Impact of Functional, Morphological and Clinical Parameters on Epicardial Adipose Tissue in Patients With Coronary Artery Disease

Doesch, Christina; Haghi, Dariusch; Süselbeck, Tim; Schoenberg, Stefan O.; Borggrefe, Martin; Papavassiliu, Theano

doi:10.1253/circj.cj-12-0301

Cited by 19 publications

(12 citation statements)

References 51 publications

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“…Doesch et al [32] measured EAT volume in patients with dilated cardiomyopathy using MRI and found that it was associated with HF with reduced EF, but not with a preserved EF as in our study. Other studies are in line with that and show a correlation for EAT and reduced LV-EF [33,34]. We concur that the influence of EAT volume on LVDD in patients with AS might be of minor concern as shown by our preliminary data and that an increase in afterload and other changes associated with AS may play a more important role in causing LVDD and LV hypertrophy.…”

Section: Plos Onesupporting

confidence: 90%

Impact of epicardial adipose tissue volume upon left ventricular dysfunction in patients with mild-to-moderate aortic stenosis: A post-hoc analysis

et al. 2020

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Background Aortic stenosis (AS) may lead to diastolic dysfunction and later on heart failure (HF) with preserved left ventricular ejection fraction (HFpEF) via increased afterload and left-ventricular (LV) hypertrophy. Since epicardial adipose tissue (EAT) is a metabolically active fat depot that is adjacent to the myocardium and can influence cardiomyocytes and LV function via secretion of proinflammatory cytokines, we hypothesized that high amounts of EAT, as assessed by computed tomography (CT), may aggravate the development and severity of LV hypertrophy and diastolic dysfunction in the context of AS. Methods We studied 50 patients (mean age 71 ± 9 years; 9 women) in this preliminary study with mild or moderate AS and mild to severe LV diastolic dysfunction (LVDD), diagnosed by echocardiography, who underwent non-contrast cardiac CT and echocardiography. EAT parameters were measured on 2nd generation dual source CT. Conventional two-dimensional echocardiography and Tissue Doppler Imaging (TDI) was performed to assess LV function and to derive myocardial straining parameter. All patients had a preserved LV ejection fraction > 50%. Data was analysed using Pearson's correlation. Results Only weak correlation was found between EAT volume or density and E/é ratio as LVDD marker (r =-.113 p = .433 and r = .260, p = .068 respectively). Also, EAT volume or density were independent from Global Strain Parameters (r = 0.058 p = .688 and r =-0.207 p = .239). E/é ratio was strongly associated with LVDD (r = .761 p�0.0001) and Strain Parameters were moderately associated with LV Ejection Fraction (r =-.669 p�0.001 and r =-.454 P�0.005).

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Section: Plos Onesupporting

confidence: 90%

Impact of epicardial adipose tissue volume upon left ventricular dysfunction in patients with mild-to-moderate aortic stenosis: A post-hoc analysis

et al. 2020

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“…Thickness in EAT is also associated with metabolic syndrome, 25 insulin resistance, 26 endothelial dysfunction, 27 and overt atherosclerotic CAD. 28 The influence of conventional cardiovascular risk factors on EAT thickness is well established; regardless, EAT has additional predictive value over these risk factors in regard to the presence of critical and complex CAD, according to our multivariate regression analysis.…”

Section: Discussionmentioning

confidence: 68%

Epicardial Adipose Tissue Thickness Is an Independent Predictor of Critical and Complex Coronary Artery Disease by Gensini and Syntax Scores

