of functionally relevant coronary artery disease. Atherosclerosis 2015; 242:161-6. [PMID: 26188540 DOI: 10.1016/j.atherosclerosis.2015.07.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 06/09/2015] [Accepted: 07/02/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIM To determine the incremental diagnostic value of epicardial adipose tissue (EAT) volume in addition to the coronary artery calcium (CAC) score for detecting hemodynamic significant coronary artery disease (CAD). METHODS AND RESULTS 122 patients (mean age 61 ± 10 years, 61% male) without a previous cardiac history underwent a non-contrast CT scan for calcium scoring and EAT volume measurements. Subsequently all patients underwent invasive coronary angiography (ICA) in conjunction with fractional flow reserve (FFR) measurements. A stenosis >90% and/or a FFR ≤0.80 were considered significant. Mean EAT volume and CACscore were 128 ± 51 cm(3) and 418 ± 704, respectively. The correlation between EAT volume and the CACscore was poor (r = 0.11, p = 0.24). Male gender (odds ratio [OR] 2.86, p = 0.01), CACscore ([cut-off value 100] OR 3.31, p = 0.003, and EAT volume ([cut-off value 92 cm(3)] OR 4.28, p = 0.01) were associated with flow-limiting disease. The multivariate model revealed that only male gender (OR 2.50, p = 0.045), CAC score (OR 3.60, p = 0.005), and EAT volume (OR 4.95, p = 0.02) were independent predictors of myocardial ischemia. Using the cut-off values of 100 (CAC score) and 92 cm(3) (EAT volume), sensitivity, specificity, negative predictive value, positive predictive value, and accuracy for detecting functionally relevant CAD as indicated by FFR were 71, 57, 77, 50 and 63% and 91, 29, 85, 44 and 52% for the CACscore and EAT volume, respectively. Adding EAT volume to the CAC score and cardiovascular risk factors did not enhance diagnostic performance for the detection of significant CAD (p = 0.57). CONCLUSION EAT volume measurements have no diagnostic value beyond calcium scoring and cardiovascular risk factors in the detection of hemodynamic significant CAD.
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Affiliation(s)
- M A Romijn
- VU University Medical Center, Department of Cardiology, Amsterdam, The Netherlands
| | - I Danad
- VU University Medical Center, Department of Cardiology, Amsterdam, The Netherlands.
| | - M J Bakkum
- VU University Medical Center, Department of Cardiology, Amsterdam, The Netherlands
| | - W J Stuijfzand
- VU University Medical Center, Department of Cardiology, Amsterdam, The Netherlands
| | - I I Tulevski
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
| | - G A Somsen
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
| | - A A Lammertsma
- VU University Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
| | - C van Kuijk
- VU University Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
| | - P M van de Ven
- VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam, The Netherlands
| | - J K Min
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College and The NewYork-Presbyterian Hospital, New York, NY, United States
| | - J Leipsic
- Department of Medical Imaging and Division of Cardiology, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - A C van Rossum
- VU University Medical Center, Department of Cardiology, Amsterdam, The Netherlands
| | - P G Raijmakers
- VU University Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
| | - P Knaapen
- VU University Medical Center, Department of Cardiology, Amsterdam, The Netherlands
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Ong KL, Ding J, McClelland RL, Cheung BMY, Criqui MH, Barter PJ, Rye KA, Allison MA. Relationship of pericardial fat with lipoprotein distribution: The Multi-Ethnic study of atherosclerosis. Atherosclerosis 2015; 241:664-70. [PMID: 26117404 DOI: 10.1016/j.atherosclerosis.2015.06.