Epicardial Adipose Tissue Thickness Research Articles

The relationship between quantitative epicardial adipose tissue based on CT and coronary artery disease: A protocol for systematic review and meta-analysis.

Background:Epicardial adipose tissue (EAT) is a kind of visceral adipose tissue with close proximity to coronary artery and myocardium, which can secrete cell factor, and influence the physiological function and pathophysiological process of myocardium and coronary artery. Clinical imaging diagnosis showed that the volume and thickness of EAT exists a certain relevance with coronary artery disease, but it lacked evidence of evidence-based medicine. The research on the implementation of this program will systematically evaluate the relationship of computed tomography (CT) quantitative EAT and coronary artery disease.Method:The English databases (Embase, PubMed, the Cochrane Library, Web of Science) and Chinese database (CNKI, Wanfang, China biomedical database, VIP) of computer retrieval has collected the case control clinical study of relationship between EAT and coronary artery disease from the establishment of the database to October 2020, which was conducted extraction and quality evaluation by 2 researchers independently for data included in the study, and was conducted Meta-analysis for the included literature by adopting RevMan5.3 software.Result:The research evaluated the correlation between EAT and coronary artery disease through the EAT thickness, EAT volume, and other indexes.Conclusion:The research has provided reliable evidence-based evidence for the correlation between CT EAT quantification and coronary artery disease.Ethics and dissemination:We will not publish private information from individuals. This kind of systematic review does not involve harming the rights of participants. No ethical approval was required. The results can be published in peer-reviewed journals or at relevant conferences.OSF Registration number:DOI 10.17605/OSF.IO/DVQNE

A Meta-Analysis of Different Types of Cardiac Adipose Tissue in HIV Patients.

Background Antiretroviral therapy transformed HIV infection into a chronic disease but accelerated cardiovascular disease (CVD). Both of epicardial adipose tissue (EAT) and pericardial fat (PCF) have close relationships with CVD. The associations between these two cardiac adipose tissue and HIV are unclear. Methods Eligible studies were searched in PubMed, Embase, Web of Science, and Scopus from database inception to March 24, 2020. The summarized standard mean difference (SMD) or weighted mean difference (WMD) with 95% confidence intervals (CIs) was used to assess the association between EAT/PCF and HIV. Subgroup analysis was performed based on EAT types. Trial sequential analysis was conducted to estimate whether the evidence of the results is sufficient. Results In total, 2561 HIV patients and 1767 non-HIV participants were included. Compared to the control group, EAT was significantly higher in the HIV overall group and subgroup with EAT thickness (SMD = 0.59, 95% CI: 0.24–0.95, P = 0.001; SMD = 1.10, 95% CI: 0.41–1.79, P = 0.002); however, the EAT volume and PCF volume were unchanged in the HIV group (SMD = 0.16, 95% CI: -0.07–0.39, P = 0.169; WMD = 10.78, 95% CI: -14.11–35.67, P = 0.396). Trial sequential analysis indicated that the available samples were sufficient in the HIV overall group and subgroup with EAT thickness, and more studies are needed for EAT volume and PCF volume. Conclusions EAT thickness was significantly higher in patients with HIV. The association between EAT/PCF volume and HIV needs more studies to confirm.

Epicardial adipose tissue thickness as a potential predictor of pre-eclampsia.

Pre-eclampsia (PE) is a leading cause of maternal and fetal morbidity and mortality. Our aim was to assess epicardial adipose tissue (EAT) thickness as a potential effective screening parameter to predict PE in the first trimester. 133 women with PE were enrolled in this study, and divided into the early-onset and late-onset subgroups. 150 healthy women were enrolled as control group. Anthropometric and echocardiographic parameters were obtained, including EAT thickness. Generalized linear models was used to assess the predict efficiency of EAT with fdds ratio (OR) and 95% confidence intervals (CIs). Compared to the controls, EAT thickness was higher in PE patients (P<0.05). Multivariate regression analysis indicated that EAT thickness was associated with PE risk (OR=1.50, 95%CI: 1.19-1.88, P<0.05). The area under curves of EAT thickness was 0.616. When the cutoff value for EAT thickness was set to 5.26mm, the sensitivity was 78.2% and the specificity was 44.7%. EAT thickness significantly both higher in the early-onset and late-onset groups compared to the controls; Meanwhile, EAT thickness was higher in the early-onset group than late-onset group (P<0.05). Logistic regressionrevealed the close relationship between onset time of PE and EAT thickness (OR=1.59, 95%CI: 1.28-1.98, P<0.001). Measured EAT thickness using echocardiography could identify high-risk people for PE as early as the first trimester. Echocardiographic EAT has the potential to be a predictor for PE prior to actual clinical diagnosis.

