Epicardial Fat in the Maintenance of Cardiovascular Health

Wu, Yang; Zhang, Aijun; Hamilton, Dale J.; Deng, Tuo

doi:10.14797/mdcj-13-1-20

Cited by 99 publications

(98 citation statements)

References 43 publications

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Section: Discussionmentioning

confidence: 99%

“…Higher BMI is associated with increased levels of circulating free fatty acids and greater accumulations of harmful visceral, hepatic, skeletal, intracardial and epicardial fat. [21][22][23] In particular, epicardial adipose tissue surrounding the heart generates pathogenic mechanical, endocrinological, immunological, paracrine and vasocrine signalling, all of which may contribute to heart failure-particularly heart failure with preserved ejection fraction. 24 Individuals with diabetes and higher baseline BMI may also have greater sodium and fluid retention and might achieve enhanced protection from SGLT2 inhibitor therapy because of the known natriuretic effects of the class.…”

Section: Discussionmentioning

confidence: 99%

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Clinical outcomes with canagliflozin according to baseline body mass index: results from post hoc analyses of the CANVAS Program

Ohkuma

Gaal

Shaw

et al. 2020

Diabetes Obesity Metabolism

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Aims Sodium glucose co‐transporter 2 (SGLT2) inhibitors reduce several cardiovascular risk factors, including plasma glucose, blood pressure, albuminuria and body weight. Long‐term treatment lowers risks of cardiovascular and renal events. The objective of this post hoc analysis was to determine the effects of canagliflozin treatment versus placebo on clinical outcomes in relation to body mass index (BMI). Materials and methods The CANVAS Program randomized 10 142 participants with type 2 diabetes to canagliflozin or placebo. These analyses tested the consistency of canagliflozin treatment effects across BMI levels for cardiovascular, renal, safety and body weight outcomes in three groups defined by baseline BMI: <25, 25‐<30 and ≥30 kg/m2. Results In total, 10 128 participants with baseline BMI measurements were included. There were 966 participants with BMI <25 kg/m2, 3153 with BMI 25‐<30 kg/m2 and 6009 with BMI ≥30 kg/m2. Mean percent body weight reduction with canagliflozin compared with placebo was greater at 12 months [−2.77% (95% confidence interval (CI): −2.95, ‐2.59)] than at 3 months [‐1.72% (95% CI: ‐1.83, ‐1.62)]. The hazard ratios (HRs) for canagliflozin compared with placebo control for the composite outcome of cardiovascular death, non‐fatal myocardial infarction or non‐fatal stroke were 1.03 (95% CI: 0.66, 1.59) in participants with BMI <25 kg/m2, 0.97 (0.76, 1.23) with BMI 25‐<30 kg/m2 and 0.79 (0.67, 0.93) with BMI ≥30 kg/m2 (P for heterogeneity = 0.55). The effects of canagliflozin on each component of the composite were also similar across BMI subgroups, as were effects on heart failure and renal outcomes (P for heterogeneity ≥0.19). The effects on safety outcomes were also broadly similar. Conclusions Canagliflozin improved cardiovascular and renal outcomes consistently across patients with a broad range of BMI levels.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical outcomes with canagliflozin according to baseline body mass index: results from post hoc analyses of the CANVAS Program

Ohkuma

Gaal

Shaw

et al. 2020

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

show abstract

“…Epicardial fat, which also seems to contain brown adipose cells (250), is an energy source for the heart and is considered to protect the myocardium from high levels of FFAs and unlikely to increase cardio-metabolic risk (209). Despite that, several human studies have shown an association between increased amount of epicardial fat, either due to, or independent of, obesity for the onset and development of coronary artery disease (316). However, this association can be confounded by the presence of other markers of ectopic fat and/or visceral obesity.…”

Section: B Ectopic Fat In Other Organs/tissuesmentioning

confidence: 99%

Impaired Adipogenesis and Dysfunctional Adipose Tissue in Human Hypertrophic Obesity