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 05/19/2015] [Accepted: 06/09/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Pericardial fat and lipoprotein abnormalities contribute to increased risk of cardiovascular disease (CVD). We investigated the relationship between pericardial fat volume and lipoprotein distribution, and whether the association of pericardial fat volume with subclinical atherosclerosis and incident CVD events differs according to lipoprotein distribution. METHODS We analyzed data from 5407 participants from the Multi-Ethnic Study of Atherosclerosis who had measurements of pericardial fat volume, lipoprotein distribution, carotid intima-media thickness (IMT), and coronary artery calcium (CAC). All participants were free of clinically apparent CVD at baseline. Incident CVD was defined as any adjudicated CVD event. RESULTS After adjusting for demographic factors, traditional risk factors, and biomarkers of inflammation and hemostasis, a larger pericardial fat volume was associated with higher large VLDL particle (VLDL-P) concentration and small HDL particle (HDL-P) concentration, and smaller HDL-P size (regression coefficients = 0.585 nmol/L, 0.366 μmol/L, and -0.025 nm per SD increase in pericardial fat volume respectively, all P < 0.05). The association of pericardial fat volume with large VLDL-P concentration and HDL-P size, but not small HDL-P concentration, remained significant after further adjusting for each other as well as LDL cholesterol, HDL cholesterol, and triglycerides. The relationship of pericardial fat volume with incident CVD events, carotid IMT, and prevalence and severity of CAC did not differ by quartiles of large VLDL-P concentration, small HDL-P concentration, or HDL-P size (P for interaction>0.05). CONCLUSION Pericardial fat is associated with atherogenic lipoprotein abnormalities. However, its relationship with subclinical atherosclerosis and incident CVD events does not differ according to lipoprotein distribution.
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Affiliation(s)
- Kwok-Leung Ong
- Centre for Vascular Research, University of New South Wales, Sydney, NSW 2025, Australia.
| | - Jingzhong Ding
- Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Robyn L McClelland
- Department of Biostatistics, University of Washington, Seattle, WA, United States
| | | | - Michael H Criqui
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA, United States
| | - Philip J Barter
- Centre for Vascular Research, University of New South Wales, Sydney, NSW 2025, Australia; Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
| | - Kerry-Anne Rye
- Centre for Vascular Research, University of New South Wales, Sydney, NSW 2025, Australia; Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
| | - Matthew A Allison
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA, United States
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Abed HS, Nelson AJ, Richardson JD, Worthley SG, Vincent A, Wittert GA, Leong DP. Impact of weight reduction on pericardial adipose tissue and cardiac structure in patients with atrial fibrillation. Am Heart J 2015; 169:655-662.e2. [PMID: 25965713 DOI: 10.1016/j.ahj.2015.02.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 02/07/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND Obesity and pericardial adipose tissue are independent risk factors for atrial fibrillation (AF) and adverse cardiac structural remodeling. The effect of weight reduction on pericardial adipose tissue and cardiac structure remains unknown. METHODS We prospectively performed cardiac magnetic resonance imaging on 87 participants with AF undergoing either structured weight management (intervention) or general lifestyle advice (control). We measured pericardial adipose tissue, atrial and ventricular volumes, and myocardial mass at baseline and 12 months. RESULTS In total, 69 participants underwent baseline and 12-month follow-up cardiac magnetic resonance imaging (intervention n = 36 and controls n = 33). From baseline to 12 months, weight loss (kg, mean [95% CI]) was greater in the intervention group from 101.5 kg (97.2-105.8 kg) to 86.5 kg (81.2-91.9 kg) as compared with controls from 102.6 kg (97.2-108.1 kg) to 98.7 kg (91.0-106.3 kg) (time-group interaction P < .001). The intervention group showed a reduction in left atrial volumes (mL) from 105.0 mL (98.9-111.1 mL) to 96.4 mL (91.6-101.1 mL), whereas the change in the control group was from 108.8 mL (99.6-117.9 mL) to 108.9 mL (99.8-118.0 mL) (time-group interaction P < .001). There was a decline in pericardial adipose tissue (cm(3)) from 140.9 cm(3) (129.3-152.4 cm(3)) to 118.8 cm(3) (108.1-129.6 cm(3)) and myocardial mass (g) from 137.6 g (128.1-147.2 g) to 123.1 g (114.5-131.7 g) in the intervention group, whereas the change in the control group was from 143.2 cm(3) (124.6-161.7 cm(3)) to 147.2 cm(3) (128.9-165.4 cm(3)) for pericardial adipose tissue and 138.3 g (124.8-151.8 g) to 140.7 g (127.4-154.1 g) for myocardial mass (both variables, time-group interaction P < .001). CONCLUSIONS Weight reduction results in favorable structural remodeling and a reduction in pericardial adipose tissue burden.
