Measurement of epicardial fat thickness by transthoracic echocardiography for predicting high-risk coronary artery plaques

Tachibana, Motomi; Miyoshi, Toru; Osawa, Kazuhiro; Toh, Norihisa; Oe, Hiroki; Nakamura, Kazufumi; Naito, Tomoharu; Sato, Shuhei; Kanazawa, Susumu; Ito, Hiroshi

doi:10.1007/s00380-016-0802-5

Cited by 27 publications

(12 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…One study was excluded because it presented the association of EAT with plaque lipid percentage rather than specified numbers of patients with HRP . Seven studies reported CT assessment of HRP (n=3573) and 2 studies reported invasive assessment of HRP (n=199). Seven studies measured EAT‐v (n=3284), and 2 studies measured EAT‐t (n=488).…”

Section: Resultsmentioning

confidence: 99%

Association of Epicardial Adipose Tissue and High‐Risk Plaque Characteristics: A Systematic Review and Meta‐Analysis

Nerlekar

Brown

Muthalaly

et al. 2017

JAHA

123

View full text Add to dashboard Cite

BackgroundEpicardial adipose tissue (EAT) is hypothesized to alter atherosclerotic plaque composition, with potential development of high‐risk plaque (HRP). EAT can be measured by volumetric assessment (EAT‐v) or linear thickness (EAT‐t). We performed a systematic review and random‐effects meta‐analysis to assess the association of EAT with HRP and whether this association is dependent on the measurement method used.Methods and ResultsElectronic databases were systematically searched up to October 2016. Studies reporting HRP by computed tomography or intracoronary imaging and studies measuring EAT‐v or EAT‐t were included. Odds ratios were extracted from multivariable models reporting the association of EAT with HRP and described as pooled estimates with 95% confidence intervals (CIs). Analysis was stratified by EAT measurement method. Nine studies (n=3772 patients) were included with 7 measuring EAT‐v and 2 measuring EAT‐t. Increasing EAT was significantly associated with the presence of HRP (odds ratio: 1.26 [95% CI, 1.11–1.43]; P<0.001). Patients with HRP had higher EAT‐v than those without (weighted mean difference: 28.3 mL [95% CI, 18.8–37.8 mL]; P<0.001). EAT‐v was associated with HRP (odds ratio: 1.19 [95% CI, 1.06–1.33]; P<0.001); however, EAT‐t was not (odds ratio: 3.09 [95% CI, 0.56–17]; P=0.2). Estimates remained significant when adjusted for small‐study effect bias (odds ratio: 1.13 [95% CI, 1.03–1.28]; P=0.04).ConclusionsIncreasing EAT is associated with the presence of HRP, and patients with HRP have higher quantified EAT‐v. The association of EAT‐v with HRP is significant compared with EAT‐t; however, a larger scale study is still required, and further evaluation is needed to assess whether EAT may be a potential therapeutic target for novel pharmaceutical agents.Clinical Trial Registration URL: https://www.crd.york.ac.uk/. Unique identifier: CRD42017055473.

show abstract

Section: Resultsmentioning

confidence: 99%

Association of Epicardial Adipose Tissue and High‐Risk Plaque Characteristics: A Systematic Review and Meta‐Analysis

Nerlekar

Brown

Muthalaly

et al. 2017

JAHA

123

View full text Add to dashboard Cite

show abstract

“…However, it is also expensive and has higher time consumption during the procedure, giving it a significant disadvantage [ 132 , 133 ]. In this sense, Tachibana et al [ 134 ] have evaluated the predictive ability of transthoracic echocardiography to predict high-risk plaques, confirmed by coronary computed tomography angiography from epicardial fat thickness, with this being considered a good noninvasive predictor. Therefore, the use of echocardiography is the most cost-effective method today especially in regions where the availability of high cost imaging studies is low.…”

