Amount Of Epicardial Fat Research Articles

Epicardial fat volume assessed with cardiac magnetic resonance imaging in patients with Takotsubo cardiomyopathy

PurposeThe aims of our study were to investigate with cardiovascular magnetic resonance (CMR) the role of Epicardial Fat Volume (EFV) and distribution in patients with Takotsubo cardiomyopathy (TTC). Moreover, we explored EFV in patients with TTC and related this to comorbidities, cardiac biomarkers, and cardiac function. MethodsThis retrospective study performed CMR scans in 30 consecutive TTC patients and 20 healthy controls. The absolute amount of EFV was quantified in consecutive short-axis cine stacks through the modified Simpson’s rule. In addition, the left atrio-ventricular groove (LV) and right ventricle (RV) Epicardial Fat Thickness (EFT) were measured as well. Besides epicardial fat, LV myocardial strain parameters and T2 mapping measurements were obtained. ResultsTTC patients and controls were of comparable age, sex, and body mass index. Compared to healthy controls, patients with TTC demonstrated a significantly increased EFV, epicardial fat mass, and EFV indexed for body 7surface area (p = 0.005; p = 0.003; p = 0.008; respectively). In a multiple regression model including age, sex, BMI, atrial fibrillation, and dyslipidemia, TTC remained an independent association with EFV (p = 0.008). Global T2 mapping and Global longitudinal strain in patients with TTC were correlated with EFV (r = 0.63, p = 0.001, and r = 0.44, p = 0.02, respectively). ConclusionPatients with TTC have increased EFV compared to healthy controls, despite a similar body mass index. The amount of epicardial fat was associated with CMR markers of myocardial inflammation and subclinical contractile dysfunction.

Relationship of epicardial adipose tissue with coronary artery disease, cardiovascular risk factors and patient outcomes

Introduction and objectivesThe epicardial adipose tissue (EAT) is a metabolically active fat depot that has shown to be implicated in the development of coronary artery disease (CAD) and the prediction of cardiovascular events. However, these findings might be influenced by body size since previous studies have demonstrated a strong correlation between the amount of epicardial fat and anthropometric measurements. Our objective was to assess the association between indexed-EAT (EAT-i) volume and the presence of CAD and cardiovascular events in a cohort of symptomatic patients. MethodsPatients referred for cardiac computed tomography from March 2010 to April 2017 were included. CAD was defined as the presence of obstructive coronary stenosis or a high amount of coronary calcium. EAT was assessed using a semiautomatic software and indexed to body surface area. A regression analysis was performed to determine the relationship between relevant CAD and EAT-i, age, sex, cardiovascular risk factors, and comorbidities. The association between EAT-i and cardiovascular events was analyzed with Cox regression models. ResultsA total of 179 patients were recruited (56±12 years, 57.5% male). EAT-i (P=.003), age (P<.001) and male sex (P<.001) were significantly and independently associated with CAD. During follow-up (5.5 years, 2.4–6.4) patients with elevated EAT-i showed an increased risk of events (HR, 2.44; 95%CI, 1.07–5.56; P=.033). ConclusionsIn symptomatic patients, an increased volume of indexed epicardial fat was associated with obstructive CAD as well as with cardiovascular events.

