Epicardial adipose tissue has an increased thickness and is a source of inflammatory mediators in patients with calcific aortic stenosis

Parisi, Valentina; Rengo, Giuseppe; Pagano, Gennaro; D’Esposito, Vittoria; Passaretti, Federica; Caruso, Aurelio; Grimaldi, M.; Lonobile, Tommaso; Baldascino, Francesco; Bellis, Antonio De; Formisano, Pietro; Ferrara, Nicola; Leosco, Dario

doi:10.1016/j.ijcard.2015.03.201

Cited by 52 publications

(50 citation statements)

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“…Under normal physiologic circumstances, pericardial (epicardial) fat is critical to normal myocardial homeostasis, serving as a local source of free-fatty acids as metabolic fuel and in a buffering capacity for excess substrates to prevent lipotoxicity 25 . However, expansion of the pericardial fat depot that accompanies obesity may be associated with similar biochemical consequences as visceral adipose tissue expansion or hepatic steatosis 26 , including elaboration of tumor necrosis factor-α, interleukin-6 and -11, and lower adiponectin, potentially independent of BMI 27–29 . In turn, this pro-inflammatory milieu has been linked to abnormalities in ventricular structure 30, 31 and incident HF 32 .…”

Section: Discussionmentioning

confidence: 99%

Pericardial, But Not Hepatic, Fat by CT Is Associated With CV Outcomes and Structure

Shah

Anderson

Ding

et al. 2017

JACC: Cardiovascular Imaging

115

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Objectives To determine the associations between local (pericardial) fat and incident CV disease (CVD) events and cardiac remodeling independent of markers of overall adiposity. Background The impact of pericardial fat—a local fat depot encasing the heart—on myocardial function and long-term cardiovascular (CV) prognosis independent of systemic consequences of adiposity or hepatic fat is an area of active debate. Methods We studied 4,234 participants enrolled in the Multi-Ethnic Study of Atherosclerosis with concomitant cardiac magnetic resonance (CMR) imaging and computed tomographic (CT) measurements for pericardial fat volume and hepatic attenuation (a measure of liver fat). Poisson and Cox regression were used to estimate the annualized risk of incident hard atherosclerotic CVD (ASCVD), all-cause death, heart failure, all-cause CVD, hard CHD and stroke as a function of pericardial and hepatic fat. Generalized additive models were used to assess the association between CMR indices of left ventricular (LV) structure and function and pericardial fat. Models were adjusted for relevant clinical, demographic, and cardiometabolic covariates. Results MESA participants with higher pericardial and hepatic fat were more likely to be older, more frequently male, and had a higher prevalence of cardiometabolic risk factors (including dysglycemia, dyslipdemia, hypertension), as well as adiposity-associated inflammation. Over a median 12.2-year follow-up (IQR 11.6–12.8 years), pericardial fat was associated with a higher rate of incident hard ASCVD (standardized hazard ratio [SHR] 1.22, 95% confidence interval [CI] 1.10–1.35, P=0.0001; hepatic fat by CT was not significantly associated with hard ASCVD (SHR 0.96, 95% CI 0.86–1.08, P=0.52). Higher pericardial fat was associated with greater indexed LV mass (37.8 vs. 33.9 g/m2.7, highest vs. lowest quartile, P<0.01), LV mass-to-volume ratio (1.2 vs. 1.1, highest vs. lowest quartile, P<0.01). In adjusted models, a higher pericardial fat volume was associated with greater LV mass (P<0.0001) and concentricity (P<0.0001). Conclusion Pericardial fat is associated with poorer CVD prognosis and LV remodeling, independent of insulin resistance, inflammation and CT measures of hepatic fat.

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Section: Discussionmentioning

confidence: 99%

Pericardial, But Not Hepatic, Fat by CT Is Associated With CV Outcomes and Structure

Shah

Anderson

Ding

et al. 2017

JACC: Cardiovascular Imaging

115

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“…First, the sample size was relatively small, and there might be a bias as a result of patient selection. The absence of difference in EAT findings between CABG and non-CABG groups might be partially due to the fact that non-CAD, such as aortic valve disease [34], are possibly associated with EAT pathogenicity. However, specific non-CAD (aortic stenosis, etc.)…”

Section: Study Limitationsmentioning

confidence: 95%

The relationship between inflammation and neoangiogenesis of epicardial adipose tissue and coronary atherosclerosis based on computed tomography analysis

et al. 2015

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“…In fact, abnormalities of EAT secretory properties are implicated in the development of pathological conditions, including coronary atherosclerosis, left ventricular (LV) hypertrophy, LV diastolic dysfunction, and aortic stenosis. [20][21][22][23][24][25][26] Moreover, EAT contains abundant adrenergic and cholinergic nerves that interact with the extrinsic nervous system.…”

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confidence: 99%

Increased Epicardial Adipose Tissue Volume Correlates With Cardiac Sympathetic Denervation in Patients With Heart Failure

Parisi

Rengo

Perrone‐Filardi

et al. 2016

Circulation Research

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Rationale: It has been reported that epicardial adipose tissue (EAT) may affect myocardial autonomic function.Objective: The aim of this study was to explore the relationship between EAT and cardiac sympathetic nerve activity in patients with heart failure. Methods and Results:In 110 patients with systolic heart failure, we evaluated the correlation between echocardiographic EAT thickness and cardiac adrenergic nerve activity assessed by Conclusions:This study provides the first evidence of a direct correlation between increased EAT thickness and cardiac sympathetic denervation in heart failure. (Circ Res.

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Epicardial adipose tissue has an increased thickness and is a source of inflammatory mediators in patients with calcific aortic stenosis

Cited by 52 publications

References 10 publications

Pericardial, But Not Hepatic, Fat by CT Is Associated With CV Outcomes and Structure

Pericardial, But Not Hepatic, Fat by CT Is Associated With CV Outcomes and Structure

The relationship between inflammation and neoangiogenesis of epicardial adipose tissue and coronary atherosclerosis based on computed tomography analysis

Increased Epicardial Adipose Tissue Volume Correlates With Cardiac Sympathetic Denervation in Patients With Heart Failure

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