Correlation of epicardial adipose tissue and skinfold thickness in professional male soccer players

Correlation of epicardial adipose tissue and skinfold thickness in professional male soccer players

Increased Epicardial Fat Tissue is Predictor for Patients with Ischemia and No Obstructive Coronary Artery Disease

Background: Epicardial adipose tissue (EAT) may play a vital role in the progression of ischemia and no obstructive coronary artery disease (INOCA). CT can achieve a precise quantification of EAT for its higher spatial resolution compared to other methods. Objectives: This study aimed at exploring EAT in patients with INOCA, and its associations with other clinical factors. Patients and Methods: From January 2017 to October 2018, a total of 254 consecutive patients suspected with coronary atherosclerotic disease (CAD) underwent cardiac computed tomography angiography (CCTA). There were 195 patients who were excluded for obstructive CAD by CCTA analysis and CT derived fractional flow reserve (CT-FFR) (≤ 0.80). Seventy-two patients with either angina and/or signs of ischemia but without obstructive CAD were recruited as INOCA group. Forty-eight controls without angina and risk factors for INOCA were enrolled as the control group. EAT volume and thickness, and other factors were analyzed in INOCA and control groups. Results: Despite similar body mass index (BMI), EAT thickness and volume were significantly elevated in INOCA patients compared with the control group (P &lt; 0.001). Receiver operating characteristic curve analysis for identifying INOCA exhibited a higher area under the curve of EAT volume (0.773, 95%CI 0.616-0.930) than EAT thickness (0.692, 95%CI 0.597-0.786). The cut-off values for EAT thickness and volume were 3.2 mm and 179.6 cm3, respectively. Presence of hypertension, triglyceride levels, and EAT thickness and volume were significantly associated with INOCA and slightly affected by other factors in multiple logistic regression analysis. Conclusion: INOCA patients have more EAT compared with controls. EAT is a marker of INOCA and may be a predictor of pharmacological therapy and a prognostic indicator. Further research should focus on the myocardial microcirculation changes by EAT volume reduction.

Evaluation of Atrial Conduction Times and Epicardial Adipose Tissue Thickness in Patients with Ankylosing Spondylitis

Evaluation of Atrial Conduction Times and Epicardial Adipose Tissue Thickness in Patients with Ankylosing Spondylitis

Epicardial adipose tissue predicted prolonged QTc interval in patients with arterial hypertension

ABSTRACT Introduction: It is important to identify those at higher risk for ventricular arrhythmia among hypertensive patients. Epicardial adipose tissue (EAT) leads to electromechanical changes in the heart by endocrine and paracrine effects with cytokines and mediators. Higher amount of EAT carries the risk of QT prolongation. Therefore, we investigated the association between EAT thickness and QTc interval in patients with arterial hypertension. Methods: A total of 230 patients who previously diagnosed with arterial hypertension between February 2019 to March 2020 were included in the study. Patients with atrial fibrillation, U-wave, atrioventricular block, left anterior or posterior fascicular block, right bundle branch block, left bundle branch block, and taking QT-prolonging medication were excluded. The corrected QT (QTc) interval was calculated with Bazzet’s formula following the calculated QT interval in the semi-automatic application tool. EAT was measured at the point on the free wall of the right ventricle using transthoracic echocardiography. Results: The mean age was 62.1 ± 11.4 years and 95 (41.3%) of the patients were male. QTc was over 450 ms were considered as the prolonged interval. Both groups were similar in terms of age (p = .862), gender (p = .265) and other demographic characteristics. Left ventricle mass index (LVMI) (82.5 ± 29.5 vs 91.9 ± 32.6 g/1.7.m2, p = .051) and EAT thickness (5.3 ± 2.3 vs 6.6 ± 2.6 mm, p = .001) were higher in the prolonged QTc group. Serum potassium (K) level was lesser in the prolonged QTc group (4.2 ± 0.39 vs 4.1 ± 0.4 mmol/mL, p = .005). Multivariate Cox regression analysis revealed that EAT thickness [OR = 1.227, 95% CI: 1.081–1.393, p = .002] and serum K level [OR = 0.348, 95% CI: 0.157–0.772, p = .009] predicted the prolonged QTc interval, independently. Conclusion: EAT thickness predicted prolonged QTc interval in patients with arterial hypertension. Patients with higher amount of EAT should be followed by closely monitoring to prevent arrhythmic events that may develop in the future. In addition, medications that have a potential effect on QTc interval prolongation may be carefully used in patients with higher EAT thickness.