The Association between Epicardial Fat and Cardiac Allograft Vasculopathy

<h3>Purpose</h3> Cardiac allograft vasculopathy (CAV) is a poorly understood, accelerated form of coronary artery disease in patients that underwent heart transplantation (HT), and substantially contributes to post-transplantation morbidity and mortality. Increasing evidence shows an active role for epicardial fat (EF) in the development of coronary artery disease, as a result of its inflammatory properties. Yet, whether the amount of EF is also related to CAV remains unknown. Hence, we investigated the association of epicardial fat volume (EFV) with CAV. <h3>Methods</h3> For this pilot study, we included post HT-patients whom underwent cardiac computed tomography (CCT) for CAV screening between February 2018 and January 2019. CCT included a non-enhanced CT (NECT) and CT angiography (CCTA). Using the NECT, we quantified the EFV using an automated algorithm (Fig 1.). CAV was graded on CCTA similar to the guidelines of the International Society for Heart and Lung Transplantation. The association of EFV with the presence and grade of CAV was investigated using binary- and ordinal logistical regression models, adjusted for recipient age and gender, time since HT and number of rejections pre-CCT. <h3>Results</h3> We included 74 patients, with a median age of 45 years [IQR 27-51] at HT of whom 29 were women. Median time since HT was 10.0 years [IQR 8.0-15.3]. CAV was prevalent in 28 (38%) patients, of whom 17 (61%) had CAV 1, 5 (18%) had CAV 2 and 6 (21%) had CAV 3. Median EFV was 198.5 [IQR 123.4-262.1] mm³. The median EFV was larger with higher CAV grades: 162.2 (CAV 0), 211.5 (CAV 1), 230.0 (CAV 2) and 278.3 (CAV 3) mm³ (p=0.031). Albeit not statistically significant, we found an association of EFV with the presence of CAV (odds ratio (OR) per 1-standard deviation increase in log-transformed EFV: 1.48 (95%CI: 0.80-2.72), p=0.21) and with CAV grade (OR 1.52 (95%CI: 0.85-2.71), p=0.15). <h3>Conclusion</h3> Our preliminary results show a promising trend towards an association of the amount of epicardial fat and the presence of CAV, which should be confirmed in larger studies.

Функциональная характеристика печени ремонтного молодняка яичных кур, выращенных при монохроматическом и белом освещении

Abstract. The aim of the research is to identify the effect of monochromatic and white lighting on the functional state of the liver of egg chickens during the growing period, taking into account the season of the year. Method of research. Laboratory diagnostics of blood of 30-, 60- and 90-day old young animals. Anatomical examination of the liver of a bird at the age of 15 weeks (70 carcasses of birds were used), using the decapitation method, histological examination of the liver (19 organs), using a light microscope Carl Zeiss. Results. In all seasons of the year, the number of hemoglobin in the blood increases by 14.6 %, red blood cells by 9.4 %, albumins by 15.8 %, high values of white blood cells decrease by 2.5 times, gamma globulins by 19.8 %, bilirubin by 37.3 %, triglycerides by 26.9 %, cholesterol by 34.6 %, and asparagine aminotransferase activity by 27.5 % and alanine at 37.7 %. In young hens under white light, the amount of epicardial fat is less by 13.0–78.1 %, abdominal fat by 30.5–64.9 %, than in birds with monochromatic lamps. Histological examination of the liver of hens containing in any light revealed chronic hepatitis. In birds by white and yellow lighting, the development of the inflammatory process is less pronounced, there is no significant increase in the size of the nucleus and cells of hepatocytes, the expansion of the lumen of blood vessels, the number of lymphoid follicles in the centre and intermediate zone of the liver lobes less is 36.2–55.7 %, than in young hens by green and blue (white-blue) lighting. Scientific novelty. The use of white and yellow compact fluorescent lamps with a color temperature of 4500–5500 K and 2800–3000 K, respectively, with a light flux of 400–800 LM in the poultry house, has a weak positive effect on the functional state of the liver of egg chickens during the the period of growing from the daily age to the age of 15 weeks in cells in conditions of gradually decreasing length of daylight hours and light level.

Epicardial fat amount is associated with the magnitude of left ventricular remodeling in aortic stenosis.

