The role of epicardial fat and obesity parameters in the prediction of coronary heart disease
Authors:
Dana Prídavková; Daniela Kantárová; Renáta Lišková; Peter Červeň; František Kovář; Marián Mokáň
Authors‘ workplace:
I. interná klinika Jesseniovej LF UK a UN Martin, Slovenská republika
Published in:
Vnitř Lék 2016; 62(4): 256-262
Category:
Original Contributions
Overview
Background:
To assess the relationship of parameters of obesity in relationship to coronary angiography findings with correlation of epicardial fat (EF) thickness in uppermentioned context.
Methods:
There were 80 patients examined (43 males, 37 postmenopausal females) undergoing elective coronary angiography. We examined the regular obesity parameters – BMI, waist circumference (WC), neck circumference (NC), total body fat (TBF), and visceral fat (VF) using bioimpedance. We assessed the echocardiographically measured EF thickness. We added examination of lipidogram, glycaemia, HOMA-IR (insulin resistance index) and AIP (aterogenic index of plasma). The set was divided into group with coronarographically proved stenosis or stenoses (withCS), and a group without finding of quantifiable stenosis or stenoses (withoutCS).
Results:
The average thickness of EF in withCS group was 6.3 vs 5.6 mm in group withoutCS (p < 0.025). The differences in the thickness of EF in mentioned groups were 6.5 vs 5.2 mm in males (p < 0.025, ∆ = 20 %) and 6.1 vs 6.0 mm in females (p < 0.025, ∆ = 1.64 %). In males in withCS group, there was a dominant fat increase in epicardial region and TBF, and in females in withCS group, the fat deposits were increased in general. BMI was not a dominant parameter of adiposity in neither group (males in withCS group 31.11 vs withoutCS 30.41 kg/m2; females in withCS group 31.40 vs withoutCS 31.20 kg/m2). EF was correlated the most by WC in males (r = 0.488; p < 0.005), and in females too (r = 0.564, p < 0.005). The patients in withCS group had increased HOMA-IR 4.75 vs 3.56 in withoutCS group, and AIP 0.22 vs 0.17.
Conclusion:
Thickness of EF in males and VT in females could be considered obesity parameters in assessment of pre-clinical stages of coronary atherosclerosis and prediction of risk of coronary heart disease. In adipose parameters, EF thickness was correlated the most by WC. Risk stratification of coronary artery disease is supplemented by increased HOMA-IR and AIP.
Key words:
coronary artery disease – epicardial fat – obesity
Sources
1. Iozoo P. Myocardial, Perivascular, and Epicardial Fat. Diabetes care 2011; 34(Suppl 2): S371-S379.
2. Mahabadi AA, Berg MH, Lehmann N et al. Association of Epicardial Fat with Cardiovascular Risk Factors and Incident Myocardial Infarction in the General Population. J Am Cardiovasc 2013; 61(13): 1388–1395.
3. Mahabadi AA, Reinsch N, Lehmann N et al. Association of pericoronary fat volume with atherosclerotic plaque burden in the underlying coronary artery: a segment analysis. Atherosclerosis 2010; 211(1): 195–199.
4. Wu FZ, Chou KJ, Huang YL et al. The relation of location-specific epicardial adipose tissue thickness and obstructive coronary artery disease: systematic review and metaanalysis of observational studies. BMC Cardiovasc Disord 2014; 14:62. Dostupné z DOI: <http://dx.doi.org/10.1186/1471–2261–14–62>.
5. Natale F, Tedesco MA, Mocerino R et al. Visceral adiposity and arterial stiffness: echocardiographic epicardial fat thickness reflects, better than waist circumference, carotid arterial stiffness in a large population of hypertensive. Eur J Echocardiogr 2009; 10(4): 549–555.
6. Dey D, Nakazato R, Debiao L et al. Epicardial and thoracic fat. Noninvasive measurement and clinical implications. Cardiovasc Diagn Ther 2012; 2(2): 85–93.
7. Kim KM, Tomita T, Kim MJ et al. Exercise training reduces epicardial fat in obese men. J Appl Physiol 2008; 106(1): 5–11.
8. Gonzales GF, Rodriguez AR, Rodriguez P et al. A home-based treadmill training reduced epicardial and abdominal fat in postmenopausal women with metabolic syndrome. Nutr Hosp 2014; 30(3): 609–613.
9. Park JH, Park YS, Kim YJ et al. Effects of Statins on the Epicardial Fat Thickness in Patients with Coronary Artery Stenosis Undrewent Percutaneous Coronary invervention: Comparison of Atorvastatin with Simvastatin/Ezetimib. J Cardiovasc Ultrasound 2010; 18(4): 121–126.
10. Veselka J, Tesař D, Urbanová T et al. Intervenční léčba nemocných s nestabilní anginou pectoris nebo non-Q infarktem myokardu refrakterních k medikamentózní terapii: výsledky 434 případů. Cardiol 2001; 10(1): 7–14.
