Correlation between epicardial fat thickness and aortic valve sclerosis

Abstract

Background Epicardial fat is a true visceral fat deposit with adverse effects through the secretion of numerous proinflammatory and proatherogenic cytokines. Previous studies showed an association between aortic valve sclerosis and coronary artery disease. The aim of this study was to determine the correlation between epicardial fat thickness and aortic valve sclerosis. Method The study involved 225 patients who were admitted for coronary angiography due to new-onset angina. They underwent transthoracic echocardiography and epicardial fat thickness was determined. The sclerosis scoring of each aortic cusp, average aortic valve sclerosis score index, and left ventricular ejection fraction were determined. The variables of left ventricular diastolic function obtained included the early diastolic velocity determined by transmitral pulsed Doppler, and early mitral annular velocity measured by tissue Doppler. Results Patients with an epicardial fat thickness ≥7 mm were older ( p = 0.006), with more hypertension ( p = 0.045) and hyperlipidemia ( p < 0.001). Their average aortic valve sclerosis score index was higher (1.4 ± 1.02 vs. 0.86 ± 0.85, p = 0.001), and left ventricular ejection fraction and early mitral annular velocity were lower ( p < 0.001 and 0.03, respectively). They also exhibited more left ventricular hypertrophy ( p = 0.026) and a trend towards more significant coronary artery disease and 3-vessel disease ( p = 0.086 and 0.073, respectively). Conclusion Our findings confirm that epicardial fat as a marker of visceral adipose tissue may have an important role in promoting inflammatory and atherosclerotic changes in the aortic valve.

Epicardial fat volume is associated with preexisting atrioventricular conduction abnormalities and increased pacemaker implantation rate in patients undergoing transcatheter aortic valve implantation

“…Parisi et al found an increased EFT thickness in patients referred for surgical aortic valve replacement due to high-grade AS compared with matched controls without AS [29]. Furthermore, greater EFT thickness significantly correlated with elevated serum levels of the pro-inflammatory cytokines IL-6, TNF-α, IL-1β, and MCP-1 [30]. In our study, there was no positive correlation between EFT and the Agatston score of the aortic valve.…”

“…In our study, there was no positive correlation between EFT and the Agatston score of the aortic valve. This would appear to contradict the findings of other studies: in 225 patients undergoing coronary angiography due to new-onset angina, Nabati et al found higher amounts of aortic valve sclerosis expressed via an aortic valve sclerosis score index in patients with an echocardiographic EFT thickness ≥ 7 mm [30]. In addition, Mahabadi et al observed a greater EFT thickness measured via echocardiography in patients with severe AS compared with patients without AS [31].…”

Cardiometabolic-Based Chronic Disease, Adiposity and Dysglycemia Drivers

“…Interestingly, epicardial and visceral adipose tissue were positively associated with atherosclerotic burden, whereas subcutaneous adipose tissue had a negative association (85). Epicardial adipose tissue was also associated with vascular inflammation and arterial stiffness (86), aortic valve sclerosis score (87), LV hypertrophy and cardiomyocyte fibrosis/ apoptosis, (88), and obstructive sleep apnea (89). Epicardial adipose tissue secretes more phospholipase A2 II with ischemia, resulting in more phospholipid hydrolysis and generation of local FFA (90).…”

Inflammation and Cardiovascular Diseases in the Elderly: The Role of Epicardial Adipose Tissue

“…Transthoracic echocardiography was performed to assess both EAT thickness and the average aortic valve sclerosis score index. The authors reported that patients with an EAT thickness ≥7 mm were older, with more frequent hypertension and hyperlipidemia, and showed greater LV hypertrophy and a higher average aortic valve sclerosis score index, thus suggesting an association between EAT and aortic leaflets calcification already in the early stages of the disease ( 99 ).…”