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Sever B, Bayraktar B, Adıyaman D, Gölbaşı H, Ömeroğlu İ, Çolak S, Pala HG, Ekin A. Association of increased fetal epicardial fat thickness with maternal pregestational and gestational diabetes. J Matern Fetal Neonatal Med 2023; 36:2183474. [PMID: 36859818 DOI: 10.1080/14767058.2023.2183474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
OBJECTIVE To evaluate the changes of fetal epicardial fat thickness (EFT) in pregnancies with pregestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM) and to identify the diagnostic effectiveness of fetal EFT in differentiating PGDM and GDM from normal pregnancies. METHODS The study was conducted with pregnant women who admitted to perinatology department between October 2020 and August 2021. Patients were grouped as PGDM (n = 110), GDM (n = 110), and control (n = 110) for comparison of fetal EFT. EFT was measured in all three groups at 29 weeks of gestation. Demographic characteristics and ultrasonographic findings were recorded and compared. RESULTS The mean fetal EFT was significantly higher in PGDM (1.47 ± 0.083 mm, p < .001) and GDM (1.40 ± 0.082 mm, p < .001) groups compared to control group (1.19 ± 0.049 mm) and was also significantly higher in PGDM group than GDM group (p < .001). Fetal EFT was significantly positively correlated with maternal age, fasting, 1st hour, 2nd hour glucose values, HbA1c, fetal abdominal circumference, and deepest vertical pocket of amniotic fluid (p < .001). Fetal EFT value of 1.3 mm diagnosed PGDM patients with a sensitivity of 97.3% and a specificity of 98.2%. Fetal EFT value of 1.27 mm diagnosed GDM patients with a sensitivity of 94% and a specificity of 95%. CONCLUSIONS Fetal EFT is greater in pregnancies with diabetes than in normal pregnancies, and also greater in PGDM than in GDM. In addition, fetal EFT is strongly correlated with maternal blood glucose levels in diabetic pregnancies.
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Affiliation(s)
- Barış Sever
- Department of Obstetrics and Gynecology Division of Perinatology, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Burak Bayraktar
- Department of Obstetrics and Gynecology Division of Perinatology, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - Duygu Adıyaman
- Department of Obstetrics and Gynecology Division of Perinatology, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | | | | | | | | | - Atalay Ekin
- Department of Obstetrics and Gynecology Division of Perinatology, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
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Ma ZY, Duan H, Han D, He B, Xie XJ, Lu L, Jiang J, Li RH. Epicardial fat in patients with metabolic syndrome: A systematic review and meta-analysis. Eur J Radiol 2023; 167:111056. [PMID: 37666076 DOI: 10.1016/j.ejrad.2023.111056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE Abnormally increased epicardial fat appears to be associated with an additional risk of major adverse cardiovascular events (MACEs) in the context of metabolic syndrome (MetS). However, evidence on the relationship between epicardial fat volumes (EFVs), epicardial fat thickness (EFT) and MetS remains inconsistent. METHODS Specific searches of electronic databases from 1 January 2000 to 31 October 2022 were independently performed by two researchers. In this study, two quantification measures of epicardial fat were included: comparison of total computed tomography-based EFVs and EFT between two groups (individuals with and without MetS), estimating standardized mean difference (SMD) with corresponding 95 % confidence intervals (CIs) through a random-effects model analysis. The heterogeneity in the included studies was explored by meta-regression and subgroup analyses. RESULTS The EFVs were significantly increased in MetS subjects compared with non-MetS subjects (SMD: 1.07, 95 % CI: 0.69-1.45, p < 0.001), and the EFT was also significantly larger in MetS patients than in the Non-MetS (SMD: 1.12, 95 % CI: 0.84-1.41, p < 0.001). We compared the Caucasian and American subgroups with the Asian and African subgroups, and the EFT was greater in the former subgroups (SMD: 1.32, 95 % CI: 0.44-2.20, p < 0.001). When comparing the EFT among the age subgroups, there was a significant SMD between adolescents and adults or elderly individuals (SMD: 1.21, 95 % CI: 0.84-1.52, p < 0.001). CONCLUSIONS MetS patients tend to present greater EFT near the right ventricular free wall and greater total EFVs. Increased epicardial fat, an imaging biomarker, independently affects the onset of MetS.
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Affiliation(s)
- Zhong-Yan Ma
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Hui Duan
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China.
| | - Dan Han
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Bo He
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Xiao-Jie Xie
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Lin Lu
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Jie Jiang
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
| | - Rui-Hong Li
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang road, Kunming 650032, China
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Gameil MA, Elsherbiny HA, Youssry IE, Gawad SA, Arafat AAELH. Potential impact of epicardial fat thickness, pentraxin-3, and high-sensitive C-reactive protein on the risk of non-proliferative diabetic retinopathy. J Diabetes Metab Disord 2023; 22:735-742. [PMID: 37255764 PMCID: PMC10225378 DOI: 10.1007/s40200-023-01195-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/02/2023] [Indexed: 02/24/2023]
Abstract
Purpose We tried to clarify the potential association between systemic inflammatory markers like high-sensitive C-reactive protein (Hs-CRP), pentraxin-3 (PTX3), and epicardial fat thickness (EFT) with the non-proliferative diabetic retinopathy (NPDR) in patients with type 2 diabetes mellitus (T2D). Previous studies dealt with diabetic retinopathy as a whole entity rather than early stages of diabetic retinopathy. Early detection of various determinants of NPDR is prioritized in clinical practice. Methods A case-control study was conducted at Mansoura University Hospital, included 207 Egyptian subjects divided into 3 groups; 69 diabetic patients without retinopathy, 69 diabetic patients with NPDR, and 69 healthy control subjects. Participants were subjected to clinical history taking, physical examination, and laboratory assessment of Hs-CRP and plasma PTX3. Transthoracic echocardiography was applied to estimate EFT. Results Hs-CRP, PTX3, and EFT were significantly higher in patients with T2D without retinopathy than control cohort (p = 0.033, p < 0.00 and p < 0.00, respectively). Moreover, patients with NPDR showed significantly higher values of Hs-CRP, PTX3, and EFT than diabetic comparators without retinopathy (p = 0.002, p = 0.012, and p < 0.001, respectively). Although, NPDR was positively correlated with Hs-CRP, PTX3, and EFT (p < 0.001), Hs-CRP was not an independent determinant of NPDR meanwhile, EFT (OR = 1.094, 95%CI: 1.036-1.154, P = 0.001) and PTX3 (OR = 16.145, 95%CI: 1.676-155.551, P = 0.016) were. Conclusion Plasma pentraxin-3 and epicardial fat thickness showed more significant association with NPDR than high-sensitive C-reactive protein in patients with type 2 diabetes mellitus.
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Affiliation(s)
- Mohammed Ali Gameil
- Endocrinology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Egypt
| | - Hanan Abdelhay Elsherbiny
- Endocrinology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Egypt
| | - Ibrahim Elsayed Youssry
- Cardiovascular Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Egypt
| | - Sara Abdel Gawad
- Ophthalmology Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Egypt
| | - Ahmed Abd EL-Hakim Arafat
- Endocrinology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Egypt
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Cau R, Bassareo P, Cademartiri F, Cadeddu C, Balestrieri A, Mannelli L, Suri JS, Saba L. Epicardial fat volume assessed with cardiac magnetic resonance imaging in patients with Takotsubo cardiomyopathy. Eur J Radiol 2023; 160:110706. [PMID: 36701825 DOI: 10.1016/j.ejrad.2023.110706] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
PURPOSE The aims of our study were to investigate with cardiovascular magnetic resonance (CMR) the role of Epicardial Fat Volume (EFV) and distribution in patients with Takotsubo cardiomyopathy (TTC). Moreover, we explored EFV in patients with TTC and related this to comorbidities, cardiac biomarkers, and cardiac function. METHODS This retrospective study performed CMR scans in 30 consecutive TTC patients and 20 healthy controls. The absolute amount of EFV was quantified in consecutive short-axis cine stacks through the modified Simpson's rule. In addition, the left atrio-ventricular groove (LV) and right ventricle (RV) Epicardial Fat Thickness (EFT) were measured as well. Besides epicardial fat, LV myocardial strain parameters and T2 mapping measurements were obtained. RESULTS TTC patients and controls were of comparable age, sex, and body mass index. Compared to healthy controls, patients with TTC demonstrated a significantly increased EFV, epicardial fat mass, and EFV indexed for body 7surface area (p = 0.005; p = 0.003; p = 0.008; respectively). In a multiple regression model including age, sex, BMI, atrial fibrillation, and dyslipidemia, TTC remained an independent association with EFV (p = 0.008). Global T2 mapping and Global longitudinal strain in patients with TTC were correlated with EFV (r = 0.63, p = 0.001, and r = 0.44, p = 0.02, respectively). CONCLUSION Patients with TTC have increased EFV compared to healthy controls, despite a similar body mass index. The amount of epicardial fat was associated with CMR markers of myocardial inflammation and subclinical contractile dysfunction.
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Affiliation(s)
- Riccardo Cau
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045, Italy
| | - Pierpaolo Bassareo
- Mater Misericordiae University Hospital and Our Lady's Children's Hospital, University College of Dublin, Crumlin, Dublin, Ireland
| | | | - Christian Cadeddu
- Department of Cardiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045, Italy
| | - Antonella Balestrieri
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045, Italy
| | | | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045, Italy.
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Farag SI, Mostafa SA, El-Rabbat KE, El-Kaffas SM, Awara DM. The relation between pericoronary fat thickness and density quantified by coronary computed tomography angiography with coronary artery disease severity. Indian Heart J 2023; 75:53-58. [PMID: 36640839 PMCID: PMC9986735 DOI: 10.1016/j.ihj.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 12/22/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To study the correlation between epicardial fat thickness (EFT), pericoronary fat thickness (PCFT), and pericoronary fat density (PCFD) with the existence and severity of coronary artery disease (CAD). METHODS This cross-sectional study included 210 patients referred for multislice CT angiography. Group I normal CTCA, Group II patients had non-obstructive atherosclerosis, and Group III patients had obstructive atherosclerosis. All patients underwent a clinical examination, history taking, and multislice CT angiography. RESULTS The mean EFT was significantly greater in group III (10.43 ± 2.31 mm) compared to groups II (6.30 ± 1.61 mm) and I (5.06 ± 1.14 mm). The mean PCFT was significantly greater in group III (17.96 ± 2.89 mm) compared to group II (11.47 ± 2.51 mm) and group I (9.67 ± 1.99 mm). PCFD was significantly higher adjacent to the lesion (-80.47 ± 29.14) compared to the normal segment (-109.03 ± 35.24), higher in the obstructive group (-59.44 ± 20.10) compared to the non-obstructive group (-101.51 ± 20.23), but lower in calcified lesions (-89.58 ± 28.94) compared to non-calcified (-75.01 ± 29.20), and mixed lesions (-74.83 ± 26.90). EFT and PCFT cut-off values for predicting obstructive CAD were 8.3 and 12.4 mm, respectively, with 87.1% and 92.9% sensitivity and 92.9% and 86.4% specificity, respectively. CONCLUSION There is a significant association between epicardial fat thickness, pericoronary fat thickness and density with the severity of coronary artery disease.
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Affiliation(s)
- Shereen I Farag
- Cardiovascular Medicine Department, Faculty of Medicine, Benha University, Egypt.
| | - Shaimaa A Mostafa
- Cardiovascular Medicine Department, Faculty of Medicine, Benha University, Egypt
| | - Khaled E El-Rabbat
- Cardiovascular Medicine Department, Faculty of Medicine, Benha University, Egypt
| | - Sameh M El-Kaffas
- Cardiovascular Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - Dalia M Awara
- Cardiovascular Medicine Department, Faculty of Medicine, Benha University, Egypt
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Jian B, Li Z, Wang J, Zhang C. Correlation analysis between heart rate variability, epicardial fat thickness, visfatin and AF recurrence post radiofrequency ablation. BMC Cardiovasc Disord 2022; 22:65. [PMID: 35193492 DOI: 10.1186/s12872-022-02496-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 02/04/2022] [Indexed: 11/30/2022] Open
Abstract
Background The aim of the present study is to investigate the possible correlation between heart rate variability (HRV), epicardial fat thickness (EFT), visfatin and AF recurrence post radiofrequency ablation. Methods Data of 337 AF patients to whom radiofrequency ablation therapy had been initiated at our hospital over the past three years were evaluated. The patients enrolled were divided into the non-recurrence group (102 patients) and the recurrence group (235 patients) according to AF recurrence in the preceding 12 months. General data in the two groups were collected and HRV, EFT, and visfatin levels were comprehensively compared for each patients of the two groups. Results The recurrence group showed significantly higher results in rMSSD, PNN50, HF, total EFT, and visfatin but with evidently lower results in LF/HF when comparing the non-recurrence group (P < 0.05). The significantly different general variables in the general data and laboratory parameters, rMSSD, PNN50, HF, total EFT, visfatin, LF/HF were used as independent variables, and AF recurrence post radiofrequency ablation was used as dependent variables. Logistic regression analysis revealed that the risk factors of AF recurrence post radiofrequency ablation were rMSSD, PNN50, HF, total EFT, visfatin, and LF/HF, and the difference was statistically significant (P < 0.05). Conclusion HRV, EFT, visfatin appear to show high association with AF recurrence post radiofrequency ablation.