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Affiliation(s)
- Hany S Abed
- NHMRC Clinical Trials Center, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia; University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia.
| | - Adam J Nelson
- University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia
| | - James D Richardson
- University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia
| | - Stephen G Worthley
- University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia
| | - Andrew Vincent
- University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia
| | - Gary A Wittert
- University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia
| | - Darryl P Leong
- University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia; The Population Health Research Institute, Hamilton Health Sciences, and McMaster University, Ontario, Canada
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Association of systemic inflammation with epicardial fat and coronary artery calcification. Inflamm Res 2015; 64:313-9. [PMID: 25763815 DOI: 10.1007/s00011-015-0809-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 02/04/2015] [Accepted: 03/05/2015] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Increased epicardial fat volume (EFV) has been shown to be associated with coronary atherosclerosis. While it is postulated to be an independent risk factor, a possible mechanism is local or systemic inflammation. We analyzed the relationship between coronary atherosclerosis, quantified by coronary calcium in CT, epicardial fat volume and systemic inflammation. METHODS Using non-enhanced dual-source CT, we quantified epicardial fat volume (EFV) and coronary artery calcium (CAC) in 391 patients who underwent coronary computed tomography for suspected coronary artery disease. In addition to traditional risk factors, serum markers of systemic inflammation were measured (IL-1α, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10,IL-12, IL-13, IL-15, IL-17, IFN-γ, TNF-α, hs-CRP, GM-CS, G-CSF, MCP-1, MIP-1, Eotaxin and IP-10). In 94 patients follow-up data were obtained after 1.9 ± 0.5 years. RESULTS The 391 patients had a mean age of 60 ± 10 years, and 69 % were males. Mean EFV was 116 ± 50 mL. Median CAC was 12 (IQR 0; 152). CAC and EFV showed a significant correlation (ρ = 0.37; P < 0.001). EFV and CAC were significantly correlated with the traditional risk factors like age, male gender, diabetes, smoking and hypertension. With regard to biomarkers, CAC was significantly associated (negatively) to G-CSF and IL-13. EFV (median binned) was significantly associated (positively) with IP-10 (P = 0.002) and MCP-1 (ρ = 0.037). In follow-up, EFV showed a mean annualized progression of 6 mL (IQR 3; 9) (P < 0.001); CAC progressed by a mean of six Agatston Units (IQR 0; 30). The progression of CAC was significantly correlated with the extent of EFV (P < 0.001) while there was no significant correlation between progression of EFV or CAC with systemic inflammation markers. CONCLUSION Epicardial fat volume and the baseline extent as well as progression of coronary atherosclerosis-measured by the calcium score-are significantly correlated. While both baseline EFV and CAC displayed significant correlations with systemic inflammation markers, biomarkers were not predictive of the progression of CAC or EFV.