Both genetic and environmental factors interact to control left ventricular (LV) remodeling in the context of aortic stenosis (AS). Epicardial adipose tissue (EAT) is a specific visceral adipose tissue with paracrine properties in close contact with the myocardium. We sought to assess determinants of EAT amount and its association with the magnitude and pattern of LV remodeling in patients suffering from severe AS. Between January 2014 and September 2017, we prospectively explored consecutive patients referred to our Heart Valve Center for SAVR presenting with severe AS and normal left ventricular ejection fraction (> 50%). Comprehensive transthoracic echocardiography (TTE) including assessment of LV remodeling and EAT amount were performed. 202 patients were included. EAT was significantly larger in elderly, diabetic and obese patients. EAT thickness was correlated positively with indexed LV mass in AS (r2 = 0.21; p < 0.0001) as well as severe LV remodeling pattern. Importantly, this observation persisted after adjustment for other factors associated with LV remodeling (β ± SE = 1.74 ± 0.34; p < 0.0001). Large amounts of EAT are positively and independently associated with more pronounced and severe LV remodeling in severe AS. Further exploration regarding the impact of functional properties of EAT on LV remodeling is required.

Is epicardial fat depot associated with atrial fibrillation? A systematic review and meta-analysis.

Atrial fibrillation (AF) is the leading rhythm disorder in western countries. A direct relationship between left atrium (LA) enlargement and electromechanical remodelling has been established. A causative link between epicardial fat (EF), visceral adipose tissue deposited around the heart, and AF has been hypothesized. Several reports suggested the association between EF and the presence of AF. The aim of this study was to verify the relationship between AF and EF depot, performing a meta-analysis of observational case series studies. Studies were identified by searching electronic databases by two independent investigators using 'atrial fibrillation' and 'epicardial fat' as keywords. Comparisons between healthy participants and AF cases were performed using a random effect meta-analysis estimating standardized mean difference among comparison groups. Meta regression was used to address the effect given by potential biological and technical confounders. Through a search result of 502 articles, only 7 were selected to conduct the present study. The comparison between all AF with respect to healthy participants resulted in a 32.0 ml of EF difference (95% confidence interval (CI) = 21.5, 42.5) showing that EF volume is higher in AF cases. A statistical significant difference of EF was observed when comparing both persistent and paroxysmal AF subtypes with respect to healthy participants (EF difference 48.0 ml (95% CI = 25.2, 70.8) and 15.7 ml (95% CI = 10.1, 21.4) for persistent and paroxysmal, respectively). A significant EF difference resulted also when comparing persistent to paroxysmal AF subtypes (29.6 ml (95% CI = 12.7, 46.5)). The present work expands the strength of previously reported association between EF amount and atrial arrhythmia.

Relationship between Regional Fat Distribution and Hypertrophic Cardiomyopathy Phenotype.

BackgroundHypertrophic cardiomyopathy (HCM), the most common genetic heart disease, is characterized by heterogeneous phenotypic expression. Body mass index has been associated with LV mass and heart failure symptoms in HCM. The aim of our study was to investigate whether regional (trunk, appendicular, epicardial) fat distribution and extent could be related to hypertrophy severity and pattern in HCM.MethodsCardiovascular magnetic resonance was performed in 32 subjects with echocardiography-based diagnosis of HCM (22M/10F, 57.2±12.6 years) characterized by predominant hypertrophy at the interventricular septum (IVS). Regional fat distribution was assessed by dual-energy X-ray absorptiometry.ResultsGender differences were detected in maximum IVS thickness (M: 18.3±3.8 mm vs. F: 14.3±4 mm, p = 0.012), right ventricle (RV) systolic function (M: 61.3±6.7%; F: 67.5±6.3%, p = 0.048), indexed RV end-diastolic (M: 64.8±16.3 ml/m2; F: 50.7±15.5 ml/m2, p = 0.04) and end-systolic volumes (M: 24.3±8.3 ml/m2; F: 16.7±7.4 ml/m2, p = 0.04). After adjusting for age and gender, maximum IVS thickness was associated with truncal fat (Tr-FAT) (β = 0.43, p = 0.02), but not with either appendicular or epicardial fat. Epicardial fat resulted independently associated with NT-proBNP levels (β = 0.63, p = 0.04). Late Gadolinium Enhancement-positive subjects displayed greater maximum IVS thickness (p = 0.02), LV mass index (p = 0.015) and NT-proBNP levels (p = 0.04), but no associations with fat amount or distribution were observed.ConclusionTruncal, but not appendicular or epicardial fat amount, seems to be related with maximum IVS thickness, the hallmark feature in our cohort of HCM patients. Further prospective researches are needed to assess a potential causative effect of central adiposity on HCM phenotype.