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Asoğlu E, Akbulut T, Doğan Z, Asoğlu R. Evaluation of the aortic velocity propagation, epicardial fat thickness, and carotid intima-media thickness in patients with subclinical hypothyroidism. Rev Cardiovasc Med 2021; 22:959-966. [PMID: 34565096 DOI: 10.31083/j.rcm2203104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/26/2021] [Accepted: 07/16/2021] [Indexed: 11/06/2022] Open
Abstract
Subclinical hypothyroidism (SH) is associated with hemodynamic and metabolic abnormalities that cause endothelial dysfunction and atherosclerotic cardiovascular diseases. Aortic velocity propagation (AVP), epicardial fat thickness (EFT), and carotid intima-media thickness (CIMT) may provide additional information in SH patients. This study aimed to evaluate thyroid stimulating hormone (TSH), AVP, EFT, and CIMT in SH patients, and determine the associations among these parameters. Eighty patients with SH and 43 euthyroid (EU) individuals were enrolled. Blood samples were collected to measure laboratory parameters. Patients were divided into two groups based on their TSH values (TSH ≥10 or TSH <10 mIU/L). AVP, EFT, and CIMT were measured and compared between the study groups. A multivariate linear regression model was used for analysis of the independent predictors of AVP (beta = -0.298; 95% confidence interval = -0.946 to -0.287; p < 0.001). AVP was significantly lower in SH patients than the control group (43.7 ± 12.5 and 62.6 ± 13.8, respectively; p < 0.001). EFT values were similar between the SH and control groups (0.7 ± 0.3 and 0.6 ± 0.2, respectively; p = 0.10). SH patients had higher CIMT values than the control group (0.8 ± 0.3 and 0.5 ± 0.2, respectively; p < 0.001). In the multivariate linear analysis, TSH was an independent predictor of AVP. AVP was lower and CIMT was higher in SH patients compared to EU individuals. The increased CIMT and decreased AVP levels were significantly associated with TSH levels in SH patients.
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Affiliation(s)
- Emin Asoğlu
- Cardiology Department, Mardin Community Hospital, 47100 Mardin, Turkey
| | - Tayyar Akbulut
- Cardiology Department, Van Training and Research Hospital,65040 Van, Turkey
| | - Zeki Doğan
- Department of Cardiology, Medicine Hospital, Istanbul Atlas University, 34403 Istanbul, Turkey
| | - Ramazan Asoğlu
- Cardiology Department, Adıyaman University Training and Research Hospital, 02040 Adıyaman, Turkey
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Zhang Y, Wang J, Shui W, Zhang Z, Li J, Ma J. Different clinical parameters inform epicardial fat thickness in pre- and post-menopausal women with obstructive sleep apnea. BMC Womens Health 2021; 21:239. [PMID: 34116655 PMCID: PMC8193883 DOI: 10.1186/s12905-021-01384-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 06/04/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a sleep-related disorder with breathing difficulties. Previous studies revealed that epicardial fat thickness (EFT) correlates with OSA severity. Interestingly, female patients display a stronger EFT-OSA correlation than males. The purpose of this study is to investigate the relationship between EFT and different clinical characteristics in pre- and post-menopausal women diagnosed with OSA. METHODS Patients diagnosed with OSA were divided into pre/early peri-menopausal (Group 1) and post/late peri-menopausal (Group 2) according to the menopause status. EFT was obtained from parasternal long-axis echocardiographic images. We also collected general clinical characteristics of patients involved in this study, and performed spearman correlation analysis to explore the correlations between EFT and the general clinical characteristics. We further applied Multiple stepwise linear regression analysis to explore the predictors for EFT in both groups. RESULTS A total number of 23 and 59 patients were enrolled in Group 1 and Group 2 respectively. EFT in Group 2 was significantly higher than that of Group 1. In both groups, EFT was positively correlated with apnea-hypopnea index (AHI), percentage of total sleep time when blood oxygen saturation was less than 90% (T90), oxygen desaturation index (ODI) and glucose; while EFT was negatively correlated with mean and lowest SaO2 (oxygen saturation) levels. However, EFT was positively correlated with total cholesterol (TC) only in Group 1 and body mass index (BMI) only in Group2, respectively. Multiple stepwise linear regression analysis showed that AHI was independently associated with EFT in Group 1. However, both AHI and BMI were independent predictors of EFT in Group 2. CONCLUSION EFT was notably correlated with menopausal status in women with OSA. AHI was the independent predictor of EFT in women with OSA. BMI was the independent predictor of EFT in post/late peri-menopausal women with OSA.
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Affiliation(s)
- Yong Zhang
- Medical Imaging College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China.,Department of Ultrasound, First Hospital of Shanxi Medical University, No.85, South Jiefang Road, Yingze District, Taiyuan, 030001, Shanxi, China
| | - Jian Wang
- Department of Ultrasound, First Hospital of Shanxi Medical University, No.85, South Jiefang Road, Yingze District, Taiyuan, 030001, Shanxi, China.
| | - Wen Shui
- Medical Imaging College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Zhenxia Zhang
- Department of Respiratory, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Juan Li
- Medical Imaging College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Jin Ma
- Medical Imaging College, Shanxi Medical University, Taiyuan, 030001, Shanxi, China
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Leroux-Stewart J, Elisha B, Tagougui S, Suppère C, Bernard S, Mircescu H, Desjardin K, Messier V, Iacobellis G, Rabasa-Lhoret R. Effect of caloric restriction with or without physical activity on body composition and epicardial fat in type 2 diabetic patients: A pilot randomized controlled trial. Nutr Metab Cardiovasc Dis 2021; 31:921-929. [PMID: 33549453 DOI: 10.1016/j.numecd.2020.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS There is debate over the independent and combined effects of caloric restriction (CR) and physical activity (PA) on reduction in fat mass and in epicardial fat thickness. We compared the impact of a similar energy deficit prescription by CR or by CR combined with PA on total fat mass, epicardial fat thickness, and cardiometabolic profile in individuals with type 2 diabetes. METHODS AND RESULTS In this 16-week randomized controlled study, 73 individuals were randomly enrolled to receive: 1) a monthly motivational phone call (Control), 2) a caloric deficit of -700 kilocalories/day (CR), or 3) a caloric deficit of -500 kilocalories/day combined with a PA program of -200 kilocalories/day (CR&PA). Total fat mass, epicardial fat, and cardiometabolic profile were measured at baseline and after 16 weeks. While comparable weight loss occurred in both intervention groups (-3.9 ± 3.5 kg [CR], -5.1 ± 4.7 kg [CR&PA], -0.2 ± 2.9 kg [Control]), changes in total fat mass were significantly different between all groups (-2.4 ± 2.9 kg [CR], -4.5 ± 3.4 kg [CR&PA], +0.1 ± 2.1 kg [Control]; p < 0.05) as well as epicardial fat thickness (-0.4 ± 1.6 mm [CR], -1.4 ± 1.4 mm [CR&PA], +1.1 ± 1.3 mm [Control]; p < 0.05). There were no significant differences in trends for cardiometabolic parameters improvement between groups. CONCLUSIONS For a similar energy deficit prescription and comparable weight loss, the combination of CR&PA provides a greater reduction in fat mass and epicardial fat thickness than CR alone in individuals with comparable weight loss and with a similar energy deficit prescription. These results, however, do not translate into significant improvements in cardiometabolic profiles. CLINICALTRIALS. GOV IDENTIFIER NCT01186952.
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Affiliation(s)
- Josée Leroux-Stewart
- Institut de Recherches Cliniques de Montréal, 110 avenue des Pins, Montreal, Quebec, H2W 1R7, Canada; Department of Medicine, Endocrinology division, Centre hospitalier de l'Université de Montréal, 3840 rue Saint-Urbain, Montreal, Quebec, H2W 1T8, Canada.
| | - Belinda Elisha
- Institut de Recherches Cliniques de Montréal, 110 avenue des Pins, Montreal, Quebec, H2W 1R7, Canada; Nutrition Department, Université de Montréal, 2405 chemin de la Côte-Sainte-Catherine, Montreal, Quebec, H3T 1A8, Canada.
| | - Sémah Tagougui
- Institut de Recherches Cliniques de Montréal, 110 avenue des Pins, Montreal, Quebec, H2W 1R7, Canada; Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, F-59000, Lille, France.
| | - Corinne Suppère
- Institut de Recherches Cliniques de Montréal, 110 avenue des Pins, Montreal, Quebec, H2W 1R7, Canada.
| | - Sophie Bernard
- Institut de Recherches Cliniques de Montréal, 110 avenue des Pins, Montreal, Quebec, H2W 1R7, Canada; Department of Medicine, Endocrinology division, Centre hospitalier de l'Université de Montréal, 3840 rue Saint-Urbain, Montreal, Quebec, H2W 1T8, Canada.
| | - Hortensia Mircescu
- Institut de Recherches Cliniques de Montréal, 110 avenue des Pins, Montreal, Quebec, H2W 1R7, Canada; Department of Medicine, Endocrinology division, Centre hospitalier de l'Université de Montréal, 3840 rue Saint-Urbain, Montreal, Quebec, H2W 1T8, Canada.
| | - Katherine Desjardin
- Institut de Recherches Cliniques de Montréal, 110 avenue des Pins, Montreal, Quebec, H2W 1R7, Canada
| | - Virginie Messier
- Institut de Recherches Cliniques de Montréal, 110 avenue des Pins, Montreal, Quebec, H2W 1R7, Canada
| | - Gianluca Iacobellis
- Department of Medicine, Diabetes, Endocrinology and Metabolism division, Miller School of Medicine, University of Miami, Miami, Forida, USA.
| | - Rémi Rabasa-Lhoret
- Institut de Recherches Cliniques de Montréal, 110 avenue des Pins, Montreal, Quebec, H2W 1R7, Canada; Department of Medicine, Endocrinology division, Centre hospitalier de l'Université de Montréal, 3840 rue Saint-Urbain, Montreal, Quebec, H2W 1T8, Canada; Nutrition Department, Université de Montréal, 2405 chemin de la Côte-Sainte-Catherine, Montreal, Quebec, H3T 1A8, Canada; Montreal Diabetes Research Center, 900 rue Saint-Denis, Montreal, Quebec, H2X 0A9, Canada.
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Ozdemir M, Asoglu R, Dogan Z, Aladag N, Akbulut T, Yurtdas M. The Association of Glomerular Filtration Rate With Echocardiographic Parameters in Chronic Kidney Disease. J Clin Med Res 2021; 13:121-129. [PMID: 33747327 PMCID: PMC7935629 DOI: 10.14740/jocmr4439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/16/2021] [Indexed: 11/20/2022] Open
Abstract
Background Cardiovascular disease (CVD) is the primary cause of mortality and morbidity in chronic kidney disease (CKD) patients. Aortic propagation velocity (APV), epicardial fat thickness (EFT) and carotid intima-media thickness (CIMT) measurements could provide additional information on assessing renal decline in CKD patients. The study aimed to evaluate EFT, AVP and CIMT in CKD patients and then investigate the association among those parameters. Methods A total of 170 CKD consecutive subjects were enrolled in the study. Patients were divided into five groups according to their estimated glomerular filtration rate (eGFR) values. Each patient underwent complete transthoracic echocardiography examination. APV, EFT and CIMT were measured for analyses. A multivariate linear regression model was used for analysis to determine the independent predictors of eGFR. Results The lowest APV was observed in stage IV-V, and the highest APV was observed in stage I-II (P < 0.001). Stage IV-V patients had the highest EFT and stage I-II patients had the lowest EFT (P < 0.001). Moreover, the lowest CIMT was observed in stage III, and the highest CIMT was observed in stage V (P < 0.001). eGFR was significantly and positively correlated with APV and negatively correlated with EFT and CIMT. In multivariate analyses, APV (odds ratio (OR): 0.289, P < 0.001), EFT (OR: -0.135, P < 0.001) and CIMT (OR: -0.388, P < 0.001) were independent predictors of eGFR. Conclusion We found that APV decreased, and EFT and CIMT increased as CKD progress. The present study suggests that APV, EFT and CIMT might be incorporated with the examination of CKD patients in daily practice.