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Larsen BA, Laughlin GA, Saad SD, Barrett-Connor E, Allison MA, Wassel CL. Pericardial fat is associated with all-cause mortality but not incident CVD: the Rancho Bernardo Study. Atherosclerosis 2015; 239:470-5. [PMID: 25702617 DOI: 10.1016/j.atherosclerosis.2015.02.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 11/21/2014] [Accepted: 02/09/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Pericardial and intra-thoracic fat are associated with prevalent cardiovascular disease (CVD) and CVD risk factors. However, it is unclear if these fat depots predict incident CVD events and/or all-cause mortality. We examined prospective associations between areas of pericardial and intra-thoracic fat and incident CVD and mortality over a 12-year follow-up in a subset of participants without baseline clinical CVD from the Rancho Bernardo Study (RBS). METHODS Participants were 343 community-dwelling older adults (mean baseline age = 67) who completed a clinic visit in 2001-02, including a computed tomography scan of the chest. Incident CVD and mortality were recorded through January 2013. RESULTS Over a 12.6-year median follow-up, there were 60 incident CVD events and 49 deaths. Pericardial fat was associated with all-cause mortality, such that each standard deviation increment predicted a 34% higher chance of death after adjusting for demographics, lifestyle factors, comorbidities, and visceral fat (95% CI = 1.01-1.78). When categorized by tertile, those in the middle tertile of pericardial fat showed no increased risk of mortality, while those in the highest tertile had 2.6 times the risk (95% CI = 1.10-5.97) compared to the lowest tertile. There was a marginal association between intra-thoracic fat and mortality (p = 0.06). Neither pericardial nor intra-thoracic fat was significantly associated with incident CVD. There were no significant interactions by sex. CONCLUSIONS Higher pericardial, but not intra-thoracic, fat was associated with earlier all-cause mortality in older adults over a 12-year follow-up. This association was primarily driven by a higher mortality rate in those in the highest tertile of pericardial fat.
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Affiliation(s)
- Britta A Larsen
- Division of Behavioral Medicine, Department of Family and Preventive Medicine, University of California, San Diego, USA.
| | - Gail A Laughlin
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, USA
| | - Sarah D Saad
- Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, USA
| | - Elizabeth Barrett-Connor
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, USA
| | - Matthew A Allison
- Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, USA
| | - Christina L Wassel
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, USA
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Pawar AS, Zhu XY, Eirin A, Tang H, Jordan KL, Woollard JR, Lerman A, Lerman LO. Adipose tissue remodeling in a novel domestic porcine model of diet-induced obesity. Obesity (Silver Spring) 2015; 23:399-407. [PMID: 25627626 PMCID: PMC4311573 DOI: 10.1002/oby.20971] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 10/24/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To establish and characterize a novel domestic porcine model of obesity. METHODS Fourteen domestic pigs were fed normal (lean, n=7) or high-fat/high-fructose diet (obese, n=7) for 16 weeks. Subcutaneous abdominal adipose tissue biopsies were obtained after 8, 12, and 16 weeks of diet, and pericardial adipose tissue after 16 weeks, for assessments of adipocyte size, fibrosis, and inflammation. Adipose tissue volume and cardiac function were studied with multidetector computed tomography, and oxygenation was studied with magnetic resonance imaging. Plasma lipids profile, insulin resistance, and markers of inflammation were evaluated. RESULTS Compared with lean pigs, obese pigs had elevated cholesterol and triglyceride levels, blood pressure, and insulin resistance. Both abdominal and pericardial fat volume increased in obese pigs after 16 weeks. In abdominal subcutaneous adipose tissue, adipocyte size and both tumor necrosis factor (TNF)-α expression progressively increased. Macrophage infiltration showed in both abdominal and pericardial adipose tissues. Circulating TNF-α increased in obese pigs only at 16 weeks. Compared with lean pigs, obese pigs had similar global cardiac function, but myocardial perfusion and oxygenation were significantly impaired. CONCLUSIONS A high-fat/high-fructose diet induces in domestic pigs many characteristics of metabolic syndrome, which is useful for investigating the effects of the obesity.
