Impact of cardiopulmonary bypass surgery on cytokines in epicardial adipose tissue: comparison with subcutaneous fat

Mach, Lukáš; Bedáňová, Helena; Souček, Miroslav; Karpíšek, Michal; Konečný, Tomáš; Němec, Petr; Orban, Marek

doi:10.1177/0267659116683791

Cited by 11 publications

(14 citation statements)

References 26 publications

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“…This can increase neointimal inflammation and plaque formation. Some studies have suggested that cytokines and adipocytokines derived from EAT increase lymphocyte, macrophage, and mast cell activities around perivascular adipose tissue [21]. Furthermore, macrophages migrating into plaques via the vasa vasorum and surrounding perivascular adipose tissue become a source of foam cells, which are involved in the pathogenesis of atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Association between epicardial adipose tissue and adverse outcomes in coronary heart disease patients with percutaneous coronary intervention

2019

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We assessed the relationship between the volume of epicardial adipose tissue and long-term outcomes in patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI). The patients with CHD were followed for at least 2 years after PCI. The epicardial adipose tissue volume (EATV) was measured using multi-slice computed tomography. Cox regression analysis was used to examine the relationship between EATV and clinical outcome. In this study, 500 patients were enrolled and followed up for a median of 25.2 months. The incidence of adverse cardiovascular events was 12.4%. No significant differences were observed in age, sex, proportion of patients with hypertension or diabetes, smoking, drinking, total cholesterol, triglyceride, high-density lipoprotein, or unstable angina pectoris among different EATV quartiles (P>0.05). The EATV was associated with body mass index (P<0.0001), low-density lipoprotein level (P=0.039), high-sensitivity C-reactive protein level (P<0.001), uric acid level (P=0.004), adiponectin level (P<0.001), and left ventricular ejection fraction (P<0.001). Kaplan–Meier analysis indicated a significant difference in survival rate of patients in EATV quartile 1 versus 4 (P=0.019). After adjusting for confounding factors, EATV quartile 4 (>216.15 cm3) was still associated with adverse cardiovascular outcomes (HR = 1.98, 95% CI: 1.15–4.47, P=0.023) compared with quartile 1 (<101.58 cm3). Our data suggest that EATV is an independent predictor of long-term major adverse cardiovascular events in CHD patients after PCI. Therefore, assessment of EATV using multi-slice computed tomography may contribute to risk stratification in these patients.

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Section: Discussionmentioning

confidence: 99%

Association between epicardial adipose tissue and adverse outcomes in coronary heart disease patients with percutaneous coronary intervention

2019

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“…As already mentioned, the perivascular adipose tissue that surrounds the coronary arteries, promotes the expression of a proinflammatory phenotype and the accumulation of epicardial adipose tissue is closely associated with the presence, severity, and progression of coronary artery disease independently from visceral obesity [103][104][105][106][107][108][109][110]. This illuminates why NAFLD is known to be associated with various markers of subclinical atherosclerosis including coronary artery calcification and increased coronary-artery calcium score, independently from traditional CVD risk factors and metabolic syndrome features [27,87,111].…”

Section: Nafld and Coronary Artery Diseasementioning

confidence: 99%

NAFLD and cardiovascular diseases: a clinical review

et al. 2020

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Non-alcoholic fatty liver DISEASE (NAFLD) is the most common chronic liver disease in Western countries and affects approximately 25% of the adult population. Since NAFLD is frequently associated with further metabolic comorbidities such as obesity, type 2 diabetes mellitus, or dyslipidemia, it is generally considered as the hepatic manifestation of the metabolic syndrome. In addition to its potential to cause liver-related morbidity and mortality, NAFLD is also associated with subclinical and clinical cardiovascular disease (CVD). Growing evidence indicates that patients with NAFLD are at substantial risk for the development of hypertension, coronary heart disease, cardiomyopathy, and cardiac arrhythmias, which clinically result in increased cardiovascular morbidity and mortality. The natural history of NAFLD is variable and the vast majority of patients will not progress from simple steatosis to fibrosis and end stage liver disease. However, patients with progressive forms of NAFLD, including non-alcoholic steatohepatitis (NASH) and/or advanced fibrosis, as well as NAFLD patients with concomitant types 2 diabetes are at highest risk for CVD. This review describes the underlying pathophysiological mechanisms linking NAFLD and CVD, discusses the role of NAFLD as a metabolic dysfunction associated cardiovascular risk factor, and focuses on common cardiovascular manifestations in NAFLD patients.