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Affiliation(s)
- Mahmut Ozdemir
- Cardiology Department, School of Medicine, Istanbul Aydin University, Istanbul, Turkey
| | - Ramazan Asoglu
- Cardiology Department, Adiyaman University Training and Research Hospital, Adiyaman, Turkey
| | - Zeki Dogan
- Cardiology Department, School of Medicine, Istanbul Atlas University, Istanbul, Turkey
| | - Nesim Aladag
- Cardiology Department, School of Medicine, Yuzuncuyil University, Van, Turkey
| | - Tayyar Akbulut
- Cardiology Department, Van Training and Research Hospital, Health Science University, Van, Turkey
| | - Mustafa Yurtdas
- Cardiology Department, School of Medicine, Istanbul Atlas University, Istanbul, Turkey
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Babapour B, Doustkami H, Avesta L, Moradi A, Saadat S, Piralaei K, Aslani MR. Correlation of Serum Adipolin with Epicardial Fat Thickness and Severity of Coronary Artery Diseases in Acute Myocardial Infarction and Stable Angina Pectoris Patients. Med Princ Pract 2021; 30:52-61. [PMID: 32438366 PMCID: PMC7923895 DOI: 10.1159/000508834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 05/18/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Adipolin/C1q/TNF-related protein-12 is a family of CTRPs highly expressed in adipose tissue with glucose-lowering and anti-inflammatory effects. Various risk factors have been suggested in the incidence of cardiovascular diseases, such as a decrease in anti-inflammatory or an increase in inflammatory factors. The purpose of the present study was to investigate the correlation of adipolin with anthropometric, angiographic, echocardiographic, and biochemical parameters. SUBJECT AND METHODS A total of 90 patients who were candidates for angiography were included in the study and divided into 3 groups: 30 patients with acute myocardial infarction (AMI), 30 patients with stable angina pectoris (SAP), and 30 subjects as a control group with a history of chest pain but normal angiography. Anthropometric, angiographic, echocardiographic, and biochemical parameters were measured in all subjects. RESULTS Serum adipolin levels were significantly decreased in patients with AMI compared with the SAP and control groups (p < 0.001 for both). In addition, there was a negative association between serum levels of adipolin and epicardial fat thickness (EFT) and Gensini score in CAD patients. The results of multivariate linear regression analysis revealed that EFT values were independently associated with serum adipolin levels. CONCLUSION The current study showed an independent association of adipolin with EFT for the first time in patients with AMI. Decreased adipolin levels in patients with AMI may be involved in the process of atherosclerosis, which requires further study.
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Affiliation(s)
- Behzad Babapour
- Department of Cardiology, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hossein Doustkami
- Department of Cardiology, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Leli Avesta
- Department of Cardiology, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Moradi
- Department of Physiology, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Saeideh Saadat
- Department of Physiology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Kiavash Piralaei
- Department of Physiology, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Reza Aslani
- Lung Inflammatory Diseases Research Center, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran,
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,
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12
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Shambu SK, Desai N, Sundaresh N, Babu MS, Madhu B, Gona OJ. Study of correlation between epicardial fat thickness and severity of coronary artery disease. Indian Heart J 2020; 72:445-447. [PMID: 33189210 PMCID: PMC7670255 DOI: 10.1016/j.ihj.2020.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/27/2020] [Accepted: 07/07/2020] [Indexed: 11/03/2022] Open
Abstract
Epicardial fat thickness (EFT) reflects visceral adiposity and is associated with coronary artery disease (CAD). This study aimed to assess the correlation of echocardiographic EFT with the severity of CAD and to determine the EFT cut-off to predict CAD. EFT was measured in 503 patients undergoing coronary angiogram. Mean EFT was significantly higher in the CAD group than control group (5.55 ± 1.21 mm vs 3.25 ± 1.15 mm, p < 0.0001). EFT correlated with Gensini score (r = 0.906, p < 0.001). EFT cut-off ≥ 4.75 mm had 87% sensitivity and 63% specificity for prediction of significant CAD (AUC: 0.831, p < 0.001).
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Affiliation(s)
- Sunil Kumar Shambu
- Head, Department of Cardiology, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, SS Nagar, Mysore 15, India.
| | - Nagaraj Desai
- Department of Cardiology, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, SS Nagar, Mysore 15, India.
| | - Nikhil Sundaresh
- Dept. of Medicine, AJ Institute of Medical Sciences, Mangalore, India.
| | - M Suresh Babu
- JSS Medical College and Hospital, JSS Academy of Higher Education and Research, SS Nagar, Mysore, 15, India.
| | - B Madhu
- Department of Community Medicine, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, SS Nagar, Mysore 15, India.
| | - Oliver Joel Gona
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, SS Nagar, Mysore 15, India.
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13
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Cekici Y, Kaya BC, Elkan H. The Effect of Laparoscopic Sleeve Gastrectomy on Subclinical Atherosclerosis in Patients with Severe Obesity. Obes Surg 2020; 31:738-745. [PMID: 33188623 DOI: 10.1007/s11695-020-05121-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/07/2020] [Accepted: 11/11/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Cardiovascular diseases (CVD) are one of the leading causes of mortality in obese patients. In this study, we investigated the effects of laparoscopic sleeve gastrectomy (LSG) operation on carotid intima-media thickness (CIMT), epicardial fat thickness (EFT), and serum endocan levels, which are independent predictors of subclinical atherosclerosis. MATERIALS AND METHODS A total of 47 patients (35 females and 12 males) with a mean age of 38 ± 10.48 with standard indications for LSG were prospectively included in the study. Mean CIMT values with B-mode duplex ultrasound, EFT measurements with standard transthoracic 2D echocardiography, and serum endocan levels were measured before the operation and 6 months after the operation. Delta (Δ) values were obtained by subtracting sixth month values from baseline values. RESULTS Body mass index (BMI) decreased significantly from an average of 47.31 ± 6.10 to 37.25 ± 5.61 kg/m2 in the sixth month after LSG (p < 0.001). EFT, CIMT, and serum endocan values decreased significantly in the sixth month after surgery (0.67 ± 0.15 vs. 0.60 ± 0.14 mm, p < 0.001; 1.07 ± 0.05 vs. 1.00 ± 0.14 mm, p < 0.001; and 89.18 ± 66.22 vs. 37.74 ± 15.37, p < 0.001, respectively). There were mild-moderate positive relationships between Δ-BMI and the values of EFT and CIMT (r = 0.386, p = 0.007 and r = 0.314, p = 0.024, respectively). We also found weak linear relationships between Δ-BMI and Δ-endocan (r = 0.267, p = 0.036), and between Δ-EFT and Δ-CIMT (r: 0.221; p: 0.046). CONCLUSION LSG can lead to reduction in the risk of cardiovascular disease by providing improvements in CIMT, EFT, and serum endocan values, which reflect early structural atherosclerotic changes in patients with severe obesity.
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Affiliation(s)
- Yusuf Cekici
- Department of Cardiology, SBÜ Mehmet Akif İnan Education and Research Hospital, Esentepe Neighborhood, Ertuğrul Street, 132A., 63040, Haliliye, Şanlıurfa, Turkey.
| | - Bedri Caner Kaya
- Department of Cardiology, SBÜ Mehmet Akif İnan Education and Research Hospital, Esentepe Neighborhood, Ertuğrul Street, 132A., 63040, Haliliye, Şanlıurfa, Turkey
| | - Hasan Elkan
- Department of General Surgery, Şanlıurfa Education and Research Hospital, Yenice Neighborhood, D: 1, 63300, Haliliye, Şanlıurfa, Turkey
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14
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Aydin S, Fatihoglu E. Fetal Epicardial Fat Thickness: Can It Serve as a Sonographic Screening Marker for Gestational Diabetes Mellitus? J Med Ultrasound 2020; 28:239-244. [PMID: 33659164 PMCID: PMC7869731 DOI: 10.4103/jmu.jmu_29_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/22/2020] [Accepted: 04/09/2020] [Indexed: 01/11/2023] Open
Abstract
Background Gestational diabetes mellitus (GDM) is defined as the new onset of impairment in carbohydrate tolerance during pregnancy. The aim of the current study was to define fetal epicardial fat thickness (fEFT) changes that developed before 24 weeks of gestation, to evaluate the diagnostic effectiveness of fEFT in predicting GDM diagnosis, and to correlate fEFT values with hemoglobin A1C (HbA1C) values. Methods The study included a total of 60 GDM patients and 60 control subjects. A record consisted of fEFT measurements, maternal body mass index, maternal subcutaneous fat thickness, and fetal subcutaneous fat thickness during sonographic screening performed at 18-22 gestational weeks. Fetal abdominal circumference (AC) values, estimated fetal weight (EFW), and fetal gender were also recorded. Results The median fEFT measurement of the whole study population was 0.9 ± 0.21 mm; 1.05 ± 0.21 mm in the GDM patients, and 0.8 ± 0.15 mm in the control group. The median fEFT values of the GDM patients were significantly higher than those of the control group (P < 0.01). According to the correlation analysis results, a strong positive correlation was determined between the fEFT and HbA1C values (r = 0.71, P < 0.01), gestational week of the fetus (r = 0.76, P = P < 0.01), AC (r = 0.81, P < 0.01), and EFW (r = 0.71, P < 0.01). According to the receiver operating characteristic analysis results, a fEFT value of > 0.95 can predict GDM diagnosis with sensitivity of 65% and specificity of 88% (odds ratio = 13). Conclusion fEFT values are increased in GDM cases, and the increase can be detected earlier than 24 weeks of gestation. fEFT values are positively correlated with HbA1C values and can serve as an early predictor for GDM diagnosis.
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Affiliation(s)
- Sonay Aydin
- Department of Radiology, Dr. Sami Ulus Training and Research Hospital, Ankara, Turkey
| | - Erdem Fatihoglu
- Department of Radiology, Erzincan University, Erzincan, Turkey
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Farghaly HS, Metwalley KA, Raafat DM, Algowhary M, Said GM. Epicardial Fat Thickness in Children with Subclinical Hypothyroidism and Its Relationship to Subclinical Atherosclerosis: A Pilot Study. Horm Res Paediatr 2020; 92:99-105. [PMID: 31618734 DOI: 10.1159/000503287] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/09/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Thyroid hormones (TSH) play a key role in the working of the cardiovascular system, with direct effects on cardiac function, vascular system, and atherosclerotic factors. Epicardial adipose tissue, the visceral fat of the heart, has emerged as a new cardiometabolic risk marker because of its close anatomical proximity to the myocardium and coronary artery. This study aimed to evaluate epicardial fat thickness (EFT) in children with subclinical hypothyroidism (SH) and its relation to early atherosclerotic changes. METHODS The study included 32 children with SH due to autoimmune thyroiditis and 32 healthy children matched for age and gender as control group. Patients and controls underwent anthropometric evaluation and measurement of fasting lipids, glucose, insulin, homeostasis model assessment for insulin resistance and high-sensitivity C-reactive protein (hs-CRP). TSH, free thyroxine (FT4 and FT3) and antithyroid autoantibodies (antithyroid peroxidase and thyroglobulin antibodies) were also measured. Conventional echo-cardiography was used to assess EFT. Noninvasive ultrasound was used to measure carotid intima-media thickness and brachial artery flow-mediated dilation (FMD) responses. RESULTS Compared to controls, patients had higher atherogenic index (AI) and hs-CRP (p = 0.001 for each). Conventional echocardiography revealed that patients with SH had higher EFT (p = 01) and significantly lower FMD response compared with the control (p = 0.001). In multivariate analysis, EFT values were significantly correlated with TSH (OR 1.2; 95% CI 1.04-1.34; p = 0.01), hs-CRP (OR 1.1; 95% CI 1.09-1.14; p = 0.001, AI (OR 1.6; 95% CI 1.17-2.03; p = 0.001), and FMD response (OR 2.4; 95% CI 1.14-2.53; p = 0.01). CONCLUSIONS Our study demonstrated that EFT is higher in children with SH compared with controls and associated with FMD responses. Measurement of EFT by echocardiography in children with SH may help to identify those at high risk of developing subclinical atherosclerosis.
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Affiliation(s)
- Hekma Saad Farghaly
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt,
| | | | - Duaa Mohamed Raafat
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Magdy Algowhary
- Department of Cardiology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ghada Mohamed Said
- Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
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16
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Cosansu K, Yilmaz S. Is epicardial fat thickness associated with acute ischemic stroke in patients with atrial fibrillation? J Stroke Cerebrovasc Dis 2020; 29:104900. [PMID: 32402718 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/12/2020] [Accepted: 04/20/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common etiology of acute ischemic stroke (AIS). In recent years, epicardial fat tissue (EFT) has been found to be associated with the presence and chronicity of AF. However, the potential association between EFT and AIS in AF patients has not been fully elucidated. The aim of this study was to evaluate the effectiveness of EFT on prediction of AIS in patients with AF. METHODS This cross-sectional study has included 80 AF patients with AIS and 80 age-gender matched AF controls without AIS. Echocardiographic evaluations were performed in the first three days after hospitalization between July 2019 and December 2019 in Sakarya University Education and Research Hospital. Echocardiographic measurement of EFT was conducted according to previously published methods. RESULTS In comparison with the control group, AF patients with AIS had significantly higher epicardial fat thickness (8.55 ± 1.08 vs 5.90 ± 1.35 mm; P < 0.0001). The multivariate regression analysis indicated that EFT independently predicts AIS in patients with AF. CONCLUSIONS The present study showed that, EFT is an independent predictor for the development of acute ischemic stroke in patients with AF.