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Affiliation(s)
- Aditya S. Pawar
- The Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905
| | - Xiang-Yang Zhu
- The Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905
| | - Alfonso Eirin
- The Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905
| | - Hui Tang
- The Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905
| | - Kyra L. Jordan
- The Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905
| | - John R. Woollard
- The Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905
| | - Amir Lerman
- The Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905
| | - Lilach O. Lerman
- The Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905
- The Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905
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Relationship of pericardial fat with biomarkers of inflammation and hemostasis, and cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 2015; 239:386-92. [PMID: 25682037 DOI: 10.1016/j.atherosclerosis.2015.01.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 01/28/2015] [Accepted: 01/28/2015] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Pericardial fat may increase the risk of cardiovascular disease (CVD) by increasing circulating levels of inflammation and hemostasis biomarkers. We investigated the associations of pericardial fat with inflammation and hemostasis biomarkers, as well as incident CVD events, and whether there are any ethnic differences in these associations. METHODS We analyzed results from 6415 participants from the Multi-Ethnic Study of Atherosclerosis who had measurements of pericardial fat volume and circulating levels of C-reactive protein (CRP), fibrinogen, interleukin (IL)-6, factor VIII, D-dimer and plasmin-antiplasmin complex (PAP), and had a mean follow-up period of 9.5 years. Incident CVD event was defined as any adjudicated CVD event. RESULTS After adjusting for confounding factors, pericardial fat volume was positively associated with natural log (ln) of IL-6 levels, but inversely associated with ln D-dimer and ln PAP levels (β = 0.067, -0.032, and -0.105 respectively, all P < 0.05). Although a larger pericardial fat volume was associated with a higher risk of incident CVD, the association was attenuated to borderline significance after adjusting for traditional cardiovascular risk factors (P = 0.050). There was a borderline significant ethnicity interaction (P = 0.080), whereby the association between pericardial fat volume and incident CVD was significant in Hispanic Americans, even after further adjusting for biomarkers of inflammation and hemostasis (hazard ratio = 1.31 per SD increase, 95% confidence interval 1.09-1.57, P = 0.004). CONCLUSION Pericardial fat was associated with several inflammation and hemostasis biomarkers. The association of pericardial fat with incident CVD events was independent of these biomarkers only among Hispanic Americans.
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Cao J, Tsenovoy PL, Thompson EA, Falck JR, Touchon R, Sodhi K, Rezzani R, Shapiro JI, Abraham NG. Agonists of epoxyeicosatrienoic acids reduce infarct size and ameliorate cardiac dysfunction via activation of HO-1 and Wnt1 canonical pathway. Prostaglandins Other Lipid Mediat 2015; 116-117:76-86. [PMID: 25677507 PMCID: PMC5553685 DOI: 10.1016/j.prostaglandins.2015.01.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 01/15/2015] [Accepted: 01/16/2015] [Indexed: 12/27/2022]
Abstract
Myocardial infarction (MI) is complicated by ventricular fibrosis and associated diastolic and systolic failure. Emerging studies implicate Wnt1 signaling in the formation of new blood vessels. Epoxyeicosatrienoic acids (EETs)-mediated up-regulation of heme oxygenase-1 (HO-1) protects against the detrimental consequences of MI in several animal models, however, the mechanism(s) by which this occurs remains unclear. The aim of this study was to examine these mechanisms in the LAD ligation animal model of post infarcted heart failure. Specifically, we sought to clarify the mechanistic basis of the interactions of the Wnt1 canonical pathway, HO-1 and associated angiogenesis. Human microvascular endothelial cells (HMECs) were exposed to anoxia and treated with the EET agonist, NUDSA, in the presence and absence of tin mesoporphyrin (SnMP). Increased capillary density, and Wnt1 and HO-1 expression occurred in cells treated with NUDSA. Anoxic HMECs treated with NUDSA and Wnt1 siRNA, exhibited decreased in the expression of β-catenin and the Wnt1 target gene, PPARδ (p<0.05 vs. NUDSA). Furthermore, blocking the Wnt 1 antagonist, Dickkopf 1, by siRNA increased β-catenin and PPARδ expression, and this effect was further enhanced by the concurrent administration of NUDSA. In in vivo experiments, C57B16 mice were divided into 4 groups: sham, mice with MI via LAD ligation and mice with MI treated with NUDSA, with and without SnMP. Increased fractional area change (FAC) and myocardial angiogenesis were observed in mice treated with NUDSA (p<0.05 vs. MI). Increased expression of HO-1, Wnt1, β-catenin, adiponectin, and phospho-endothelial nitric oxide synthetase (p-eNOS), and a decrease in the glycosylated subunit of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, gp91(phox) expression occurred in cardiac tissue of mice treated with NUDSA (p<0.05 vs. MI). SnMP reversed these effects. This novel study demonstrates that increasing the canonical Wnt1 signaling cascade with the subsequent increase in HO-1, adiponectin and angiogenesis ameliorates fibrosis and cardiac dysfunction in a mouse model of MI and supports the hypothesis that HO-1 is an integral component of the EETs-adiponectin axis and is central for the control of resistance to fibrosis and vascular dysfunction and in part determine how they influence the cellular/vascular homeostasis and provides insight into the mechanisms involved in vascular dysfunction as well as potential targets for the treatment of CVD.