Section: Epicardial Fat: How To Quantify It?mentioning

confidence: 99%

Epicardial Fat: Physiological, Pathological, and Therapeutic Implications

Salazar

Luzardo

Mejías

et al. 2016

Cardiology Research and Practice

View full text Add to dashboard Cite

Epicardial fat is closely related to blood supply vessels, both anatomically and functionally, which is why any change in this adipose tissue's behavior is considered a potential risk factor for cardiovascular disease development. When proinflammatory adipokines are released from the epicardial fat, this can lead to a decrease in insulin sensitivity, low adiponectin production, and an increased proliferation of vascular smooth muscle cells. These adipokines move from one compartment to another by either transcellular passing or diffusion, thus having the ability to regulate cardiac muscle activity, a phenomenon called vasocrine regulation. The participation of these adipokines generates a state of persistent vasoconstriction, increased stiffness, and weakening of the coronary wall, consequently contributing to the formation of atherosclerotic plaques. Therefore, epicardial adipose tissue thickening should be considered a risk factor in the development of cardiovascular disease, a potential therapeutic target for cardiovascular pathology and a molecular point of contact for “endocrine-cardiology.”

show abstract

“…One study was excluded because it presented the association of EAT with plaque lipid percentage rather than specified numbers of patients with HRP. 20 Seven studies reported CT assessment of HRP [21][22][23][24][25][26][27] (n=3573) and 2 studies reported invasive assessment of HRP 29,30 (n=199). Seven studies measured EAT-v 21-26,29,30 (n=3284), and 2 studies measured EAT-t 27,28 (n=488).…”

Section: Resultsmentioning

confidence: 99%

The Association of Epicardial Adipose Tissue and High Risk Plaque Characteristics: A Systematic Review and Meta-Analysis

Nerlekar

Brown

Muthalaly

et al. 2017

Heart, Lung and Circulation

View full text Add to dashboard Cite

Background--Epicardial adipose tissue (EAT) is hypothesized to alter atherosclerotic plaque composition, with potential development of high-risk plaque (HRP). EAT can be measured by volumetric assessment (EAT-v) or linear thickness (EAT-t). We performed a systematic review and random-effects meta-analysis to assess the association of EAT with HRP and whether this association is dependent on the measurement method used.Methods and Results--Electronic databases were systematically searched up to October 2016. Studies reporting HRP by computed tomography or intracoronary imaging and studies measuring EAT-v or EAT-t were included. Odds ratios were extracted from multivariable models reporting the association of EAT with HRP and described as pooled estimates with 95% confidence intervals (CIs). Analysis was stratified by EAT measurement method. Nine studies (n=3772 patients) were included with 7 measuring EAT-v and 2 measuring EAT-t. Increasing EAT was significantly associated with the presence of HRP (odds ratio: 1.26 [95% CI, 1.11-1.43]; P<0.001). Patients with HRP had higher EAT-v than those without (weighted mean difference: 28.3 mL [95% CI, 18.8-37.8 mL]; P<0.001). EAT-v was associated with HRP (odds ratio: 1.19 [95% CI, 1.06-1.33]; P<0.001); however, EAT-t was not (odds ratio: 3.09 [95% CI, 0.56-17]; P=0.2). Estimates remained significant when adjusted for small-study effect bias (odds ratio: 1.13 [95% CI, 1.03-1.28]; P=0.04).Conclusions--Increasing EAT is associated with the presence of HRP, and patients with HRP have higher quantified EAT-v. The association of EAT-v with HRP is significant compared with EAT-t; however, a larger scale study is still required, and further evaluation is needed to assess whether EAT may be a potential therapeutic target for novel pharmaceutical agents.

show abstract

Measurement of epicardial fat thickness by transthoracic echocardiography for predicting high-risk coronary artery plaques

Cited by 27 publications

References 41 publications

Association of Epicardial Adipose Tissue and High‐Risk Plaque Characteristics: A Systematic Review and Meta‐Analysis

Association of Epicardial Adipose Tissue and High‐Risk Plaque Characteristics: A Systematic Review and Meta‐Analysis

Epicardial Fat: Physiological, Pathological, and Therapeutic Implications

The Association of Epicardial Adipose Tissue and High Risk Plaque Characteristics: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About