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Affiliation(s)
- Kahraman Cosansu
- Sakarya University, Education and Research Hospital, Deparment of Cardiology, Sakarya 54100, Turkey.
| | - Sabiye Yilmaz
- Sakarya University, Education and Research Hospital, Deparment of Cardiology, Sakarya 54100, Turkey
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17
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Calan M, Demirpence M. Increased circulating levels of irisin are associated with cardiovascular risk factors in subjects with acromegaly. Hormones (Athens) 2019; 18:435-442. [PMID: 31696447 DOI: 10.1007/s42000-019-00151-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 10/23/2019] [Indexed: 02/07/2023]
Abstract
AIMS Irisin, a peptide secreted from muscle and adipose tissues, is associated with insulin resistance as well as metabolic and cardiovascular diseases. Acromegaly is a rare disorder caused by overproduction of growth hormone (GH) and is associated with functional and structural differentiation of adipose and muscle tissues. Acromegalic subjects are also at risk of vascular diseases and metabolic dysfunctions. We aimed to determine the altered levels of irisin in subjects with active acromegaly and controlled acromegaly and in controls, and to ascertain whether there is an association between irisin and hormonal and cardiometabolic parameters. METHODS We enrolled 40 subjects with active acromegaly, 30 subjects with controlled acromegaly, and 40 control subjects of matched age, gender, BMI, and occurrence of hypertension, diabetes, and metabolic syndrome distribution in the present cross-sectional study. Hormonal and metabolic parameters, carotid intima media thickness (cIMT), and epicardial fat thickness (EFT) of the subjects were evaluated. Irisin levels were measured using ELISA. RESULTS Circulating levels of irisin were significantly higher in acromegalic subjects compared to both controlled acromegalic subjects and controls. Moreover, irisin levels were elevated in controlled acromegalic subjects compared to controls. Irisin displayed a positive correlation with insulin resistance, cIMT, EFT, BMI, GH, and insulin-like growth factor (IGF-1) in acromegalic subjects. Irisin levels were independently associated with cIMT and EFT according to multiple regression analyses. There was an independent relationship between irisin and IGF-1. CONCLUSIONS Elevated irisin levels in acromegalic subjects were associated with cIMT and EFT, suggesting that irisin is a surrogate marker for cardiovascular risk in acromegalic subjects.
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Affiliation(s)
- Mehmet Calan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, Bozyaka, 35170, Izmir, Turkey.
| | - Mustafa Demirpence
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Tepecik Training and Research Hospital, Tepecik, 35120, Izmir, Turkey
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18
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Yafei S, Elsewy F, Youssef E, Ayman M, Elshafei M, Abayazeed R. Echocardiographic association of epicardial fat with carotid intima-media thickness in patients with type 2 diabetes. Diab Vasc Dis Res 2019; 16:378-384. [PMID: 31271311 DOI: 10.1177/1479164119827602] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Epicardial fat is recognized as active endocrine organ and as emerging risk factor for cardio-metabolic diseases. The aim of this study was to explore the relationship between epicardial fat and carotid intima-media thickness in type 2 diabetes patients. METHODS Epicardial fat thickness was measured in 76 type 2 diabetes patients without clinical atherosclerotic cardiovascular disease and 30 age- and sex-matched controls. In addition to laboratory tests, all patients underwent transthoracic echocardiography for epicardial fat thickness and ultrasonographic examination of carotid intima-media thickness. RESULTS Patients with diabetes had higher epicardial fat thickness and carotid intima-media thickness than those of the controls (6.23 ± 1.27 mm vs 4.6 ± 1.03 mm, p < 0.001 and 0.77 ± 0.150 mm vs 0.58 ± 0.08 mm, p < 0.001, respectively). Epicardial fat thickness was correlated significantly with age, duration of type 2 diabetes, body mass index, waist circumference, HbA1c, carotid intima-media thickness, Homeostasis Model Assessment Index for insulin resistance and lipid profile in the type 2 diabetic patients. Stepwise regression analysis showed that carotid intima-media thickness, duration of diabetes, triglyceride and body mass index were the independent predictors of epicardial fat thickness, with carotid intima-media thickness the most important predictor (β = 3.078, t = 4.058, p < 0.001). Receiver operating characteristic curve analysis was done and cut-off high-risk epicardial fat thickness value of 6.1 mm was determined with a sensitivity and specificity of 71.4% and 72%, respectively. CONCLUSION Patients with type 2 diabetes have higher carotid intima-media thickness and epicardial fat thickness. Epicardial fat thickness was found to be a strong predictor of subclinical atherosclerosis.
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Affiliation(s)
- Saeed Yafei
- 1 Diabetes and Metabolism Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- 2 Department of Internal Medicine, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
| | - Fathy Elsewy
- 1 Diabetes and Metabolism Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Eman Youssef
- 1 Diabetes and Metabolism Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mohamed Ayman
- 3 Cardiology and Angiology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mohamed Elshafei
- 4 Department of Radiodiagnosis, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Rasha Abayazeed
- 3 Cardiology and Angiology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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19
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Dönmez Y, Bulut A. Epicardial fat thickness is significantly increased and related to LDL cholesterol level in patients with familial hypercholesterolemia. J Ultrasound 2019; 22:309-14. [PMID: 30852775 DOI: 10.1007/s40477-019-00368-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/22/2019] [Indexed: 10/27/2022] Open
Abstract
PURPOSE Increased epicardial fat thickness (EFT) is accepted as a risk factfcardiovascular diseases in some studies. There are conflicting results about the relation between plasma low-density lipoprotein cholesterol (LDL-C) level and EFT. As well, the relation between EFT and familial hypercholesterolemia is not clearly documented in the literature. Our aim was to investigate EFT in familial hypercholesterolemia patients and to determine which parameters were related to EFT increase. METHODS A total of 150 subjects enrolled in our study. Subjects were separated into two groups: 75 hypercholesterolemia patients (16 men, mean age 52.8 ± 7.4 years) and 75 familial hypercholesterolemia patients (26 men, mean age 50.7 ± 9.2 years). Medical history assessments and complete physical examinations were done. Routine laboratory tests and echocardiographic measurements were performed. RESULTS Coronary artery disease frequency was significantly higher in the familial hypercholesterolemia group (p < 0.001). This group had significantly higher TC and LDL-C levels than the hypercholesterolemia group (p < 0.05 for all). EFT values were higher in the familial hypercholesterolemia group, and were significantly different than in the other group (p < 0.001). LDL-C was found to be independently related to EFT in the linear regression analysis. CONCLUSIONS Epicardial fat thickness increased in the familial hypercholesterolemia patients. In addition, LDL-C levels were significantly crelated with increased EFT.
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20
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Demirpence M, Guler A, Yilmaz H, Sayin A, Pekcevik Y, Turkon H, Colak A, Ari EM, Aslanipour B, Kocabas GU, Calan M. Is elevated urotensin II level a predictor for increased cardiovascular risk in subjects with acromegaly? J Endocrinol Invest 2019; 42:207-215. [PMID: 29804270 DOI: 10.1007/s40618-018-0905-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 05/18/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Acromegaly is a rare disorder existed in the result of overproduction of growth hormone (GH). The disorder is associated with increased cardiovascular risk factors and metabolic abnormalities. Urotensin II (UII), a secreted vasoactive peptide hormone, belonging somatostatin superfamily, plays an essential role in atherosclerosis and glucose metabolism. The aim of this study was to ascertain whether circulating UII levels are altered in subjects with acromegaly, and to describe the relationship between UII and hormonal or cardiometabolic parameters. METHODS This cross-sectional study included 41 subjects with active acromegaly, 28 subjects with controlled acromegaly, and 37 age- and BMI-matched controls without acromegaly. Hormonal and metabolic features of the subjects as well as carotid intima media thickness (cIMT) and epicardial fat thickness (EFT) were defined. Circulation of UII levels was determined via ELISA. RESULTS Both active and controlled acromegalic subjects showed a significant elevation of circulating levels of UII with respect to controls. There was no remarkable difference in circulating levels of UII between active and controlled acromegalic groups. Both cIMT and EFT were remarkably increased in acromegaly subjects comparing to controls. UII positively correlated with cIMT, EFT, BMI, and HOMA-IR. There was no correlation between UII and GH, insulin-like growth factor-1. According to the results obtained from regression models, UII levels independently predicted cIMT and EFT. CONCLUSION Elevated UII levels are associated with severity of cardiovascular risk factors including cIMT and EFT in acromegalic subjects.
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Affiliation(s)
- M Demirpence
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Tepecik Training and Research Hospital, Tepecik, 35120, Izmir, Turkey
| | - A Guler
- Department of Family Physician, Izmir Bozyaka Training and Research Hospital, Bozyaka, 35170, Izmir, Turkey
| | - H Yilmaz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Tepecik Training and Research Hospital, Tepecik, 35120, Izmir, Turkey
| | - A Sayin
- Department of Cardiology, Izmir Tepecik Research and Training Hospital, Tepecik, 35120, Izmir, Turkey
| | - Y Pekcevik
- Department of Radiology, Izmir Tepecik Training and Research Hospital, Tepecik, 35120, Izmir, Turkey
| | - H Turkon
- Department of Medical Biochemistry, Faculty of Medicine, Canakkale Onsekiz Mart University, 17120, Canakkale, Turkey
| | - A Colak
- Department of Clinical Biochemistry, Izmir Tepecik Training and Research Hospital, Tepecik, 35120, Izmir, Turkey
| | - E M Ari
- Department of Clinical Biochemistry, Izmir Tepecik Training and Research Hospital, Tepecik, 35120, Izmir, Turkey
| | - B Aslanipour
- Department of Bioengineering, Faculty of Engineering, Ege University, Bornova, 35100, Izmir, Turkey
| | - G U Kocabas
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, Bozyaka, 35170, Izmir, Turkey
| | - M Calan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, Bozyaka, 35170, Izmir, Turkey.
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Ansari MA, Mohebati M, Poursadegh F, Foroughian M, Shamloo AS. Is echocardiographic epicardial fat thickness increased in patients with coronary artery disease? A systematic review and meta-analysis. Electron Physician 2018; 10:7249-7258. [PMID: 30258557 PMCID: PMC6140987 DOI: 10.19082/7249] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/04/2018] [Indexed: 01/16/2023] Open
Abstract
Background The relation of epicardial fat thickness (EFT) to coronary artery disease (CAD) has recently been reported in multiple studies. Echocardiography is a safe and relatively inexpensive and accessible approach to assess regional EFT, which can be performed easily in many centers. Objective To determine the association between echocardiographic EFT and the presence or the absence of CAD. Methods This was a systematic review and meta-analysis conducted on literature available in electronic databases up to March 2018. The articles measuring EFT by echocardiography in the right ventricular (RV) free wall were included in the study. The quality of the enrolled items was assessed using the Methodological Index for Non-Randomized Studies (MINORS) checklist. The analyses were performed using the Comprehensive Meta-Analysis version 2 software. Cochran’s Q test and I2 index were used to evaluate heterogeneity. Results This meta-analysis was performed on 13 studies involving 2,436 patients (1,622 with CAD, and 814 without CAD). The maximum EFT reported by echocardiography was 12.9±2.7 mm in the CAD group and 8.4±2.5 mm in the non-CAD group. The minimum EFT reported by echocardiography was 2.2±1.8 mm in the CAD group and 1.8±1.4 mm in the non-CAD group. The heterogeneity was found among the researched studies (I2=91.8%, p=0.000, Q-value=146.43, df [Q] =12) using the random effect model. The patients with CAD had a significantly higher echocardiographic EFT than those without CAD (SMD=1.03, 95% CI= 0.70–1.37, p=0.000). Conclusion According to the findings of this meta-analysis, the echocardiographic EFT in the subjects with CAD was significantly higher than that of those without CAD. The measurement of echocardiographic EFT seems to be an acceptable strategy for risk stratification of heart diseases considering ease of use, cost-effectiveness and non-exposure characteristics, compared to other imaging interventions.