Cardiac Systolic and Diastolic Function can be Improved and Epicardial Fat be can Decreased Over a Very Short Period of Time in Obese Patients without Heart Disease by the Very Low Calorie Diet

The objective of the study was to evaluate the effect of an eight week period of very low calorie diet (VLCD) on heart function and amount of epicardial adipose tissue in obese people without heart disease. Methods: Fifty-two obese patients (38 women, 14 men, mean age 47.6 ± 12.3 years, mean BMI 46.2±7.0 kg/m2) were assigned to a VLCD enriched with vegetables for eight weeks. Transthoracic echocardiography was performed before and after the diet period. Left ventricular size, ejection fraction, diastolic function, left and right ventricular myocardial performance index (MPI) and thickness of epicardial adipose tissue were measured. Heart rate, blood pressure and plasma glucose and triglyceride concentration were also analysed. Results: During the diet period the BMI decreased from 46.2±7.0 kg/m2 to 41.8± 6.1 kg/m2 (p<0.0001). The left ventricular MPI decreased from 0.42± 0.07 to 0.37± 0.07 (p<0.0001) and right ventricular MPI decreased from 0.30± 0.09 to 0.27± 0.09 (p=0.0256) showing significant systolic and diastolic improvement in the performance of both ventricles. The thickness of epicardial fat decreased from 4.4±1.5 mm to 3.4±1.4 mm (p<0.0001). The heart rate decreased from 75.8±9.7 beats/min to 67.0 ±10.3 beats/min (p<0.0001) and the systolic blood pressure decreased from 140±14.3 mmHg to 135.2±10.6 mmHg (p=0.0087). The plasma glucose concentration decreased from 6.71±1.96 mmol/l to 6.02±1.59 mmol/l (p<0.0001). The plasma triglyceride concentration decreased from 1.77±0.89 mmol/l to 1.36±0.68 mmol/l (p=0.0002). Conclusion: VLCD caused during only eight weeks period significant reduction in BMI as well as in the amount of epicardial fat and significant improvement in the systolic and diastolic function of both ventricles in obese persons.

Relationship Between Neck Circumference and Epicardial Fat Thickness in a Healthy Male Population.

Background:Epicardial fat is an upper body visceral fat depot that may play a significant role in the development of adverse metabolic and cardiovascular risk profiles. There is a significant direct relationship between the amount of epicardial fat and general body adiposity (body mass index, BMI), but data regarding subcutaneous adiposity is limited.Objective:We conducted a study to determine the association between neck circumference and epicardial fat thickness in healthy young male individuals, and assess their individual correlations with general body adiposity and cardiometabolic risk factors.Methods:One hundred consecutive male patients aged 18 years or older with no known major medical conditions were included in the study. All participants underwent detailed physical examination including measurement of blood pressure, weight, height, waist/hip ratio, and neck circumference. Blood was collected to determine fasting glucose and lipid parameters. A standard echocardiographic examination was performed with additional epicardial fat thickness determination.Results:Among 100 study participants, neck circumference correlated significantly with weight, waist circumference, BMI, blood glucose, serum total cholesterol, low-density (LDL)-cholesterol, and triglycerides levels. No significant correlation was found between neck circumference and high-density lipoprotein (HDL)-cholesterol levels. Neck circumference correlated moderately and positively with echocardiographic epicardial fat thickness.Conclusion:Among patients with low cardiometabolic risk, increased neck circumference was associated with increased epicardial fat thickness.

Relationships between total and regional adiposity and epicardial fat in obese women: how can dual-energy X-ray absorptiometry be associated with echocardiographic epicardial fat measurements?

