Epicardial Adipose Tissue Thickness Correlates with the Presence and Severity of Angiographic Coronary Artery Disease in Stable Patients with Chest Pain

Picard, Fabien; Guéret, Pascal; Laissy, Jean-Pierre; Champagne, Stéphane; Leclercq, Florence; Carrié, Didier; Juliard, Jean‐Michel; Henry, Patrick; Niarra, Ralph; Châtellier, Gilles; Steg, Philippe Gabriel

doi:10.1371/journal.pone.0110005

Cited by 53 publications

(40 citation statements)

References 26 publications

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“…Nevertheless, there is an emerging literature implicating pericardial fat in the pathogenesis of a variety of CV diseases 37–40 . Here, we demonstrate pericardial fat is associated with incident CVD over long-term follow-up as well as cardiac structure, independent of selected measured influences of dysfunctional adiposity, defined by cardiometabolic risk factors, insulin resistance, inflammation, and imaging surrogates of hepatic fat content.…”

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

126

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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

126

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“…Current understandings of the pathophysiology of EAT and atherosclerosis were strengthened by cross-sectional studies that revealed independent associations between increased EAT and the presence of CAD 9, 23, 24) . Moreover, several serial studies demonstrated that increased baseline EAT volume was associated with the progression or new development of coronary artery calcification (CAC).…”

Section: Discussionmentioning

confidence: 99%

Epicardial Adipose Tissue Contributes to the Development of Non-Calcified Coronary Plaque: A 5-Year Computed Tomography Follow-up Study

Hwang

Park

Choi

2017

J Atheroscler Thromb

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Aim: Epicardial adipose tissue (EAT) has been suggested as a contributing factor for coronary atherosclerosis based on the previous cross-sectional studies and pathophysiologic background. However, a causal relationship between EAT and the development of non-calcified coronary plaque (NCP) has not been investigated.Methods: A total of 122 asymptomatic individuals (age, 56.0 ± 7.6 years; male, 80.3%) without prior history of coronary artery disease (CAD) or metabolic syndrome and without NCP or obstructive CAD at baseline cardiac computed tomography (CT) were enrolled. Repeat cardiac CT was performed with an interval of more than 5 years. Epicardial fat volume index (EFVi; cm3/m2) was assessed in relation to the development of NCP on the follow-up CT where the results were classified into “calcified plaque (CP),” “no plaque,” and “NCP” groups.Results: On the follow-up CT performed with a median interval of 65.4 months, we observed newly developed NCP in 24 (19.7%) participants. Baseline EFVi was significantly higher in the NCP group (79.9 ± 30.3 cm3/m2) than in the CP group (63.7 ± 22.7 cm3/m2; P = 0.019) and in the no plaque group (62.5 ± 24.7 cm3/m2; P = 0.021). Multivariable logistic regression analysis demonstrated that the presence of diabetes (OR, 9.081; 95% CI, 1.682–49.034; P = 0.010) and the 3rd tertile of EFVi (OR, 4.297; 95% CI, 1.040–17.757; P = 0.044 compared to the 1st tertile) were the significant predictors for the development of NCP on follow-up CT.Conclusions: Greater amount of EAT at baseline CT independently predicts the development of NCP in asymptomatic individuals.

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“…Increased EAT is independently related to the presence and angiographic severity of CAD [8], a well as MACE [10]. Inflammatory infiltrations have been found in EAT in the areas near coronary lesions.…”

Section: Discussionmentioning

confidence: 91%

“…Increased EAT is related to the presence and angiographic severity of CAD [8] and coronary plaque vulnerability [9], and independently predicts major adverse cardiovascular events (MACE) [10].…”

Section: Introductionmentioning

confidence: 99%

Thickening of the epicardial adipose tissue can be alleviated by thyroid hormone replacement therapy in patients with subclinical hypothyroidism

et al. 2016

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A b s t r a c tBackground: Subclinical hypothyroidism (SCH) is a common disorder which has adverse cardiovascular effects. Epicardial adipose tissue (EAT), a novel marker of cardiovascular risk, is increased in SCH. Aim:We aimed to investigate whether L-thyroxine treatment can reverse the thickening of EAT in SCH. Methods:Forty-four patients with SCH and 42 euthyroid control subjects were included. EAT thickness was measured using transthoracic echocardiography at baseline and after restoration of the euthyroid status with 3 months of L-thyroxine treatment.Results: At baseline, mean EAT thickness was significantly greater in the SCH group when compared to the control group (6.3 ± 1.7 mm vs. 4.1 ± 0.9 mm, respectively, p < 0.001). There was a significant positive correlation between baseline serum thyroid stimulating hormone (TSH) level and EAT thickness in the SCH group. There was a significant reduction in mean EAT thickness in response to L-thyroxine treatment (6.3 ± 1.7 mm vs. 5.1 ± 1.4 mm, p < 0.001). The decrease in EAT thickness after L-thyroxine treatment when compared to baseline (DEAT) significantly correlated to the difference in TSH levels before and after treatment (DTSH; r = 0.323; p = 0.032). Conclusions:Epicardial adipose tissue thickness is increased in patients with SCH. This thickening was alleviated with restoration of the euthyroid status with L-thyroxine treatment in our study population of predominantly male, relatively old subjects with greater baseline EAT thickness.

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Epicardial Adipose Tissue Thickness Correlates with the Presence and Severity of Angiographic Coronary Artery Disease in Stable Patients with Chest Pain

Cited by 53 publications

References 26 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

Epicardial Adipose Tissue Contributes to the Development of Non-Calcified Coronary Plaque: A 5-Year Computed Tomography Follow-up Study

Thickening of the epicardial adipose tissue can be alleviated by thyroid hormone replacement therapy in patients with subclinical hypothyroidism

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