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Affiliation(s)
- Mohammad Ali Ansari
- Atherosclerosis Prevention Research Center, Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Mohebati
- Associate Professor, Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farid Poursadegh
- Internal Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Foroughian
- Emergency Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Sepehri Shamloo
- Atherosclerosis Prevention Research Center, Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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22
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Cho KI, Kim BJ, Cho SH, Lee JH, Kim MK, Yoo BG. Epicardial Fat Thickness and Free Fatty Acid Level are Predictors of Acute Ischemic Stroke with Atrial Fibrillation. J Cardiovasc Imaging 2018; 26:65-74. [PMID: 29971268 PMCID: PMC6024837 DOI: 10.4250/jcvi.2018.26.e1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 04/02/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Increased epicardial fat is known to be associated with the presence and chronicity of atrial fibrillation (AF). Free fatty acids (FFAs) are major components of epicardial fat; however, their potential association with AF in ischemic stroke has not been investigated. We aimed to assess the performance of echocardiographic epicardial fat thickness (EFT) and plasma FFA level in identifying patients with ischemic stroke and AF. METHODS We enrolled a total of 214 consecutive patients (mean age, 66.8 ± 12.3 years; 39.7% women) diagnosed with acute ischemic stroke between March 2011 and June 2014. The patients were divided into two groups: ischemic stroke with AF (n = 35, 16.4%) and ischemic stroke without AF (n = 179, 83.6%). RESULTS The ischemic stroke with AF group showed significantly higher serum FFA level (1379.7 ± 717.5 vs. 757.8 ± 520.5 uEq/L, p < 0.0001) and EFT (6.5 ± 1.2 vs. 5.3 ± 1.2 mm, p < 0.001) than the group without AF. Multivariable logistic regression analysis demonstrated that age (odds ratio [OR], 1.112), serum FFA level (OR, 1.002), and EFT (OR, 1.740) were independently associated with the ischemic stroke group with AF. EFT and FFA significantly improved the goodness-of-fit and discriminability of the simple regression model including age as a covariate (log likelihood difference, 21.35; p < 0.001; c-index difference, 17.9%; p < 0.001). CONCLUSIONS High EFT and serum FFA level were associated with ischemic stroke in patients with AF. Echocardiographic EFT and serum FFA level can play a significant role in identifying ischemic stroke with AF.
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Affiliation(s)
- Kyoung-Im Cho
- Department of Cardiology, Kosin University College of Medicine, Busan, Korea
| | - Bong-Joon Kim
- Department of Cardiology, Kosin University College of Medicine, Busan, Korea
| | - Sang-Hoon Cho
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Jin-Hyung Lee
- Department of Neurology, Kosin University College of Medicine, Busan, Korea
| | - Meyung-Kug Kim
- Department of Neurology, Kosin University College of Medicine, Busan, Korea
| | - Bong-Goo Yoo
- Department of Neurology, Kosin University College of Medicine, Busan, Korea
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Concistrè A, Petramala L, Scoccia G, Sciomer S, Bisogni V, Saracino V, Iannucci G, Lai S, Mastroluca D, Iacobellis G, Letizia C. Epicardial Fat Thickness in Patients with Autosomal Dominant Polycystic Kidney Disease. Cardiorenal Med 2018; 8:199-207. [PMID: 29723863 DOI: 10.1159/000488064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 02/28/2018] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Autosomal dominant polycystic kidney disease (ADPKD) is associated with early organ damage such as left ventricular hypertrophy and higher cardiovascular risk when compared to essential hypertension (EH). Epicardial adipose tissue (EAT) is a new cardiovascular risk factor, but its role and correlation with left ventricular mass (LVM) in ADPKD is unknown. AIMS we sought to investigate whether EAT is higher and related to LVM indexed by body surface area (LVMi) in hypertensive patients with ADPKD compared to those with EH. METHODS We performed ultrasound measurement of EAT thickness, LVM, LVMi, and left atrium size (left atrial volume indexed for body surface, LAVI) in 41 consecutive hypertensive patients with ADPKD, compared to 89 EH patients. RESULTS EAT was significantly higher in the ADPKD group in comparison to EH subjects (9.2 ± 2.9 mm vs. 7.8 ± 1.6 mm, p < 0.001), and significantly correlated with LVM, LVMi, and LAVI in the ADPKD group (r = 0.56, p = 0.005; r = 0.424, p = 0.022; and r = 0.48, p = < 0.001, respectively). Comparing EAT against body mass index, systolic blood pressure, and age, we found that EAT was the strongest predictor of LVMi (β = 0.42, p = 0.007). CONCLUSION Our data showed that EAT was higher in ADPKD patients than in EH subjects and independently correlated with LVMi. EAT measurement can be a useful marker for the cardiovascular risk stratification in ADPKD.
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Affiliation(s)
- Antonio Concistrè
- Unit of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Luigi Petramala
- Unit of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Gianmarco Scoccia
- Unit of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Susanna Sciomer
- Department of Cardiovascular and Respiratory Sciences, Sapienza University of Rome, Rome, Italy
| | - Valeria Bisogni
- Unit of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Vincenza Saracino
- Unit of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Gino Iannucci
- Unit of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Silvia Lai
- Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Daniela Mastroluca
- Nephrology and Dialysis Unit, Hospital ICOT Latina, Sapienza University of Rome, Rome, Italy
| | - Gianluca Iacobellis
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Claudio Letizia
- Unit of Secondary Hypertension, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
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Altin C, Erol V, Aydin E, Yilmaz M, Tekindal MA, Sade LE, Gulay H, Muderrisoglu H. Impact of weight loss on epicardial fat and carotid intima media thickness after laparoscopic sleeve gastrectomy: A prospective study. Nutr Metab Cardiovasc Dis 2018; 28:501-509. [PMID: 29571589 DOI: 10.1016/j.numecd.2018.02.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/09/2018] [Accepted: 02/02/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Cardiovascular disease (CVD) is one of the leading causes of mortality in obese patients. We aimed to investigate the influence of significant weight loss following laparoscopic sleeve gastrectomy (LSG) on carotid intima media thickness (CIMT) and epicardial fat thickness (EFT) which are the independent predictors of subclinical atherosclerosis. METHODS AND RESULTS Patients were recruited for standard indications. A total of 105 patients (79 women and 26 men) with the mean age of 43.61 ± 12.42 were prospectively enrolled. On B-mode duplex ultrasound; the mean CIMT at the far wall of both left and right common carotid arteries were measured. EFT was measured on the free wall of the right ventricle at end-diastole from the parasternal long-axis view by standard transthorasic 2D echocardiography. Delta (Δ) values were obtained by subtracting sixth month values from the baseline values. Body mass index (BMI) was significantly reduced from 46.95 ± 7.54 to 33.54 ± 6.41 kg/m2 (p < 0.001) in sixth months after LSG. Both EFT and CIMT were significantly decreased after surgery (8.68 ± 1.95 mm vs. 7.41 ± 1.87 mm; p < 0.001 and 0.74 ± 0.13 mm vs. 0.67 ± 0.11 mm; p < 0.001 respectively). A significant correlation between ΔEFT and ΔBMI (r = 0.431, p < 0.001) was shown. ΔCIMT is significantly correlated with ΔEFT, ΔBMI and Δ systolic blood pressure (r = 0.310, r = 0.285 and r = 0.231 respectively, p < 0.05 for all). In multivariate stepwise linear regression analysis; among variables only ΔBMI was the independent predictor of ΔEFT (β = 153, p = 0.001). CONCLUSION Early atherosclerotic structural changes may be reversed or improved by sustained weight loss after LSG in asymptomatic obese patients.
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Affiliation(s)
- C Altin
- Department of Cardiology, Baskent University Faculty of Medicine Hospitals, İzmir, Turkey.
| | - V Erol
- Department of General Surgery, Baskent University Faculty of Medicine Hospitals, İzmir, Turkey
| | - E Aydin
- Department of Radiology, Baskent University Faculty of Medicine Hospitals, İzmir, Turkey
| | - M Yilmaz
- Department of Cardiology, Baskent University Faculty of Medicine Hospitals, Adana, Turkey
| | - M A Tekindal
- Department of Biostatistics, Selcuk University, Konya, Turkey
| | - L E Sade
- Department of Cardiology, Baskent University Faculty of Medicine Hospitals, Ankara, Turkey
| | - H Gulay
- Department of General Surgery, Baskent University Faculty of Medicine Hospitals, İzmir, Turkey
| | - H Muderrisoglu
- Department of Cardiology, Baskent University Faculty of Medicine Hospitals, Ankara, Turkey
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Mohammadzadeh M, Mohammadzadeh V, Shakiba M, Motevalli M, Abedini A, Kadivar S, Entezari P, Mohammadzadeh A. Assessing the Relation of Epicardial Fat Thickness and Volume, Quantified by 256-Slice Computed Tomography Scan, With Coronary Artery Disease and Cardiovascular Risk Factors. Arch Iran Med 2018; 21:95-100. [PMID: 29688734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 01/03/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND This study aimed to investigate the association between epicardial adipose tissue (EAT) and coronary artery disease (CAD) as well as cardiovascular risk factors. METHODS Complete medical records of subjects were reviewed and cardiovascular risk factors were recorded. Epicardial fat volume (EFV) and epicardial fat thickness (EFT) were measured using digital volumetry of acquired images using a 256-slice CT-scanner. Calcium score was measured using Agatston method in non-contrast images. After contrast administration, bolus-tract images were obtained. Coronary arteries were assessed using reconstructed images in arterial phase of contrast-enhanced images. EFV and EFT measurements were compared to computed tomography angiography (CTA) findings of coronary arteries. RESULTS A total of 269 patients (Mean age: 55.5 ± 12.1, 44% female) were included. Higher means of EFT and EFV were associated with coronary artery stenosis. However, the correlation coefficients of the arterial stenosis with EFT and EFV were weak. EFV and EFT had a significant association with age (P < 0.001, P < 0.001 respectively), body mass index (BMI) (P < 0.001, P < 0.001 respectively) and hypertension (P < 0.016, P < 0.003 respectively). Diabetes mellitus (DM) and hyperlipidemia were not significantly associated with EFV (P = 0.069 and 0.639 respectively) and EFT (P = 0.103 and 0.366 respectively). EFV and EFT showed a weak correlation coefficient with calcium scoring (Spearman correlation coefficients: 0.26 and 0.22 respectively, both P < 0.001). In multivariate logistic regression models considering coronary stenosis as dependent variable and EFV, EFT and other CAD risk factors as independent variables, EFV and EFT did not show significant P values and were omitted from the model by other CAD risk factors. CONCLUSION Increased EFV and EFT are associated with CAD, age, BMI and hypertension. However, no remarkable association was found between them and calcium score, hyperlipidemia or DM. These variables could weakly predict CAD in univariate models but they are not independent predictive factors for CAD in multivariate models consisting of other CAD risk factors. Hence, EFT and EFV are not independent predictors for CADs when they are considered simultaneously with other CAD risk factors.
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Affiliation(s)
- Maryam Mohammadzadeh
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Mohammadzadeh
- Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Madjid Shakiba
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Motevalli
- Department of Radiology, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Abedini
- Department of Radiology, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sakineh Kadivar
- Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Pouya Entezari
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Mohammadzadeh
- Department of Radiology, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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26
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Kim BJ, Kang JG, Lee SH, Lee JY, Sung KC, Kim BS, Kang JH. Relationship of Echocardiographic Epicardial Fat Thickness and Epicardial Fat Volume by Computed Tomography with Coronary Artery Calcification: Data from the CAESAR Study. Arch Med Res 2017; 48:352-359. [PMID: 28916241 DOI: 10.1016/j.arcmed.2017.06.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 06/23/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIMS No study has assessed the association between echocardiographic epicardial fat thickness (EFT) and computed tomography (CT)-based epicardial fat volume (EFV) and coronary artery calcification. The aim of this study is to evaluate the association between EFT and EFV and coronary artery calcification. METHODS Among the 2,299 individuals enrolled in the CArdiometabolic risk, Epicardial fat, and Subclinical Atherosclerosis Registry (CAESAR) study, 2,276 (1,851 men; mean age 45 ± 8.9 years) who underwent echocardiographic EFT and CT-based EFV measurements and obtained a coronary artery calcium score (CACS) were included in this study. RESULTS The overall prevalence of CAC >0 was 19.3%. EFT was significantly correlated with EFV (r = 0.374, p <0.001) but the k statistic showed only slight agreement (k = 0.146, p <0.001). Multivariate regression analyses adjusted for age, sex, body mass index, waist circumference, systolic blood pressure, daily alcohol intake, smoking status, and vigorous exercise and glucose, blood urea nitrogen, uric acid, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, high-sensitivity C reactive protein, and hemoglobinA1c levels revealed that an increase in the absolute values of EFT and EFV was significantly associated with the presence of coronary artery calcium (ORs [95% CIs], 2.023 [1.282-3.193] and 1.785 [1.173-2.716], respectively) and CACS (standardized β values = 0.082 and 0.061, p = 0.001 and 0.042, respectively). CONCLUSION These results show that EFT and EFV are associated with coronary artery calcification in Korean adults despite the relatively weak correlation between EFT and EFV.