Obesity is an increasingly prevalent metabolic disorder and it is associated with a large number of comorbidities, including cardiovascular diseases. Adipose tissue is an active endocrine organ and its ectopic depots and distribution have different metabolic meanings on risks for health; as a matter of fact, epicardial fat seems to play a specific role in cardiovascular diseases. The use of dual-energy X-ray absorptiometry (DXA) to evaluate and follow-up patients affected by obesity is becoming a very important point in the management of the disease. An investigation of the association between epicardial fat and regional adiposity by DXA in female obese patients. The total amount of central (trunk) fat mass is more strongly correlated than android visceral fat mass to epicardial thickness in obese women. In the interpretation of whole-body DXA data, physician should consider trunk fat mass for good and independent predictivity on epicardial fat depots. Our aim was to analyse in a population of obese women the relationship between the amount of epicardial fat as measured by transthoracic echocardiography (US) and the parameters of regional adiposity by dual-energy X-ray absorptiometry (DXA), with particular reference to a new software for visceral fat assessment and to a new 'heart-suited' regions of interests (ROIs). Sixty patients who satisfied technical inclusion criteria underwent whole-body DXA scan and US on the same day. Total and android fat mass (FM) and FM percentage (FM%) were considered as well as visceral fat (VAT) subcompartment in the android region; moreover, six new ROIs were designed on whole-body DXA images for the investigation of adiposity parameters at heart level. US provided epicardial fat thickness (EPI-thickness) and area (EPI-area), as measured following previously validated methods. Body mass index (BMI), gynoid and lower limbs (FM and FM%) were found not statistically correlated with EPI-thickness. The highest correlation was achieved by trunk FM (and FM%, with r = 0.544 and 0.480 respectively, P < 0.001), followed by ROI-1 FM (ROI-1 was drawn following thoroughly the cardiac profile), and android FM. Multivariate analysis including age, weight, BMI, trunk FM and the new ROIs (added one by one), retained in the final model trunk FM. Correlations of DXA with EPI-area were superimposable. In obese women, VAT or other new-designed ROIs are not better correlated than traditional ROIs (i.e. trunk) with epicardial fat amount.

Adipocytokines modulate ionic currents – A key to lipotoxicity potentiated cardiac arrhythmia

Obesity with excessive fat was an important risk factor for the occurrence or progression of cardiac arrhythmia. As compared to abdominal fat, the amount of epicardial fat more correlates with the occurrences of atrial fibrillation, which suggests the distinctive arrhythmogenic effects of epicardial fat. Adipose tissue secrets numerous adipocytokines, thus epicardial fat may have more cardiac effects than other body fat [1]. Adipocytokines can enhance local inflammation and generate myocardial remodeling, which play a role in the pathophysiology of arrhythmia. Fatty infiltration or fatty metamorphosis can induce abnormal automaticity from degenerated myocardial cells. Adipose tissues also serve as obstacles for an activation wave front or by producing atrial fibrosis, which may interfere with atrial conduction and enhance the generation of reentry circuits. Lee et al. investigated the effects of adipocytokines from different body fats on delayed rectifier K outward currents (IKr) in cardiomyocytes [2]. In their study, H9c2 cells were treated with adipocytokine-free medium (the Adipo-free group), and with adipocytokines from rat epicardial (central fat group) or limb (peripheral fat group) fat tissues. They found that adipocytokines significantly decreased IKr in H9c2 cells, and IKr was more prominently decreased by adipocytokines from epicardial fat than from limb fat. Although the mechanisms were not fully elucidated, Lee et al. pointed out the direct electrophysiological effects of adipocytokines and also demonstrated stronger ionic effects of epicardial fat than other body fat. Decreased IKr can prolong action

Is the Measurement of Epicardial Fat in Obese Adolescents Valuable?

Is the Measurement of Epicardial Fat in Obese Adolescents Valuable?