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Affiliation(s)
- Jian Cao
- Chinese PLA General Hospital, Beijing 100853, China
| | | | - Ellen A Thompson
- Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, United States
| | - John R Falck
- University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390, United States
| | - Robert Touchon
- Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, United States
| | - Komal Sodhi
- Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, United States
| | - Rita Rezzani
- New York Medical College, Valhalla, NY, United States
| | - Joseph I Shapiro
- Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, United States
| | - Nader G Abraham
- New York Medical College, Valhalla, NY, United States; Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, United States.
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The isoprostanes--25 years later. Biochim Biophys Acta Mol Cell Biol Lipids 2014; 1851:433-45. [PMID: 25449649 DOI: 10.1016/j.bbalip.2014.10.007] [Citation(s) in RCA: 226] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 10/13/2014] [Accepted: 10/21/2014] [Indexed: 01/26/2023]
Abstract
Isoprostanes (IsoPs) are prostaglandin-like molecules generated independent of the cyclooxygenase (COX) by the free radical-induced peroxidation of arachidonic acid. The first isoprostane species discovered were isomeric to prostaglandin F2α and were thus termed F2-IsoPs. Since the initial discovery of the F2-IsoPs, IsoPs with differing ring structures have been identified as well as IsoPs from different polyunsaturated fatty acids, including eicosapentaenoic acid and docosahexanenoic acid. The discovery of these molecules in vivo in humans has been a major contribution to the field of lipid oxidation and free radical research over the course of the past 25 years. These molecules have been determined to be both biomarkers and mediators of oxidative stress in numerous disease settings. This review focuses on recent developments in the field with an emphasis on clinical research. Special focus is given to the use of IsoPs as biomarkers in obesity, ischemia-reperfusion injury, the central nervous system, cancer, and genetic disorders. Additionally, attention is paid to diet and lifestyle factors that can affect endogenous levels of IsoPs. This article is part of a Special Issue entitled "Oxygenated metabolism of PUFA: analysis and biological relevance."
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Strissel KJ, Denis GV, Nikolajczyk BS. Immune regulators of inflammation in obesity-associated type 2 diabetes and coronary artery disease. Curr Opin Endocrinol Diabetes Obes 2014; 21:330-8. [PMID: 25106001 PMCID: PMC4251956 DOI: 10.1097/med.0000000000000085] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW To summarize current work identifying inflammatory components that underlie associations between obesity-associated type 2 diabetes and coronary artery disease. RECENT FINDINGS Recent studies implicate immune cells as drivers of pathogenic inflammation in human type 2 diabetes. Inflammatory lymphocytes characterize unhealthy adipose tissue, but regional adipose volume, primarily visceral and pericardial fat, also predict severity and risk for obesity-associated coronary artery disease. Having a greater understanding of shared characteristics between inflammatory cells from different adipose tissue depots and a more accessible tissue, such as blood, will facilitate progress toward clinical translation of our appreciation of obesity as an inflammatory disease. SUMMARY Obesity predisposes inflammation and metabolic dysfunction through multiple mechanisms, but these mechanisms remain understudied in humans. Studies of obese patients have identified disproportionate impacts of specific T cell subsets in metabolic diseases like type 2 diabetes. On the basis of demonstration that adipose tissue inflammation is depot-specific, analysis of adiposity by waist-to-hip ratio or MRI will increase interpretive value of lymphocyte-focused studies and aid clinicians in determining which obese individuals are at highest risk for coronary artery disease. New tools to combat obesity-associated coronary artery disease and other comorbidities will stem from identification of immune cell-mediated inflammatory networks that are amenable to pharmacological interventions.