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Affiliation(s)
- Byung Jin Kim
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Pyung-dong, Jongro-gu, Seoul, Republic of Korea.
| | - Jung Gyu Kang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Taepyung-ro 2ga, Jung-gu, Seoul, Republic of Korea
| | - Sung Ho Lee
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Pyung-dong, Jongro-gu, Seoul, Republic of Korea
| | - Jong Young Lee
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Pyung-dong, Jongro-gu, Seoul, Republic of Korea
| | - Ki Chul Sung
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Pyung-dong, Jongro-gu, Seoul, Republic of Korea
| | - Bum Soo Kim
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Pyung-dong, Jongro-gu, Seoul, Republic of Korea
| | - Jin Ho Kang
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Pyung-dong, Jongro-gu, Seoul, Republic of Korea
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Kim BJ, Cho KI, Choi JH, Park DH, Yu GI, Im SI, Kim HS, Heo JH, Cha TJ. Epicardial Fat Thickness and Neutrophil to Lymphocyte Ratio are Increased in Non-Dipper Hypertensive Patients. J Cardiovasc Ultrasound 2016; 24:294-302. [PMID: 28090257 PMCID: PMC5234339 DOI: 10.4250/jcu.2016.24.4.294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 11/22/2022] Open
Abstract
Background In this study, we aimed to investigate the relationship between echocardiographic epicardial fat thickness (EFT), neutrophil to lymphocyte ratio (NLR; an important inflammatory marker), and diurnal blood pressure (BP) changes in patients with recently diagnosed essential hypertension. Methods A total of 647 patients underwent echocardiography and 24 hours of ambulatory BP monitoring. EFT was measured by echocardiography, while NLR was measured by dividing the neutrophil count by the lymphocyte count. Patients were categorized into three groups according to BP pattern: the normotensive group, the dipper group, and the non-dipper group. Results The mean EFT was highest in the non-dipper group (non-dipper group, 7.3 ± 3.0 mm; dipper group, 6.1 ± 2.0 mm; control group, 5.6 ± 2.0 mm; p < 0.001). NLR was also highest in the non-dipper group (non-dipper, 2.75 ± 2.81; dipper, 2.01 ± 1.32; control, 1.92 ± 1.11; p < 0.001). EFT was significantly correlated with age (r = 0.160, p < 0.001) and NLR (r = 0.353, p < 0.001). Furthermore, an EFT ≥ 7.0 mm was associated with the non-dipper BP pattern with 51.3% sensitivity and 71.6% specificity [95% confidence interval (CI) = 0.56–0.65, p < 0.001]. In a multivariate analysis, EFT [adjusted odds ratio (OR) = 3.99, 95% CI = 1.22–13.10, p = 0.022] and NLR (OR = 1.34, 95% CI = 1.05–1.71, p = 0.018) were independent parameters that distinguished a non-dipper pattern after adjustment for cardiovascular risk factors. Conclusion EFT and NLR are independently associated with impaired diurnal BP profiles in hypertensive individuals. EFT (as measured by echocardiography) and NLR appear to be helpful in stratifying cardiometabolic risk.
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Affiliation(s)
- Bong Joon Kim
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Kyoung Im Cho
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Ji Hun Choi
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Dong Hyun Park
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Ga In Yu
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Sung Il Im
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Hyun Su Kim
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Jeong Ho Heo
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Tae-Joon Cha
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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Barakat AAEK, Nasr FM, Metwaly AA, Morsy S, Eldamarawy M. Atherosclerosis in chronic hepatitis C virus patients with and without liver cirrhosis. Egypt Heart J 2016; 69:139-147. [PMID: 29622968 PMCID: PMC5839344 DOI: 10.1016/j.ehj.2016.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 10/16/2016] [Indexed: 12/19/2022] Open
Abstract
Background Chronic Hepatitis C virus (HCV) infection and liver cirrhosis may be associated with atherosclerosis and coronary artery disease (CAD). There are two phases to atherosclerosis, Subclinical and Clinical. Assessment of atherosclerosis may be started at its Subclinical phase by the evaluation of Epicardial Fat Thickness (EpFT) and Carotid Intima Thickness (CIMT). Aim of the study The aim of the study was to evaluate Clinical and Subclinical atherosclerosis in chronic HCV patients with and without liver cirrhosis by evaluating CIMT and EpFT and correlating the results with Child-Pugh functional scoring of cirrhosis as well as with ultrasound and laboratory parameters that define the severity of liver disease. Patients and methods This study involved 64 chronic HCV patients that were divided into two groups: 24 patients without liver cirrhosis and 40 patients with liver cirrhosis in addition to 20 apparently healthy volunteers serving as control. All of the 84 subjects were subjected to the following: Clinical evaluation; Routine Laboratory Evaluation (CBC, Liver Function Tests, Renal Function Tests, Serum electrolytes, Cholesterol, Triglycerides, HBs antigen and HCV antibody); ECG; Abdominal ultrasound; Echocardiographic evaluation of segmental wall motion abnormalities and EpFT and B-Mode Carotid ultrasonography for evaluation of CIMT. Results In the cirrhotic HCV group, the CIMT and EpFT were both significantly increased [Compared to control group (p = 0.000), compared to the non-cirrhotic HCV group (p = 0.000)]. In the non-cirrhotic HCV group, the CIMT and EpFT were both significantly increased compared to the control group with a p-value of 0.003 for CIMT and 0.048 for EpFT. The CIMT and EpFT were also positively correlated with each other (r = 0.456, p = 0.001). There was a statistically significant increase in the EpFT and CIMT in Child class B patients compared to Child class A (p = 0.007 for CIMT and p = 0.028 for EpFT) and in Child class C patients compared to Child class B patients (p = 0.001 for CIMT and 0.005 for EpFT). CIMT and EpFT were correlated positively with AST (r = 0.385, p = 0.002 for CIMT, and r = 0.379, p = 0.003 for EpFT), Total Bilirubin (r = 0.378, p = 0.003 for CIMT, and r = 0.384, p = 0.002 for EpFT), INR% (r = 0.456, p = 0.001 for CIMT, and r = 0.384, p = 0.001 for EpFT), CRP (r = 0.378, p = 0.003 for CIMT, and r = 0.386, p = 0.002 for EpFT), spleen span (r = 0.417, p = 0.001 for CIMT, and r = 0.437, p = 0.001 for EpFT) and portal Vein Diameter (r = 0.372, p = 0.003 for CIMT, and r = 0.379, p = 0.003 for EpFT). CIMT and EpFT were correlated negatively with Albumin (r = -0.379, p = 0.003 for CIMT, and r = -0.370, p = 0.003 for EpFT), platelets count (r = -0.382, p = 0.002 for CIMT, and r = -0.378, p = 0.003 for EpFT) and Liver Span (r = -0.433, p = 0.001 for CIMT, and r = -0.424, p = 0.001 for EpFT). Conclusion EpFT and CIMT significantly increased in chronic hepatitis C virus patients especially in those with cirrhosis and closely correlated with each other. Their thickness also correlated with the Child-Pugh functional scoring of cirrhosis as well as with ultrasound and laboratory parameters that define the severity of liver disease.The echocardiographic assessment of EpFT and the carotid Doppler assessment of CIMT may provide appropriate and simple screening markers for subclinical atherosclerosis and cardiovascular risk in chronic HCV patients with and without cirrhosis.
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Key Words
- BMI, body mass index
- CAD, coronary artery disease
- CHD, coronary heart disease
- CIMT, carotid intima media thickness
- Carotid intima media thickness
- Chronic hepatitis C virus
- ESLD, end-stage liver disease
- EpFT, epicardial fat thickness
- Epicardial fat thickness
- FRS, Framingham risk score
- HBs, hepatitis B surface antigen
- HCV, chronic hepatitis C virus
- LT, liver transplantation
- Liver cirrhosis
- TTE, transthoracic echocardiography
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Affiliation(s)
| | - Fatma Mohammad Nasr
- Intensive Care Department (ICU), Theodor Bilharz Research Institute (TBRI), Giza, Egypt
- Corresponding author at: ICU, Theodor Bilharz Research Institute, 12-14 El-Nile Street, Warraq El-hadar, Giza 12411, Egypt and 15 Wadi Degla Street, Zahraa Al-Maadi, Cairo, Egypt.
| | - Amna Ahmed Metwaly
- Intensive Care Department (ICU), Theodor Bilharz Research Institute (TBRI), Giza, Egypt
| | - Sherif Morsy
- Gastroenterology and Hepatology Department, Theodor Bilharz Research Institute (TBRI), Giza, Egypt
| | - Mervat Eldamarawy
- Intensive Care Department (ICU), Theodor Bilharz Research Institute (TBRI), Giza, Egypt
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Ghaderi F, Eshraghi A, Shamloo AS, Mousavi S. Assosiation of Epicardial and Pericardial Fat Thickness with Coronary Artery Disease. Electron Physician 2016; 8:2982-2989. [PMID: 27790354 PMCID: PMC5074760 DOI: 10.19082/2982] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 06/01/2016] [Indexed: 02/05/2023] Open
Abstract
Introduction Visceral adipose tissue is a known important risk factor for coronary artery disease (CAD). While some studies have suggested relationship between epicardial fat thickness (EFT) and CAD, there are no adequate studies for pericardial fat thickness (PFT). The aim of this study was to determine the association of EFT and PFT with CAD. Methods This cross-sectional study was conducted on patients who were candidates for elective coronary artery angiography, referred to Emam Reza Hospital, Mashhad, Iran during Jan 2014–2016. Demographic and laboratory data were collected. Transthoracic echocardiography was performed to determine average EFT and PFT at the standard parasternal long-axis view at end-systole for 3 cardiac cycles. SCA was performed on the same day. The patients were divided into two groups: CAD (n=59) and non-CAD (n=41) based on presence or absence of epicardial coronary artery stenosis of > 50%. Chi-square, independent T-test, and receiver operating characteristic (ROC) curve were used by SPSS Version 16 for data analysis. Results One hundred patients (44 women and 56 men) with an average age of 56.4 ± 9.9 years were studied. The two groups were not significantly different in demographic profile and cronary risk factors. While PFT was not significantly different between the two groups, EFT was significantly higher in CAD group (3.0 ± 3.69 vs. 1.2 ± 3.6, p <0.0001). Moreover, with the increase of the affected coronary arteries, EFT increased (p <0.0001). Gensini score had a strong correlation with amount of EFT (r = 0.765, p <0.0001). EFT with a cutoff value of 4.25 mm (sensitivity=79%, specificity=68%) was specified in predicting CAD. Conclusion EFT measured by echocardiography can be used as an independent marker to predict CAD. More studies are needed to determine the predictive role of PFT for CAD.
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Affiliation(s)
- Fereshteh Ghaderi
- M.D., Assistant Professor, Department of Cardiology, Atherosclerosis Prevention Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Eshraghi
- M.D., Assistant Professor, Department of Cardiology, Atherosclerosis Prevention Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Sepehri Shamloo
- M.D., Research Administrator, Department of Cardiac Surgery, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sareh Mousavi
- M.D., Cardiologist, Department of Cardiology, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
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Pisano G, Fracanzani AL, Caccamo L, Donato MF, Fargion S. Cardiovascular risk after orthotopic liver transplantation, a review of the literature and preliminary results of a prospective study. World J Gastroenterol 2016; 22:8869-8882. [PMID: 27833378 PMCID: PMC5083792 DOI: 10.3748/wjg.v22.i40.8869] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/27/2016] [Accepted: 09/28/2016] [Indexed: 02/06/2023] Open
Abstract
Improved surgical techniques and greater efficacy of new anti-rejection drugs have significantly improved the survival of patients undergoing orthotopic liver transplantation (OLT). This has led to an increased incidence of metabolic disorders as well as cardiovascular and cerebrovascular diseases as causes of morbidity and mortality in OLT patients. In the last decade, several studies have examined which predisposing factors lead to increased cardiovascular risk (i.e., age, ethnicity, diabetes, NASH, atrial fibrillation, and some echocardiographic parameters) as well as which factors after OLT (i.e., weight gain, metabolic syndrome, immunosuppressive therapy, and renal failure) are linked to increased cardiovascular mortality. However, currently, there are no available data that evaluate the development of atherosclerotic damage after OLT. The awareness of high cardiovascular risk after OLT has not only lead to the definition of new but generally not accepted screening of high risk patients before transplantation, but also to the need for careful patient follow up and treatment to control metabolic and cardiovascular pathologies after transplant. Prospective studies are needed to better define the predisposing factors for recurrence and de novo occurrence of metabolic alterations responsible for cardiovascular damage after OLT. Moreover, such studies will help to identify the timing of disease progression and damage, which in turn may help to prevent morbidity and mortality for cardiovascular diseases. Our preliminary results show early occurrence of atherosclerotic damage, which is already present a few weeks following OLT, suggesting that specific, patient-tailored therapies should be started immediately post OLT.