Epicardial fat: properties, function and relationship to obesity

Epicardial fat is a relatively neglected component of the heart. The purpose of this review was to examine the anatomic and biochemical data on epicardial fat; to examine the relationship of epicardial fat to obesity and to explore the potential role of epicardial fat in the relationship of obesity to coronary atherothrombotic disease. Epicardial fat covers 80% of the heart's surface and constitutes 20% of total heart weight. It is present along the distribution of the coronary arteries, over the right ventricle especially along the right border, anterior surface and at the apex. There is three- to fourfold more epicardial fat associated with the right than the left ventricle. Putative physiologic functions of epicardial fat are based on observational data and include: buffering coronary arteries against the torsion induced by the arterial pulse wave and cardiac contraction, facilitating coronary artery remodelling, regulating fatty acid homeostasis in the coronary microcirculation and providing fatty acids to cardiac muscle as a local energy source in times of high demand. A considerable amount of the data on epicardial fat originates from autopsy series that have the inherent problem that conditions leading to death may have altered body composition and adiposity. With this caveat, data indicate that epicardial fat mass increases age until age 20-40 years but thereafter the amount of epicardial fat is not dependent on age. The amount of epicardial fat correlates with heart weight but the presence of myocardial ischemia and hypertrophy does not alter the ratio of epicardial fat to cardiac muscle mass. A number of properties differentiate epicardial fat from other fat depots specifically its smaller adipocytes size; different fatty acid composition, high protein content; high rates of fatty acid incorporation, fatty acid synthesis, insulin-induced lipogenesis or fatty acid breakdown; low rates of glucose utilization, low expression (mRNA) of lipoprotein lipase, stearoyl-CoA desaturase and acetyl-CoA carboxylase-alpha, and slow regression during weight loss. There is a significant direct relationship between the amount of epicardial fat and general body adiposity. Clinical imaging studies have demonstrated a strong direct correlation between epicardial fat and abdominal visceral adiposity. Several lines of evidence support a role for epicardial fat in the pathogenesis of coronary artery disease, namely the close anatomic relationship between epicardial fat and coronary arteries; the positive correlation between the amount of epicardial fat and the presence of coronary atherosclerosis and the ability of adipose tissue to secrete hormones and cytokines that modulate coronary artery atherothrombosis. Thus, epicardial fat maybe an important factor responsible for cardiovascular disease in obesity.

Some factors affecting right and left atrial weights and volumes and total heart weight.

SUMMARYThe hearts from 156 patients who came to routine hospital autopsy were examined. The amount of epicardial fat was assessed by macroscopic examination, the amount of atrial fat was assessed by microscopic examination and the thickness of the body fat was measured at the midline ventral incision. The patient's age, sex, and height were recorded, and the degree of rigor mortis of the heart assessed. The hearts were weighed, the volume of each atrium was measured, and the atria were individually dissected and weighed.Correlations were sought between atrial weights and volumes and the patient's age, sex, height, amount of body and heart fat, and the degree of rigor mortis of the heart.The total heart weight, both atrial weights and both atrial volumes were greater for males than for females. For each sex the right atrial volume was significantly greater than the left atrial volume, but right and left atrial weights did not differ significantly. Significant positive correlations existed between right and left atrial weights. For both sexes, also, each atrial weight was correlated with its corresponding atrial volume.For males, atrial magnitudes were positively correlated with body height and with the thickness of body fat. For females, left atrial volumes only were positively correlated with the thickness of body fat, and there were no positive correlations with height. For females, but not for males, both atrial weights were positively correlated with age. The total heart weight for males was greatest in taller, fatter subjects, but for females it was greatest in shorter, fatter subjects. For both sexes, atrial magnitudes correlated positively with total heart weight, independently of the amount of heart fat. The amount of epicardial fat (assessed by macroscopic examination) was positively correlated with the thickness of subcutaneous fat, while the amount of atrial fat (assessed by microscopic examination) was not.