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Affiliation(s)
- Katherine J. Strissel
- Department of Medicine, Boston University School of Medicine, Boston MA, USA
- Cancer Research Center, Boston University School of Medicine, Boston MA, USA
| | - Gerald V. Denis
- Department of Medicine, Boston University School of Medicine, Boston MA, USA
- Cancer Research Center, Boston University School of Medicine, Boston MA, USA
| | - Barbara S. Nikolajczyk
- Department of Medicine, Boston University School of Medicine, Boston MA, USA
- Department of Microbiology, Boston University School of Medicine, Boston MA, USA
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Kahl KG, Hueper K, Schweiger U, Gutberlet M, Detlef AM, Weiss C, von Bohlen A, Pul R, Lichtinghagen R, Wacker F, Hartung D. Pericardial, intra-abdominal, and subcutaneous adipose tissue in patients with major depressive disorder. Acta Psychiatr Scand 2014; 130:137-43. [PMID: 24433292 DOI: 10.1111/acps.12242] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/03/2013] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is associated with an increased risk for developing coronary artery disease (CAD). Recently, pericardial adipose tissue, a metabolically active visceral fat depot surrounding the heart, has been implicated in the pathogenesis of CAD. Therefore, we investigated pericardial adipose tissue volumes in patients with MDD and compared them to healthy comparison subjects. METHOD In this case-control study at a university medical center, 50 male and female in-patients with MDD and 25 healthy men and women were examined. The main outcome measures were the volumes of pericardial adipose tissue, intra-abdominal adipose tissue (IaAT) and subcutaneous adipose tissue (ScAT) which were measured using magnetic resonance imaging. RESULTS The pericardial adipose tissue volumes were greater in men and women with MDD compared with the healthy comparison group following adjustments for the effects of age, weight, height, and physical activity. CONCLUSION This study expands our knowledge about the alterations in body composition that occur in patients with MDD. The findings are highly relevant for understanding the comorbidity between heart disease and depressive disorders.
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Affiliation(s)
- K G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany
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Munteanu MA, Mircea PA. From NAFLD to Cardiovascular Disease. Is it (Still) the Metabolic Syndrome? ACTA ACUST UNITED AC 2014; 87:80-6. [PMID: 26528002 PMCID: PMC4620846 DOI: 10.15386/cjmed-277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 06/04/2014] [Indexed: 12/28/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in developed countries. The incidence of NAFLD in the general population is 30–38% deppending on the geographical area and the diagnostic method used. NAFLD is considered to be the liver manifestation of the metabolic syndrome. A better understanding of the natural evolution would have practical consequences related mainly to the need of early and aggressive diagnosis, active monitoring and therapeutic solutions. Cardiovascular disease appears to be the main cause of death in these patients. The mechanisms linking NAFLD with cardiovascular disease are not fully understood yet, but attention was focused primarily on insulin resistance. The visceral adipose tissue, the epicardial adipose tissue, the systemic inflammatory response syndrome, the lipid profile, the procoagulants factors, the oxidative stress, and type 2 diabetes mellitus, they all might play a role in the link between NAFLD and cardiovascular disease. Currently, there isn’t any medication specifically recommended for the treatment of NAFLD. Although the mechanisms underlying the association between NAFLD and cardiovascular disease are not fully known, attention must be paid to this association, given that these patients are more likely to die due to heart disease rather than liver disease.