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“…159,163 Furthermore, the premise that an expanded epicardial fat mass is biologically abnormal is supported by the analyses of tissue obtained during surgery and by the finding of an elevated transcardiac gradient for proinflammatory adipocytokines in states of epicardial adiposity. [164][165][166][167] Yet, the intimacy of epicardial fat and the myocardium can be bidirectional; conceivably, epicardial adipose tissue expansion may reflect the extension of inflammation originating in the heart to the epicardium. If so, then increases in epicardial fat would represent a biomarker rather than a cause of cardiac inflammation.…”

Section: Challenges In Assessing the Role Of Epicardial Adipose Tissumentioning

confidence: 99%

“…Nevertheless, epicardial fat depots (as well as intramyocardial lipids) are unique in their exceptionally close proximity to the myocardium, and fat expansion adjacent to cardiomyocytes may be particularly linked to cardiac derangements 159,163 . Furthermore, the premise that an expanded epicardial fat mass is biologically abnormal is supported by the analyses of tissue obtained during surgery and by the finding of an elevated transcardiac gradient for proinflammatory adipocytokines in states of epicardial adiposity 164–167 . Yet, the intimacy of epicardial fat and the myocardium can be bidirectional; conceivably, epicardial adipose tissue expansion may reflect the extension of inflammation originating in the heart to the epicardium.…”

Section: Deleterious Biological Transformation Of Epicardial Adipose Tissue In Systemic Inflammatory and Metabolic Disordersmentioning

confidence: 99%

Characterization of the inflammatory‐metabolic phenotype of heart failure with a preserved ejection fraction: a hypothesis to explain influence of sex on the evolution and potential treatment of the disease

Packer

Lam

Lund

et al. 2020

European J of Heart Fail

110

109

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Accumulating evidence points to the existence of an inflammatory-metabolic phenotype of heart failure with a preserved ejection fraction (HFpEF), which is characterized by biomarkers of inflammation, an expanded epicardial adipose tissue mass, microvascular endothelial dysfunction, normal-to-mildly increased left ventricular volumes and systolic blood pressures, and possibly, altered activity of adipocyte-associated inflammatory mediators. A broad range of adipogenic metabolic and systemic inflammatory disorders-e.g. obesity, diabetes and metabolic syndrome as well as rheumatoid arthritis and psoriasis-can cause this phenotype, independent of the presence of large vessel coronary artery disease. Interestingly, when compared with men, women are both at greater risk of and may suffer greater cardiac consequences from these systemic inflammatory and metabolic disorders. Women show disproportionate increases in left ventricular filling pressures following increases in central blood volume and have greater arterial stiffness than men. Additionally, they are particularly predisposed to epicardial and intramyocardial fat expansion and imbalances in adipocyte-associated proinflammatory mediators. The hormonal interrelationships seen in inflammatory-metabolic phenotype may explain why mineralocorticoid receptor antagonists and neprilysin inhibitors may be more effective in women than in men with HFpEF. Recognition of the inflammatory-metabolic phenotype may improve an understanding of the pathogenesis of HFpEF and enhance the ability to design clinical trials of interventions in this heterogeneous syndrome.

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Impact of cardiopulmonary bypass surgery on cytokines in epicardial adipose tissue: comparison with subcutaneous fat

Cited by 11 publications

References 26 publications

Association between epicardial adipose tissue and adverse outcomes in coronary heart disease patients with percutaneous coronary intervention

Association between epicardial adipose tissue and adverse outcomes in coronary heart disease patients with percutaneous coronary intervention

NAFLD and cardiovascular diseases: a clinical review

Characterization of the inflammatory‐metabolic phenotype of heart failure with a preserved ejection fraction: a hypothesis to explain influence of sex on the evolution and potential treatment of the disease

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