Reduction of epicardial adipose tissue thickness with PCSK9 inhibitors

Abstract Introduction Epicardial adipose tissue (EAT) is clinically related to atherosclerosis and increased cardiovascular risk. The proprotein convertase subtilisin/kexin type 9 inhibitors (IPCSK9) are a novel group of effective drugs for lowering LDL cholesterol and cardiovascular events, however their effect on EAT has not yet been determined. Objective To assess the effect of treatment with PCSK9 inhibitors on epicardial adipose tissue. Methods The study enrolled 41 patients under treatment with PCSK9 inhibitors. At the end of the study only 24 patients were included, who were measured thickness of epicardial adipose tissue (TEAT) by transthoracic echocargiogram (just an echocardiographer using Siemens Acuson SC 2000 Prime with two-dimensional 4V1c transducer in two projections: long parasternal axis in the pericardial space of the outer edge of the myocardium above the right ventricle and in a short parasternal axis at the height of papillary muscles on the right ventricle, in telesystole and averaging three measurements; It was measured in millimeters.) using in 2 times before and after 6 months of initiation of treatment. Results Of 24 patients, 16 patients recieved evolocumab and 8 alirocumab patients; the mean TEAT pre-treatment and post-treatment was 6.84 mm (1.97) and 5.41 mm (1.86), respectively (p=0.0001); The mean percentage of change of the TEAT after 6 months of treatment was −20.39 (17.20). The mean serum LDL cholesterol levels pre-treatment and post-treatment were 188.04 mg/dL (144.0) and 94.96 mg/dL (106.04), respectively (p=0.0001); The mean change in LDL cholesterol was −51.89 (22.81). Just one patient had myocardial infarction. There was no difference between the means of reducing the percentage of change in epicardial adipose thickness between evolocumab and alirocumab. There was no correlation between lipid decrease and TEAT. Conclusion There is a significant reduction after 6 months of treatment with PSCK9 inhibitors in thickness of epicardial adipose tissue. Effect of IPCSK9 in TEAT and Lipids Funding Acknowledgement Type of funding source: None

Impact of epicardial adipose tissue increase after ST elevation Myocardial Infarction (STEMI) on IL-13 and left ventricular remodelling

Abstract Background The role of epicardial adipose tissue (EAT) in myocardial diseases is well established, and several evidence suggest that EAT may negatively affect left ventricular (LV) remodelling through an imbalanced production and secretion of pro and anti-inflammatory cytokines. Of these, the IL-13 it is known to play a positive activity on cardiac remodelling. Nowadays, the crosstalk between EAT and the myocardium is still poorly understood and the effects of myocardial ischemia on morphological and functional properties of EAT are almost unknown. Purpose In the present study we explored whether an increase of EAT thickness after STEMI might be associated with unfavourable LV remodelling at 3 months (T1). We also evaluated the relationship between changes (Δ) of EAT thickness and systemic levels of Interleukin (IL)-13 which is known to play a favourable activity on LV remodelling after STEMI. Methods We enrolled 66 patients with first STEMI, undergoing primary percutaneous angioplasty. At baseline and at 3 months we performed a complete echocardiogram, including EAT maximal thickness assessment, and determined circulating levels of IL-13. Results At 3 months after STEMI, the population was stratified into two groups according to different EAT remodelling after cardiac event: Group 1, patients with an increased EAT thickness (Δ EAT&amp;gt;1; 30 patients) and Group 2, patients with unchanged or decreased EAT thickness (Δ EAT&amp;lt;1). The two groups did not differ for age, gender and atherosclerotic risk factors. Group 1 had a worse LV remodelling at 3 months with higher LV diastolic and systolic volumes, lower LV ejection fraction (p=0.003; p=0.013; p=0.013 respectively) and worse diastolic function (E/e'; p=0.011). Of interest, EAT thickness increase was paralleled by circulating IL-13 reduction (p=0.022). Conclusion Myocardial injury can result in EAT increase which is associated to worse LV remodelling probably through the loss of the protective role of IL-13. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This research has been funded by the University of Naples “Federico II” and “Compagnia di San Paolo e l'Istituto Banco di Napoli” within the competitive grant STAR 2018; Valentina Parisi is the principal investigator