Hammarstedt

Gogg

Hedjazifar

et al. 2018

Physiological Reviews

304

256

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The subcutaneous adipose tissue (SAT) is the largest and best storage site for excess lipids. However, it has a limited ability to expand by recruiting and/or differentiating available precursor cells. When inadequate, this leads to a hypertrophic expansion of the cells with increased inflammation, insulin resistance, and a dysfunctional prolipolytic tissue. Epi-/genetic factors regulate SAT adipogenesis and genetic predisposition for type 2 diabetes is associated with markers of an impaired SAT adipogenesis and development of hypertrophic obesity also in nonobese individuals. We here review mechanisms for the adipose precursor cells to enter adipogenesis, emphasizing the role of bone morphogenetic protein-4 (BMP-4) and its endogenous antagonist gremlin-1, which is increased in hypertrophic SAT in humans. Gremlin-1 is a secreted and a likely important mechanism for the impaired SAT adipogenesis in hypertrophic obesity. Transiently increasing BMP-4 enhances adipogenic commitment of the precursor cells while maintained BMP-4 signaling during differentiation induces a beige/brown oxidative phenotype in both human and murine adipose cells. Adipose tissue growth and development also requires increased angiogenesis, and BMP-4, as a proangiogenic molecule, may also be an important feedback regulator of this. Hypertrophic obesity is also associated with increased lipolysis. Reduced lipid storage and increased release of FFA by hypertrophic SAT are important mechanisms for the accumulation of ectopic fat in the liver and other places promoting insulin resistance. Taken together, the limited expansion and storage capacity of SAT is a major driver of the obesity-associated metabolic complications.

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“…Особый интерес к изучению такого типа висцеральной жировой ткани как эпикардиальная (ЭЖТ) объясняется ее анатомическими особенностями. Известно, что ЭЖТ -это висцеральные жировые отложения, которые прилегают к миокарду и окружают коронарные артерии [8,9]. Предполагается, что ЭЖТ играет немаловажную роль в развитии атеросклероза и ИБС [10].…”

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Subcutaneous and Epicardial Adipose Tissue Leptin Gene Expression in Coronary Artery Disease Patient

Полякова

Колодина

Miroshnikova

et al. 2019

Transl. med. (Print)

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Objective. To assess the expression of the leptin gene (LEP) in the epicardial (EAT) and subcutaneous (SAT) adipose tissue in coronary artery disease (CAD) patients.Methods. 107 people were examined: 87 with CAD (57 men, 30 women), 20 without CAD (10 men, 10 women). Biopsy of EAT, SAT, coronary angiography, heart computed tomography, blood leptin levels were estimate, mRNA expression of the LEP gene evaluated by PCR.Results. In CAD patients with multivessel coronary artery lesion, the level of blood leptin is the highest. The expression of the LEP gene in EAT is higher in men than in women, in men with CAD higher than in non-coronary artery disease patients, and with a multivascular coronary lesion higher than in a 1–2 vascular lesion. Expression of the LEP gene in EAT in women with CAD is higher than with no CAD, and does not depend on the severity of coronary atherosclerosis. In SAT, LEP gene expression in men with CAD is higher than without CAD; women with CAD are lower than without CAD. Expression of the LEP gene in SAT is higher in men with a multivascular lesion than in 1–2 vascular lesion, and lower in women with a multivascular damage.Conclusions. The expression of the leptin gene in women is higher in SAT, and in men in EAT. Expression of the leptin gene in EAT with CAD is higher than without CAD. The expression of the leptin gene in SAT in men with CAD, especially with multivessel lesions, is higher than without coronary artery disease.

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Epicardial Fat in the Maintenance of Cardiovascular Health

Cited by 99 publications

References 43 publications

Clinical outcomes with canagliflozin according to baseline body mass index: results from post hoc analyses of the CANVAS Program

Clinical outcomes with canagliflozin according to baseline body mass index: results from post hoc analyses of the CANVAS Program

Impaired Adipogenesis and Dysfunctional Adipose Tissue in Human Hypertrophic Obesity

Subcutaneous and Epicardial Adipose Tissue Leptin Gene Expression in Coronary Artery Disease Patient

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