Erkan¹,

Tanındı²,

Kocaman³

et al. 2016

Texas Heart Institute Journal

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Epicardial adipose tissue thickness is associated with the severity and extent of atherosclerotic coronary artery disease. We prospectively investigated whether epicardial adipose tissue thickness is related to coronary artery disease extent and complexity as denoted by Gensini and Syntax scores, and whether the thickness predicts critical disease. After performing coronary angiography in 183 patients who had angina or acute myocardial infarction, we divided them into 3 groups: normal coronary arteries, noncritical disease (≥1 coronary lesion with<70% stenosis), and critical disease (≥1 coronary lesion with <70% stenosis). We used transthoracic echocardiography to measure epicardial adipose tissue thickness, then calculated Gensini and Syntax scores by reviewing the angiograms. Mean thicknesses were 4.3 ± 0.9, 5.2 ± 1.5, and 7.5 ± 1.9 mm in patients with normal coronary arteries, noncritical disease, and critical disease, respectively (P <0.001). At progressive thicknesses (<5, 5-7, and >7 mm), mean Gensini scores were 4.1 ± 5.5, 19.8 ± 15.6, and 64.9 ± 32.4, and mean Syntax scores were 4.7 ± 5.9, 16.6 ± 8.5, and 31.7 ± 8.7, respectively (both P <0.001). Thickness had strong and positive correlations with both scores (Gensini, r =0.82, P <0.001; and Syntax, r =0.825, P <0.001). The cutoff thickness value to predict critical disease was 5.75 mm (area under the curve, 0.875; 95% confidence interval, 0.825-0.926; P <0.001). Epicardial adipose tissue thickness is independently related to coronary artery disease extent and complexity as denoted by Gensini and Syntax scores, and it predicts critical coronary artery disease.

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“…In contrast, adiponectin which has antiatherogenic properties through improvement of endothelial function and anti-inflammatory effect was shown to be under expressed in EAT in patients with CAD (16). In the light of these findings, EAT is associated with metabolic syndrome (17), insulin resistance (17, 18), endothelial dysfunction, subclinical atherosclerosis (19) and overt atherosclerotic CAD (20). …”

Section: Discussionmentioning

confidence: 99%

Epicardial adipose tissue thickness is associated with myocardial infarction and impaired coronary perfusion

Tanındı¹,

Kocaman²,

Erkan³

et al. 2015

Anatol J Cardiol

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Objective:Epicardial adipose tissue (EAT) is associated with the presence, severity and extent of atherosclerotic coronary artery disease (CAD) in addition to subclinical atherosclerosis. We investigated if EAT thickness is related to acute myocardial infarction in patients with CAD. We also searched for the association between EAT thickness and objective coronary flow and myocardial perfusion parameters such as Thrombolysis in Myocardial Infarction Frame count (TFC) and myocardial blush grade (MBG).Methods:Two-hundred consecutive patients with stable angina pectoris or acute coronary syndrome who were admitted to Ufuk University Faculty of Medicine, Dr Ridvan Ege Hospital cardiology department were included in this observational, cross-sectional study. EAT thickness was evaluated by conventional transthoracic echocardiography. Coronary angiography was performed to determine the coronary involvement and perfusion.Results:Mean EAT thicknesses were 5.4±1.9 mm, 6.3±1.8 mm, and 8.5±1.4 mm in the stable angina pectoris (SAP), unstable angina pectoris (USAP) and acute myocardial infarction groups, respectively (p<0.001). With increasing EAT thickness, TFC increases whereas mean MBG values decrease (for EAT thickness <5 mm, 5-7 mm, >7 mm; mean TFC: 21.6±2.2, 25.3±3.3 and 35.2±7.7; and MBG values: 2.98±0.14, 2.83±0.57 and 1.7±1.16, respectively; both p<0.001). Cut-off EAT value to predict AMI was identified as 7.8 mm (ROC analysis AUC: 0.876; p<0.001, 95% CI: 0.822-0.927). Sensitivity and specificity of EAT cut-off value 7.8 mm to predict AMI were 81.8% and 82.5% respectively.Conclusion:Increased EAT is associated with AMI and it may prove beneficial for choosing patients who would need more aggressive approach in terms of risk reduction using echocardiography which is a relatively cheap and readily available tool as a follow-up parameter.

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Impact of Functional, Morphological and Clinical Parameters on Epicardial Adipose Tissue in Patients With Coronary Artery Disease

Cited by 19 publications

References 51 publications

Impact of epicardial adipose tissue volume upon left ventricular dysfunction in patients with mild-to-moderate aortic stenosis: A post-hoc analysis

Impact of epicardial adipose tissue volume upon left ventricular dysfunction in patients with mild-to-moderate aortic stenosis: A post-hoc analysis

Epicardial Adipose Tissue Thickness Is an Independent Predictor of Critical and Complex Coronary Artery Disease by Gensini and Syntax Scores

Epicardial adipose tissue thickness is associated with myocardial infarction and impaired coronary perfusion

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