Is there relationship between epicardial fat and cardiovascular parameters in incident kidney transplant patients? A post-hoc analysis

Abstract

BackgroundEpicardial fat (EF) has been related to increased cardiovascular risk in chronic kidney disease patients. Kidney transplantation is associated with weight gain, especially within the first 12 months. Recently an association between EF and left ventricular mass (LVM) has been suggested in kidney transplant (KTX) recipients.ObjectiveEvaluate the EF in KTX recipients and its association with cardiovascular parameters in a 12-month follow-up study.MethodsEF volume was determined using thoracic computed tomography. The EF progressor group (EF gain) was defined by any increment in EF after 12 months. LVM and LVM index were calculated by echocardiography.ResultsNinety-eight incident KTX patients [57% men, 41.2 ± 10.1 years, mean dialysis time prior to transplant of 24 (11–60) months] were analyzed. At baseline and after 12 months, EF was 318.6 (275.2–392.6) ml and 329.5 (271.7–384.8) ml, respectively (p = 0.03). When compared to patients who EF decreased (n = 33), those with EF gain (n = 65) had a greater increase of body mass index, abdominal circumference and blood glucose. These patients also had a lower reduction of LVM index. However in the multivariate analysis, there was no difference in LVM index change between groups (interaction p = 0.565), even after adjustment for hypertension, glucose and coronary calcium score (interaction p = 0.538).ConclusionThe impact of EF gain on ventricular mass after KTX could not be definitely confirmed. Further prospective studies in a large sample of KTX patients should be considered to address a possible causal relationship between EF gain and cardiac hypertrophy in this population.

Epicardial Adipose Tissue: A Novel Potential Imaging Marker of Comorbidities Caused by Chronic Inflammation

“…A study conducted by Yazbek et al evaluated the role of EAT volume in the kidney transplantation population and its association with CVD, considering that obesity is common in patients with CKD and weight gain is observed in approximately one-third of patients after kidney transplantation. The EAT progressor group was defined by any increment in EAT after 12 months, using thoracic CT. No relationship was observed between the presence or progression of coronary calcification and EAT, but this result could be attributed to the young age of the study population, short duration of previous dialysis therapy, low prevalence of diabetic patients and incidence of coronary calcification, and a well-functioning kidney graft [ 90 ]. To date, baseline measurement of EAT has been associated with all-cause mortality in a single study of hemodialysis patients [ 124 ] and with cardiovascular events in CKD 3–5 patients [ 125 ], becoming an indicator of early atherosclerosis in hemodialysis patients [ 91 ].…”

Epicardial Adipose Tissue and Renal Disease

“…Limited literature is available on the EAT in kidney transplant patients. In a post hoc analysis on 98 kidney transplant patients, the impact of the epicardial fat gain on ventricular mass after kidney transplantation could not be positively confirmed [59]. Similar to hemodialysis patients, PON-1 activity was found to be inversely correlated with EAT thickness in renal transplant patients [60].…”