11. Tse-Min L, Yu-Lan J, Ying-Hwa C et al. The Clinical Significance of Right Coronary Artery Stenosis on the Prognosis of Patients with Unprotected Left Main Disease Undergoing Percutaneous Coronary Intervention. Acta Cardiol Sin 2011; 27(1): 14–20.
12. Eroglu S, Sade LE, Yildirir A et al. Epicardial adipose tissue thickness by echocardiography is a marker for the presence and severity of coronary artery disease. Nutr Metab Cardiovasc Dis 2009; 19(3): 211–217.
13. Iacobellis G, Willens HJ, Barbaro G et al. Threshold values of high-risk echocardiographic epicardial fat thickness. Obesity 2008; 16(4): 887–892.
14. Nelson MR, Mookadam F, Thota V et al. Epicardial fat: an additional measurement for subclinical atherosclerosis and cardiovascular risk stratification? J Am Soc Echocardiogr 2011; 24(3): 339–345.
15. de Feyter PJ. Epicardial Adipose Tissue: An Emerging Role for the Development of Coronary Atherosclerosis. Clin Cardiol 2011; 34(3): 143–144.
16. Jeong JW, Jeong MH, Yun KH et al. Echocardiographic epicardial fat thickness and coronary artery dinase. Circ J 2007; 71(4): 536–539.
17. Pierdomenico SD, Pierdomenico AM, Cuccurullo F et al. Meta-analysis of the relation of echocardiografic epicardial adipose tissue thickness and the metabolic syndrome. Am J Cardiol 2013; 111(1): 73–78.
18. Iacobellis G, Willens HJ. Echocardiografic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr 2009; 22(12): 1311–1319.
19. Bertaso AG, Bertol D, Duncan BB et al. Epicardial fat: definition, measurement and systematic review of main outcomes. Arq Bras Cardiol 2013; 101(1): e18-e28. Dostupné z DOI: http://dx.doi.org/10.5935/abc.20130138.
20. Rabkin SW. Epicardial fat: properties, function and relationship to obesity. Obes Rev 2007; 8(3): 253–261.
21. Park JS, Ahn SG, Hwang JW et al. Impact of Body Mass Index on the relationship of epicardial adipose tissue to metabolic syndrome and coronary artery disease in an Asian popopulation. Cardiovasc Diabetolog 2010; 9: 29. Dostupné z DOI: <http://dx.doi.org/10.1186/1475–2840–9-29>.
22. Gambacciani M, Ciapponi M, Cappagli B et al. Climacteric modifications in body weight and fat tissue distribution. Climacteric 1999; 2(1): 37–44.
23. Iwao S, Iwao N, Muller DC et al. Does waist circumference add to the predictive power of the body mass index for coronary risk? Obes Res 2001; 9(11): 685–695.
24. Faghihi S, Vashegani-Farahani A, Parsaee M et al. Association Between Epicardial Fat Thickness and Premature Coronary Artery Disease: A Case Control Study. Res Cardiovasc Med 2015; 4: e25679. Dostupné z DOI: http://dx.doi.org/10.5812/cardiovascmed.4(2)2015.25679.
25. Zhou J, Ge H, Zhu M et al. Neck Circumference as ad Independent Predictive Contributor to Cardio-Metabolic Syndrome. Cardiovasc Diabetol 2013; 12: 76. Dostupné z DOI: <http://dx.doi.org/10.1186/1475–2840–12–76>.
26. Hoebel S, Malan L, deRidder JH. Determining cut-off values for neck circumferemce as a measure of the metabolic syndrome amongst a South Africa cohort: the SABPA study. Endocrine 2012; 42(2): 335–342.
27. Yusuf S, Hawken S, Ounpuu S et al. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-controly study. Lancet 2005; 366(9497): 1640–1649.
28. Romero-Corral A, Somers VK, Sierra-Johnson J et al. Normal wieght obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality. Eur Heart J 2010; 31(6): 737–746.
29. Zeman D. Obezita a metabolický syndrom. Vnitř Lék 2005; 51(1): 72–75.
30. Kang SH, Cho KH, Park JW et al. Association of Visceral Fat Area with Chronic Kidney Disease and Metabolic Syndrome Risk in the General Population: Analysis Using Multi-Frequency Bioimpedance. Kidney Blood Press Res 2015; 40(3): 223–230.
31. Zamrazilová H, Hlavatý P, Dušátková L et al. Nová jednoduchá metóda stanovení viscerálního a trunkálního tuku pomocí bioelektrické impendance: srovnání s magnetickou rezonancí a duální rentgenovou absorpciometrií u českých adolescentů. Čas Lék Čes 2010; 149(9): 417–422.
32. Blachnio-Zabielska AU, Baranowksi M, Hirnle T et al. Increased bioactive lipids contentin human subcutaneous and epicardial fat tissue correlates with insulin resistance. Lipids 2012; 47(12): 1131–1141.
33. Mazzoccoli G, Dagostino MP, Greco A et al. Age related changes of epicardial fat thickness. Biomedicine and Preventive Nutrition 2012; 2(1): 38–41.
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