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Altin C, Sade LE, Gezmis E, Yilmaz M, Ozen N, Muderrisoglu H. Assessment of epicardial adipose tissue and carotid/femoral intima media thickness in insulin resistance. J Cardiol 2016; 69:843-850. [PMID: 27613385 DOI: 10.1016/j.jjcc.2016.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 08/01/2016] [Accepted: 08/15/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Metabolic syndrome is a combination of multiple cardiovascular (CV) risk factors including insulin resistance (IR). Carotid, femoral intima media thickness (IMT), and epicardial fat thickness (EFT) are considered as novel cardiometabolic risk factors. We aimed to test the hypothesis that carotid, femoral IMT, and EFT are increased in patients with IR. METHODS We enrolled consecutively and prospectively 113 patients with IR. Then we collected data from an age- and sex-matched control group of 112 individuals without IR. Homeostasis model assessment (HOMA) index value >2.5 was accepted as IR. Patients with diabetes mellitus, CV diseases, systolic heart failure, chronic liver or renal diseases were excluded. On B-mode duplex ultrasound the mean IMT at the far wall of both left and right common carotid/femoral arteries were measured manually. EFT was measured on the free wall of the right ventricle at end-diastole from the parasternal long-axis views by standard transthoracic 2D echocardiography. RESULTS Both carotid IMT and EFT were significantly higher in patients with IR compared to controls (0.80±0.21mm vs 0.60±0.21mm; p<0.001 and 7.34±1.96mm vs 5.22±1.75mm; p<0.001, respectively). However, there were no significant differences in femoral IMT between the groups (0.74±0.20 vs 0.69±0.17; p=0.062). In multivariate linear regression analysis age (β=0.223, p=0.010), 2-h blood glucose (β=0.198, p=0.021), and IR (β=0.369, p<0.001) were independent predictors of EFT. On the other hand age (β=0.363, p<0.001) and IR (β=0.321, p<0.001) were independent predictors of carotid IMT. CONCLUSIONS Patients with IR have increased carotid IMT and EFT, but not femoral IMT. This apparent incoherence may be due to the involvement of carotid arteries prior to femoral arteries in patients with IR.
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Affiliation(s)
- Cihan Altin
- Department of Cardiology, Baskent University Faculty of Medicine, Izmir, Turkey.
| | - Leyla Elif Sade
- Department of Cardiology, Baskent University Faculty of Medicine, Ankara, Turkey
| | - Esin Gezmis
- Department of Radiology, Baskent University Faculty of Medicine, Izmir, Turkey
| | - Mustafa Yilmaz
- Department of Cardiology, Baskent University Faculty of Medicine, Adana, Turkey
| | - Necmi Ozen
- Department of Cardiology, Baskent University Faculty of Medicine, Izmir, Turkey
| | - Haldun Muderrisoglu
- Department of Cardiology, Baskent University Faculty of Medicine, Ankara, Turkey
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Balta S, Ozturk C, Aparci M, Demir M, Osman Yildirim A, Celik T. The relation between epicardial fat thickness and metabolic syndrome. J Geriatr Cardiol 2016; 13:369-70. [PMID: 27403148 DOI: 10.11909/j.issn.1671-5411.2016.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Colgecen E, Ede H, Erkoc MF, Akyuz Y, Erbay AR. The Relation of Androgenetic Alopecia Severity with Epicardial Fat Thickness. Ann Dermatol 2016; 28:205-9. [PMID: 27081268 PMCID: PMC4828384 DOI: 10.5021/ad.2016.28.2.205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 06/27/2015] [Accepted: 07/13/2015] [Indexed: 11/30/2022] Open
Abstract
Background Androgenetic alopecia (AGA) is the most commonly encountered baldness pattern in men. Epicardial fat tissue is found on the cardiac surface between the myocardium and visceral pericardium. Both AGA and epicardial fat thickness (EFT) are related to coronary artery disease, which is also reflected by an increase in carotid intima media thickness (CIMT). Objective The purpose of this study was to investigate the relation of AGA severity with EFT. Methods One hundred twenty-six male patients with AGA aged 18 to 55 years without histories of chronic disease were enrolled. Subjects were divided into three groups (mild, moderate, and severe) on the basis of the Hamilton baldness scale as modified by Norwood. Maximum EFT was measured at end-systole on the midventricular free wall of the right ventricle. CIMT was also recorded for all patients. Results The groups did not have statistically significant differences with respect to age, height, weight, body mass index, left ventricular ejection fraction, or left atrial diameter (p>0.05 for all comparisons), but the severe group had a higher EFT compared with the moderate (p<0.001; z score, -7.040) and mild groups (p<0.001; z score, -6.667). The moderate group also had higher EFT than the mild group (p<0.001; z score, -5.931). Mean CIMT value in the severe group was significantly higher compared with the value in the other groups. Conclusion The study showed that subjects in advanced stages of AGA had increased EFT, which was measured via echocardiography.
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Affiliation(s)
- Emine Colgecen
- Department of Dermatology, Medical Faculty, Bozok University, Yozgat, Turkey
| | - Huseyin Ede
- Department of Cardiology, Medical Faculty, Bozok University, Yozgat, Turkey
| | | | - Yurdanur Akyuz
- Department of Radiology, Medical Faculty, Bozok University, Yozgat, Turkey
| | - Ali Riza Erbay
- Department of Cardiology, Medical Faculty, Bozok University, Yozgat, Turkey
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Sinha SK, Thakur R, Jha MJ, Goel A, Kumar V, Kumar A, Mishra V, Varma CM, Krishna V, Singh AK, Sachan M. Epicardial Adipose Tissue Thickness and Its Association With the Presence and Severity of Coronary Artery Disease in Clinical Setting: A Cross-Sectional Observational Study. J Clin Med Res 2016; 8:410-9. [PMID: 27081428 PMCID: PMC4817582 DOI: 10.14740/jocmr2468w] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2016] [Indexed: 11/17/2022] Open
Abstract
Background Obesity is an important risk factor for atherosclerotic cardiovascular disease (ASCVD). Estimation of visceral adipose tissue is important and several methods are available as its surrogate. Although correlation of epicardial adipose tissue (EAT) with visceral adipose tissue as estimated by magnetic resonance imaging (MRI) and/or CT is excellent, it is costlier and cumbersome. EAT can be accurately measured by two-dimensional (2D) echocardiography. It tends to be higher in patients with acute coronary syndrome than in subjects without coronary artery disease (CAD) and in those with stable angina. It also carries advantage as index of high cardiometabolic risk as it is a direct measure of visceral fat rather than anthropometric measurements. The present study evaluated the relationship of EAT to the presence and severity of CAD in clinical setting. Methods In this prospective, single-center study conducted in the Department of Cardiology, LPS Institute of Cardiology, Kanpur, India, 549 consecutive patients with acute coronary syndrome or chronic stable angina were enrolled. Sensitivity, specificity, and receiver operating characteristic (ROC) curve were estimated to find cut-off value of EAT thickness for diagnosing CAD using coronary angiographic findings as gold standard. Results Patients were diagnosed as CAD group (n = 464, 60.30 ± 8.36 years) and non-CAD group (n = 85, 54.42 ± 11.93 years) after assessing coronary angiograms. The EAT was measured at end-systole from the PLAX views of three cardiac cycles on the free wall of the right ventricle. Lesion was significant if > 50% in left main and > 70% in other coronary arteries. The mean EAT thickness in CAD group was 5.10 ± 1.06 and in non-CAD group was 4.36 ± 1.01 which was significant (P = 0.003). Significant correlation was demonstrated between EAT thickness and presence of CAD (P < 0.003). Higher EAT was associated with severe CAD and presence of multivessel disease. By ROC analysis, EAT > 4.65 mm predicated the presence of significant coronary stenosis by 71.6% sensitivity and 73.1% specificity. Conclusion EAT thickness measured using transthoracic echocardiography (TTE) significantly correlates with the presence and severity of CAD. It is sensitive, easily available, and cost-effective and assists in the risk stratification and may be an additional marker on classical risk factors for CAD.
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Affiliation(s)
- Santosh Kumar Sinha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Ramesh Thakur
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Mukesh Jitendra Jha
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Amit Goel
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Varun Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Ashutosh Kumar
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Vikas Mishra
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Chandra Mohan Varma
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Vinay Krishna
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Avinash Kumar Singh
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
| | - Mohit Sachan
- Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh 208002, India
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Çetin S, Vural MG, Gündüz H, Akdemir R, Fırat H. Epicardial fat thickness regression with continuous positive airway pressure therapy in patients with obstructive sleep apnea: assessment by two-dimensional echocardiography. Wien Klin Wochenschr 2016; 128:187-92. [PMID: 26964554 DOI: 10.1007/s00508-016-0975-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 02/11/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a common syndrome in patients with metabolic syndrome (MetS). Epicardial fat thickness (EFT), an indicator of visceral adiposity, is a novel parameter for studying patients with OSA. Our aim was to investigate the effects of continuous positive airway pressure therapy (CPAP) therapy on EFT. METHODS A total of 162 subjects (68 women and 94 men) were included and divided into three groups: Group I: Apnea-hypopnea index (AHI) < 5 (n = 45), Group II: AHI 5-15 (n = 22), and Group III: AHI > 15 (n = 95). All participants underwent full-night polysomnography and transthoracic echocardiography. There were 28 symptomatic patients with AHI > 15 who received compliant CPAP therapy for 24 weeks. RESULTS MetS was more frequent, and systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose were higher in Group III compared with I (p < 0.05). High-density lipoprotein (HDL) levels were lower in Group III compared with I (p < 0.05). Triglyceride levels and waist circumference were higher in Group III compared with I and II (p < 0.05). EFT was higher in Group III compared with I and higher in Group II compared with I (p < 0.05). EFT was predicted by MetS and AHI. After CPAP therapy high-sensitive C-reactive protein (hsCRP) and EFT were reduced (p < 0.05). CONCLUSION EFT was significantly higher in patients with AHI > 15 and predicted by MetS and AHI. CPAP therapy reduced hsCRP levels and EFT.
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Affiliation(s)
- Süha Çetin
- Department of Cardiology, Kudret Private Hospital, GMK Bulvarı Nr. 81, Ankara, Turkey.
| | - Mustafa Gökhan Vural
- Department of Cardiology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Hüseyin Gündüz
- Department of Cardiology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Ramazan Akdemir
- Department of Cardiology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Hikmet Fırat
- Pulmonology Clinic, Ministery of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara, Turkey
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Kim BJ, Cheong ES, Kang JG, Kim BS, Kang JH. Relationship of epicardial fat thickness and nonalcoholic fatty liver disease to coronary artery calcification: From the CAESAR study. J Clin Lipidol 2016; 10:619-626.e1. [PMID: 27206950 DOI: 10.1016/j.jacl.2016.01.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/21/2016] [Accepted: 01/26/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Epicardial fat and nonalcoholic fatty liver disease (NAFLD) are associated with subclinical atherosclerosis; however, the combined effect of both EAT and NAFLD on coronary artery calcium (CAC) is unclear. OBJECTIVE The present study was performed to evaluate the association of both epicardial fat thickness (EFT) and NAFLD with CAC. METHODS Among 2277 individuals enrolled in the CArdiometabolic risk, Epicardial fat, and Subclinical Atherosclerosis Registry (CAESAR) Study, 1473 individuals (1242 men, mean age, 44 ± 9 years) were included for analysis. Echocardiographic EFT and ultrasonographic fatty liver were measured. Individuals were divided into 4 groups according to EFT and NAFLD (group I: low EFT and without NAFLD; group II: low EFT and with NAFLD; group III: high EFT and without NAFLD; and group IV: high EFT and with NAFLD). RESULTS The median EFT value (interquartiles) was 3.17 mm (2.58 mm, 3.85 mm), and the prevalence of NAFLD and CACS >0 was 46.0% and 16.8%, respectively. The prevalence of CACS >0 was 7.9%, 16.8%, 18.0%, and 26.0% in group I, II, III, and IV, respectively (P < .001). On multivariate regression after adjusting for variables with a univariate relationship (P < .20), group IV had a significantly higher OR for CACS >0, and the OR in group III was marginally significant, compared to group I (1.458 [0.795, 2.672], 1.744 [0.999, 3.046], and 1.864 [1.041, 3.337] for groups II, III, and IV, respectively). CONCLUSION This study shows that both increased EFT and presence of NAFLD are associated with coronary artery calcification, and that increased EFT is more strongly related to CAC than NAFLD, in spite of NAFLD having greater cardiometabolic risk than EFT.
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Affiliation(s)
- Byung Jin Kim
- Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Eun Sun Cheong
- Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Gyu Kang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Bum Soo Kim
- Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin Ho Kang
- Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Meenakshi K, Rajendran M, Srikumar S, Chidambaram S. Epicardial fat thickness: A surrogate marker of coronary artery disease - Assessment by echocardiography. Indian Heart J 2016; 68:336-41. [PMID: 27316487 DOI: 10.1016/j.ihj.2015.08.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 07/10/2015] [Accepted: 08/04/2015] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE Epicardial fat is considered as indicator of cardiovascular risk. Several studies have tested the association between epicardial fat thickness (EFT) and coronary artery disease. The aim of our study is to test the hypothesis that echocardiographic EFT is a marker of coronary artery disease. METHODS One hundred and ten patients (70 males and 40 females with mean age of 51.5±10.6 and 52.6±9.6, respectively) admitted for coronary angiogram underwent assessment of epicardial fat thickness by echocardiography. Routine clinical examination, evaluation of risk factor profile, and anthropometric variables were also done. Epicardial fat thickness was measured on the free wall of right ventricle in parasternal long- and short-axis views at end-systole for 3 cardiac cycles. RESULTS Mean epicardial fat thickness in angiographically normal patients and acute coronary syndromes were 4.4±1.2 and 6.9±1.9, respectively. Epicardial fat thickness in males and females were not statistically different. Burden of coronary arterial lesions denoted by Gensini score shows linear association with epicardial fat thickness and the severity of the coronary disease. CONCLUSION Epicardial fat is independently and linearly associated with CAD and its severity.
