Epicardial fat, cardiovascular risk factors and calcifications in patients with chronic kidney disease

Abstract

Background Epicardial adipose tissue (EAT) exerts cardiopathogenic effects, but the independent association between EAT and cardiovascular (CV) calcification in patients with chronic kidney disease (CKD) remains controversial. We therefore assessed the association between EAT, CV risk factors and CV calcifications. Methods 257 patients with CKD Stage 3 and/or overt proteinuria underwent quantification of EAT, coronary artery calcification and aortic valve calcification by computed tomography. Framingham and American College of Cardiology and American Heart Association (ACC-AHA) 10-year CV event risk scores were calculated for each patient. Results Using multivariable regression analysis, higher EAT was significantly associated with the majority of investigated risk factors {higher age: odds ratio [OR] 1.05/year [95% confidence interval (CI) 1.02–1.08]; male sex: OR 4.03 [95% CI 2.22–7.31]; higher BMI: OR 1.28/kg/m2 [95% CI 1.20–1.37]; former smoking: OR 1.84 [95% CI 1.07–3.17]; lower high-density lipoprotein cholesterol: OR 0.98/mg/dL [95% CI 0.96–1.00] and lower estimated glomerular filtration rate: OR 0.98/mL/min/1.73 m2 [95% CI 0.97–0.99]; all P < 0.05} and was not associated with diabetes mellitus, hypertensive nephropathy, total cholesterol and albuminuria. EAT was positively associated with higher ACC-AHA and Framingham risk scores. EAT correlated with coronary artery calcification and aortic valve calcification [Spearman ρ = 0.388 (95% CI 0.287–0.532) and rrb = 0.409 (95% CI 0.310–0.556), respectively], but these correlations were dependent on CV risk factors. Conclusions The increase of EAT can be explained by individual CV risk factors and kidney function and correlates with 10-year risk for CV event scores, suggesting that EAT is a modifiable risk factor in patients with CKD. Although EAT correlates with CV calcifications, these relations depend on CV risk factors.

Carbamylated sortilin associates with cardiovascular calcification in patients with chronic kidney disease

“…Computed tomographic imaging was performed on a Dual Source CT scanner (SOMATOM Definition Flash or Force; Siemens), as previously described. 14 With a median follow-up time of 4.4 years, 41 of 78 patients agreed or were available for a second computed tomographic scan during the second CARVIDA visit in 2019 and 2020.…”

The Relationship of Epicardial Adipose Tissue and Cardiovascular Disease in Chronic Kidney Disease and Hemodialysis Patients

“…A meta-analysis of nine studies involving over 3500 patients revealed a link between increased EAT volume and CAD [ 11 ], as well as a link between increased EAT volume and high-risk coronary plaque formation [ 25 ]. EAT was discovered to be an independent risk factor for CVD in a meta-analysis of over 40,000 patients, and EAT volume was also linked to coronary artery calcification and myocardial ischemia [ 27 ]. According to recent research, EAT is an independent predictor of coronary events and left ventricular dysfunction, but visceral adipocyte tissue accumulation is not an independent risk factor for cardiovascular events [ 28 , 29 , 30 , 31 ].…”

“…Dyslipidemia is another well-known traditional risk factor for cardiovascular disease. EAT was found to be inversely correlated with HDL cholesterol and positively correlated with LDL cholesterol and TG in studies examining the relationship between cholesterol levels and CVH and EAT [ 27 , 30 , 44 , 52 , 53 ].…”

“…It is well known that dialysis patients consume more EAT than the general population. Saritas et al [ 27 ] discovered that eGFR was independently and inversely related to EAT volume, and they hypothesized that EAT could be a marker of the uremia-specific component of CV risk based on this finding.…”

Aortic Valve Calcium Associates with All-Cause Mortality Independent of Coronary Artery Calcium and Inflammation in Patients with End-Stage Renal Disease

“…Patients with chronic kidney disease (CKD) are at high risk of cardiovascular morbidity and mortality [1,2]. Aortic valve calcium (AVC) has been reported to occur 10-20 years earlier in CKD patients with a higher prevalence (28-55%) than that reported in the general population [3][4][5][6][7][8]. The association of cardiac valve (mitral and aortic) calcification and clinical outcomes has been studied in patients with end-stage renal disease (ESRD).…”