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Affiliation(s)
- Mihai Alexandru Munteanu
- Department of Internal Medicine, 1 Medical Clinic - Internal Medicine, Cardiology and Gastroenterology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Petru Adrian Mircea
- Department of Internal Medicine, 1 Medical Clinic - Internal Medicine, Cardiology and Gastroenterology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Hayashi H, Hayashi M, Miyauchi Y, Takahashi K, Uetake S, Tsuboi I, Yodogawa K, Iwasaki YK, Shimizu W. Left atrial wall thickness and outcomes of catheter ablation for atrial fibrillation in patients with hypertrophic cardiomyopathy. J Interv Card Electrophysiol 2014; 40:153-60. [DOI: 10.1007/s10840-014-9894-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 02/27/2014] [Indexed: 11/29/2022]
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Epicardial Fat and Coronary Artery Calcification in Patients on Long-Term Hemodialysis. J Comput Assist Tomogr 2014; 38:768-72. [DOI: 10.1097/rct.0000000000000113] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abed HS, Wittert GA. Obesity and atrial fibrillation. Obes Rev 2013; 14:929-38. [PMID: 23879190 DOI: 10.1111/obr.12056] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 05/03/2013] [Accepted: 05/24/2013] [Indexed: 12/31/2022]
Abstract
Atrial fibrillation (AF) is an increasing public health problem, often described as the epidemic of the new millennium. The rising health economic impact of AF, its association with poor quality of life and independent probability of increased mortality, has recently been highlighted. Although population ageing is regarded as an important contributor to this epidemic, obesity and its associated cardiometabolic comorbidities may represent the principal driving factor behind the current and projected AF epidemic. Obesity-related risk factors, such as hypertension, vascular disease, obstructive sleep apnea and pericardial fat, are thought to result in atrial electro-structural dysfunction. In addition, insulin resistance, its associated abnormalities in nutrient utilization and intermediary metabolic by-products are associated with structural and functional abnormalities, ultimately promoting AF. Recent elucidation of molecular pathways, including those responsible for atrial fibrosis, have provided mechanistic insights and the potential for targeted pharmacotherapy. In this article, we review the evidence for an obesity-related atrial electromechanical dysfunction, the mechanisms behind this and its impact on AF therapeutic outcomes. In light of the recently described mechanisms, we illustrate proposed management approaches and avenues for further investigations.
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Affiliation(s)
- H S Abed
- Department of Medicine, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Wassel CL, Laughlin GA, Araneta MRG, Kang E, Morgan CM, Connor EB, Allison MA. Associations of pericardial and intrathoracic fat with coronary calcium presence and progression in a multiethnic study. Obesity (Silver Spring) 2013; 21:1704-12. [PMID: 23666866 PMCID: PMC3748173 DOI: 10.1002/oby.20111] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 09/09/2012] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Body mass index (BMI) may not accurately or adequately reflect body composition or its role in the development of cardiovascular disease (CVD). Ectopic adipose depots may provide a more refined representation of the role of adiposity in CVD. Thus, the association of pericardial and intra-thoracic fat with coronary artery calcium (CAC) was examined. DESIGN AND METHODS Nearly 600 white men and women, as well as Filipina women and African-American women, all without known CVD, had abdominal and chest computed tomography (CT) scans at two time points about 4 years apart from which CAC presence, severity and progression, as well as pericardial and intrathoracic fat volumes were obtained. Logistic and linear regression models with staged adjustment were used to assess associations of pericardial and intra-thoracic fat with CAC presence, severity, and progression. RESULTS After adjustment for age, BMI, sex/ethnic group, ever smoking, and lipids, each standard deviation higher increment of intra-thoracic fat, but not pericardial fat, was significantly associated with 3.84-fold higher odds of prevalent CAC (95% CI (1.54, 9.58), P = 0.004) and a 38.4% higher CAC score (95% CI (3.5%, 90.0%), P = 0.03). Neither pericardial nor intrathoracic fat were associated with CAC progression. CONCLUSIONS Contrary to previous reports, pericardial fat was not associated with the presence, severity or progression of CAC. However, a significant association between intrathoracic fat and both the presence and severity of CAC was demonstrated. Studies measuring fat in the thoracic cavity may consider defining intrathoracic fat as a separate entity from pericardial fat.
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Affiliation(s)
- Christina L. Wassel
- Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
| | - Gail A. Laughlin
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
| | - Maria Rosario G. Araneta
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
| | - Eugene Kang
- Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
| | - Cindy M. Morgan
- Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
| | - Elizabeth Barrett Connor
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
| | - Matthew A. Allison
- Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
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