Dysregulation of epicardial adipose tissue in cachexia due to heart failure: the role of natriuretic peptides and cardiolipin.

BackgroundCachexia worsens long‐term prognosis of patients with heart failure (HF). Effective treatment of cachexia is missing. We seek to characterize mechanisms of cachexia in adipose tissue, which could serve as novel targets for the treatment.MethodsThe study was conducted in advanced HF patients (n = 52; 83% male patients) undergoing heart transplantation. Patients with ≥7.5% non‐intentional body weight (BW) loss during the last 6 months were rated cachectic. Clinical characteristics and circulating markers were compared between cachectic (n = 17) and the remaining, BW‐stable patients. In epicardial adipose tissue (EAT), expression of selected genes was evaluated, and a combined metabolomic/lipidomic analysis was performed to assess (i) the role of adipose tissue metabolism in the development of cachexia and (ii) potential impact of cachexia‐associated changes on EAT‐myocardium environment.ResultsCachectic vs. BW‐stable patients had higher plasma levels of natriuretic peptide B (BNP; 2007 ± 1229 vs. 1411 ± 1272 pg/mL; P = 0.010) and lower EAT thickness (2.1 ± 0.8 vs. 2.9 ± 1.4 mm; P = 0.010), and they were treated with ~2.5‐fold lower dose of both β‐blockers and angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers (ACE/ARB‐inhibitors). The overall pattern of EAT gene expression suggested simultaneous activation of lipolysis and lipogenesis in cachexia. Lower ratio between expression levels of natriuretic peptide receptors C and A was observed in cachectic vs. BW‐stable patients (0.47 vs. 1.30), supporting activation of EAT lipolysis by natriuretic peptides. Fundamental differences in metabolome/lipidome between BW‐stable and cachectic patients were found. Mitochondrial phospholipid cardiolipin (CL), specifically the least abundant CL 70:6 species (containing C16:1, C18:1, and C18:2 acyls), was the most discriminating analyte (partial least squares discriminant analysis; variable importance in projection score = 4). Its EAT levels were higher in cachectic as compared with BW‐stable patients and correlated with the degree of BW loss during the last 6 months (r = −0.94; P = 0.036).ConclusionsOur results suggest that (i) BNP signalling contributes to changes in EAT metabolism in cardiac cachexia and (ii) maintenance of stable BW and ‘healthy’ EAT‐myocardium microenvironment depends on the ability to tolerate higher doses of both ACE/ARB inhibitors and β‐adrenergic blockers. In line with preclinical studies, we show for the first time in humans the association of cachexia with increased adipose tissue levels of CL. Specifically, CL 70:6 could precipitate wasting of adipose tissue, and thus, it could represent a therapeutic target to ameliorate cachexia.

Epicardial Adipose Tissue and IL-13 Response to Myocardial Injury Drives Left Ventricular Remodeling After ST Elevation Myocardial Infarction.