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Affiliation(s)
- K Meenakshi
- Department of Cardiology, Madras Medical College, Chennai, India.
| | - M Rajendran
- Department of Cardiology, Madras Medical College, Chennai, India
| | - S Srikumar
- Department of Cardiology, Madras Medical College, Chennai, India
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Keles N, Dogan B, Kalcik M, Caliskan M, Keles NN, Aksu F, Bulut M, Kostek O, Isbilen B, Yilmaz Y, Oguz A. Is serum Klotho protective against atherosclerosis in patients with type 1 diabetes mellitus? J Diabetes Complications 2016; 30:126-32. [PMID: 26601789 DOI: 10.1016/j.jdiacomp.2015.09.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 09/07/2015] [Accepted: 09/23/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Klotho deficiency is associated with several metabolic disorders. Two dimensional (2D) longitudinal strain (LS) of left ventricle (LV), carotid artery intima-media thickness (CIMT), flow-mediated dilation (FMD) of brachial artery and epicardial fat thickness (EFT) have been reported to be early predictors of atherosclerosis. We aimed to investigate the relationship between serum Klotho levels and these early predictors of atherosclerosis in patients with type 1 diabetes mellitus (DM). METHODS The study included 45 type 1 diabetic patients and 35 controls. Serum Klotho levels were determined by ELISA method. The patient group was also divided into two subgroups according to serum Klotho levels: high (HK) and low Klotho (LK) groups. EFT, CIMT and FMD were measured according to appropriate recommendations. Speckle tracking analysis was performed using the Echopac software. RESULTS The patient group had significantly lower serum Klotho (p=0.001), FMD (p<0.001) and LS of LV (p<0.001) values, but larger EFT (p<0.001) and CIMT (p<0.001) values than controls. LK subgroup had also significantly lower FMD (p<0.001) and LS of LV (p<0.001) but larger EFT (p=0.002) and CIMT (p<0.001) values than HK subgroup. CONCLUSION Serum Klotho may have a protective effect against atherosclerosis and endothelial dysfunction in type 1 DM.
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Affiliation(s)
- Nursen Keles
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Cardiology, İstanbul, Turkey.
| | - Burcu Dogan
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Family Physicians, Istanbul, Turkey
| | - Macit Kalcik
- Iskilip Atif Hoca State Hospital, Department of Cardiology, Corum, Turkey
| | - Mustafa Caliskan
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Cardiology, İstanbul, Turkey
| | | | - Feyza Aksu
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Cardiology, İstanbul, Turkey
| | - Mustafa Bulut
- İstanbul Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Istanbul, Turkey
| | - Osman Kostek
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Internal Medicine, Istanbul, Turkey
| | - Banu Isbilen
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Biochemistry, Istanbul, Turkey
| | - Yusuf Yilmaz
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Cardiology, İstanbul, Turkey
| | - Aytekin Oguz
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Internal Medicine, Istanbul, Turkey
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Akyildiz ZI, Polat S, Yurekli BS, Kocabas GU, Tuluce K, Tuluce SY, Kocabas U, Bozkaya G, Yuksel A, Nazli C. Epicardial fat, body mass index, and triglyceride are independent contributors of serum fibroblast growth factor 21 level in obese premenopausal women. J Endocrinol Invest 2015; 38:361-6. [PMID: 25312836 DOI: 10.1007/s40618-014-0185-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/29/2014] [Indexed: 12/24/2022]
Abstract
PURPOSE The hormone fibroblast growth factor 21 (FGF-21) regulates carbohydrate and lipid homeostasis. FGF-21 represents an attractive novel therapy for obesity since administration of FGF-21 has been shown to improve metabolic abnormalities in obese animal models. We investigated FGF-21 and its relationship with epicardial fat thickness (EFT), metabolic parameters, and inflammatory markers in premenopausal obese women compared to controls with similar Systematic Coronary Risk Evaluation (SCORE) project risk profiles. METHODS Forty-five obese premenopausal women with body mass index (BMI) ≥30 kg/m(2) and 41 control premenopausal women with BMI <25 kg/m(2) with similar SCORE project risk profiles were included in this case-control study. EFT was evaluated by two-dimensional transthoracic echocardiography. Serum FGF-21 was measured with an ELISA kit. RESULTS FGF-21 and EFT were significantly higher in obese women compared to controls (p < 0.001). Multiple stepwise linear regression analysis showed that EFT, BMI, and triglycerides (TG) independently contributed to FGF-21 (R(2) = 0.757, p < 0.001). However, homeostasis model assessment of insulin resistance (HOMA-IR), visceral ectopic fat, and inflammatory markers were not found as a direct contributor to serum FGF-21 level (p > 0.05). CONCLUSIONS EFT, BMI, and TG may play an important role in predicting serum FGF-21 level which may be a potential therapeutic target in cardiometabolic disorders in the future.
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Affiliation(s)
- Z I Akyildiz
- Department of Cardiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Basin Sitesi, 35360, Izmir, Turkey.
| | - S Polat
- Department of Internal Medicine, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - B S Yurekli
- Department of Endocrinology and Metabolism, Ege University Faculty of Medicine, Izmir, Turkey
| | - G U Kocabas
- Department of Endocrinology, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - K Tuluce
- Department of Cardiology, Izmir Karsiyaka State Hospital, Izmir, Turkey
| | - S Y Tuluce
- Department of Cardiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Basin Sitesi, 35360, Izmir, Turkey
| | - U Kocabas
- Department of Cardiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Basin Sitesi, 35360, Izmir, Turkey
| | - G Bozkaya
- Department of Biochemistry, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - A Yuksel
- Department of Internal Medicine, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - C Nazli
- Department of Cardiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Basin Sitesi, 35360, Izmir, Turkey
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Jain S, Mahadevaiah M, Shivanagappa M. A Comparative Study of Epicardial Fat Thickness and its Association with Abdominal Visceral Fat Thickness in Obese and Nonobese Type 2 Diabetes Subjects. J Cardiovasc Echogr 2015; 25:103-107. [PMID: 28465946 PMCID: PMC5353421 DOI: 10.4103/2211-4122.172487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Context: The concept of visceral fat and its role in various metabolic disorders is well-known. Epicardial fat (EF) is also visceral fat, and very few studies are done, especially in the Indian subcontinent. Aims: To study and establish the relationship of EF thickness (EFT) and abdominal visceral fat thickness (VAT) in obese and nonobese type 2 diabetics and to evaluate the usefulness of EFT as a marker of visceral adiposity. Settings and Designs: This cross-sectional study was carried out in the Department of Medicine, JSS Hospital, Mysore, India, between October 2012 and October 2014. Materials and Methods: A total of 68 patients were studied. Patients underwent transthoracic echocardiography and ultrasound abdomen. EFT and VAT were measured. Statistical Analysis: SPSS version 17.0 (SPSS Inc., Chicago, IL, USA) was used. T-test used for comparing quantitative variables. Correlation analysis was done using Pearson correlation test. P ≤ 0.05 was considered statistically significant. Kruskal-Wallis and Mann-Whitney test were used for analysis. Results: The mean value of EFT was 5.92 mm, 7.43 mm, 12.97 mm, 11.27 mm, and 13.8 mm for nonobese, obesity Grade I, II, III, and morbid, respectively (P < 0.0001). The mean EFT between nonobese and obese diabetics was 5.92 mm and 10.2 mm, respectively (P < 0.0001). The mean VAT between nonobese and obese diabetics was 16.58 mm and 38.53 mm, respectively. EFT was significantly correlating with VAT in obese diabetics. Conclusion: EFT and VAT were significantly correlated among obese diabetics while not significantly correlated among nonobese diabetics, suggesting obesity is an independent risk factor for visceral adipose tissue deposition both in abdomen as well as in epicardial surface.
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Affiliation(s)
- Siddharth Jain
- Department of Medicine, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
| | - Mahesh Mahadevaiah
- Department of Medicine, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
| | - Mamatha Shivanagappa
- Department of Obstetrics and Gynaecology, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India
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Sunbul M, Agirbasli M, Durmus E, Kivrak T, Akin H, Aydin Y, Ergelen R, Yilmaz Y. Arterial stiffness in patients with non-alcoholic fatty liver disease is related to fibrosis stage and epicardial adipose tissue thickness. Atherosclerosis 2014; 237:490-3. [PMID: 25463079 DOI: 10.1016/j.atherosclerosis.2014.10.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 09/18/2014] [Accepted: 10/04/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Non-alcoholic fatty liver disease (NAFLD) is associated with atherosclerosis and reduced vascular compliance. The purpose of this study was to examine the relationships between arterial stiffness measures, the histological severity of NAFLD, and epicardial fat thickness (EFT). METHODS A total of 100 patients with biopsy-proven NAFLD and 50 age- and sex-matched controls were enrolled. The histological severity was assessed in all NAFLD patients. Measurements of arterial stiffness [pulse-wave velocity (PWV) and augmentation index (AIx)] were carried out using a Mobil-O-Graph arteriograph system. EFT was assessed by means of echocardiography. RESULTS Compared with controls, NAFLD patients had significantly higher PWV and AIx values. Stepwise linear regression analysis demonstrated that the liver fibrosis score and EFT were independent predictors of both PWV and AIx values in NAFLD patients. CONCLUSIONS Patients with NAFLD have an increased arterial stiffness, which reflects both the severity of liver fibrosis and increased EFT values.
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Affiliation(s)
- Murat Sunbul
- Department of Cardiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Mehmet Agirbasli
- Department of Cardiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Erdal Durmus
- Cardiology Clinic, Silifke State Hospital, Mersin, Turkey
| | - Tarik Kivrak
- Cardiology Clinic, Sivas Numune Hospital, Sivas, Turkey
| | - Hakan Akin
- Department of Gastroenterology, School of Medicine, Marmara University, Fevzi Cakmak Mah, Mimar Sinan Cad. No. 41 Ust Kaynarca, Pendik, Istanbul, Turkey
| | - Yucel Aydin
- Department of Gastroenterology, School of Medicine, Marmara University, Fevzi Cakmak Mah, Mimar Sinan Cad. No. 41 Ust Kaynarca, Pendik, Istanbul, Turkey
| | - Rabia Ergelen
- Department of Radiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Yusuf Yilmaz
- Department of Gastroenterology, School of Medicine, Marmara University, Fevzi Cakmak Mah, Mimar Sinan Cad. No. 41 Ust Kaynarca, Pendik, Istanbul, Turkey; Institute of Gastroenterology, Marmara University, Basibuyuk, Maltepe, Istanbul 34840, Turkey.
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Kaya H, Ertaş F, Oylumlu M, Bilik MZ, Yıldız A, Yüksel M, Polat N, Acet H, Işık F, Ülgen MS. Relation of epicardial fat thickness and brachial flow-mediated vasodilation with coronary artery disease. J Cardiol 2013; 62:343-7. [PMID: 23810068 DOI: 10.1016/j.jjcc.2013.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 05/09/2013] [Accepted: 05/11/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study is to investigate the presence of a statistical association between epicardial fat thickness (EFT) and coronary artery disease (CAD) and between flow-mediated vasodilation (FMD) and CAD. METHODS We measured the EFT and FMD in 64 subjects with suspected stable angina pectoris. The patients were separated into two groups according to their coronary angiography results: 34 patients with CAD and 30 patients with normal coronary arteries (NCA). RESULTS EFT was significantly higher in the patients with CAD than the NCA group (6.43 ± 0.90 mm vs. 5.35 ± 0.75 mm, p<0.001) while FMD was significantly lower in the patients with CAD than those in the NCA group (6.41 ± 2.51% vs. 8.33 ± 3.45%, p=0.015). No significant correlation was found between EFT and FMD. After adjustment for EFT, FMD, age, sex, ejection fraction, glucose, and low-density lipoprotein cholesterol through multivariate logistic regression analysis, EFT (odds ratio: 6.325, 95% confidence interval 2.289-17.476, p<0.001) and age (odds ratio: 1.093, 95% confidence interval 1.008-1.185, p=0.032) remained significant predictors of CAD. A cut-off value of EFT≥5.8mm predicted the presence of CAD with 77% sensitivity and 70% specificity. CONCLUSION An echocardiographic EFT assessment is independently associated with the presence of CAD. Thus, EFT may be helpful in cardiometabolic risk stratification and therapeutic interventions.
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Affiliation(s)
- Hasan Kaya
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey.
| | - Faruk Ertaş
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Mustafa Oylumlu
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Mehmet Zihni Bilik
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Abdulkadir Yıldız
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Murat Yüksel
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Nihat Polat
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Halit Acet
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Ferhat Işık
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Mehmet Sıddık Ülgen
- Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
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