IntroductionLeft ventricular (LV) remodeling after ST-segment elevation myocardial infarction (STEMI) is explained only in part by the infarct size, and the inter-patient variability may be ascribed to different inflammatory response to myocardial injury. Epicardial adipose tissue (EAT) is a source of inflammatory mediators which directly modulates the myocardium. EAT increase is associated to several cardiovascular diseases; however, its response to myocardial injury is currently unknown. Among inflammatory mediators, IL-13 seems to play protective role in LV regeneration, but its variations after STEMI have not been described yet. Purpose: In the present study we analyzed the association between infarct-related changes of EAT and IL-13 in post-STEMI LV remodeling.MethodsWe enrolled 100 patients with STEMI undergoing primary angioplasty. At the enrolment (T0) and after 3 months (T1), we measured EAT thickness by echocardiography and circulating levels of IL-13 by ELISA.ResultsAt T1, the 60% of patients displayed increased EAT thickness (ΔEAT > 0). ΔEAT was directly associated to LV end-diastolic volume (r = 0.42; p = 0.014), LV end-systolic volume (r = 0.42; p = 0.013) and worse LV ejection fraction (LVEF) at T1 (r = −0.44; p = 0.0094), independently of the infarct size. In the overall population IL-13 levels significantly decreased at T1 (p = 0.0002). The ΔIL-13 was directly associated to ΔLVEF (r = 0.42; p = 0.017) and inversely related to ΔEAT (r = −0.51; p = 0.022), thus suggesting a protective role for IL-13.ConclusionThe variability of STEMI-induced “inflammatory response” may be associated to the post-infarct LV remodeling. ΔEAT thickness and ΔIL-13 levels could be novel prognostic markers in STEMI patients.

Assessment of arterial stiffness and epicardial adipose tissue thickness in predicting the subclinical atherosclerosis in patients with ankylosing spondylitis

ABSTRACT Objective Atherosclerosis is a chronic, progressive, inflammatory disease. Recognition of subclinical atherosclerotic vascular changes before clinical manifestation in an asymptomatic population is important for risk stratification and optimal management, which finally leads to the prevention of cardiovascular disease. We aimed to determine the risk of premature subclinical atherosclerosis by evaluating epicardial adipose tissue thickness (EATT) and arterial stiffness parameters in patients with ankylosing spondylitis (AS). Methods We performed a prospective study of 60 consecutive patients meeting modified New York criteria for AS compared to 60 controls matched for age and sex. Patients with traditional cardiovascular risk factors were excluded. Arterial stiffness parameters and EATT (examined via echocardiography) values of all patients and control groups were measured. Results There was no difference between basal characteristic and echocardiographic parameters in patients with AS and in the control group. EATT and pulse wave velocity (PWV) were higher in the AS patients compared to the control group. EATT was 5.74 ± 1.22 mm and 4.91 ± 1.21 mm (p < .001) and PWV was 9.90 ± 0.98 m/s and 6.46 ± 0.83 m/s (p = .009) in the AS and control groups, respectively. Also, PWV was significantly correlated with EATT, age, and central blood pressure in patients with AS. Conclusions EATT and PWV, markers of atherosclerosis and cardiovascular disease, were significantly higher in patients with AS than the control group. In addition, in this study, it has been shown that there is a significant relationship between PWV and EATT in patients with AS.

The Association of CT-measured Cardiac Indices with Lung Involvement and Clinical Outcome in Patients with COVID-19

Rationale and ObjectivesCardiac indices can predict disease severity and survival in a multitude of respiratory and cardiovascular diseases. Herein, we hypothesized that CT-measured cardiac indices are correlated with severity of lung involvement and can predict survival in patients with COVID-19.Materials and MethodsEighty-seven patients with confirmed COVID-19 who underwent chest CT were enrolled. Cardiac indices including pulmonary artery-to-aorta ratio (PA/A), cardiothoracic ratio (CTR), epicardial adipose tissue (EAT) thickness and EAT density, inferior vena cava diameter, and transverse-to-anteroposterior trachea ratio were measured by non-enhanced CT. Logistic regression and Cox-regression analyses evaluated the association of cardiac indices with patients' outcome (death vs discharge). Linear regression analysis was used to assess the relationship between the extent of lung involvement (based on CT score) and cardiac indices.ResultsMean (±SD) age of patients was 54.55 (±15.3) years old; 65.5% were male. Increased CTR (>0.49) was seen in 52.9% of patients and was significantly associated with increased odds and hazard of death (odds ratio [OR] = 12.5, p = 0.005; hazard ratio = 11.4, p = 0.006). PA/A >1 was present in 20.7% of patients and displayed a nonsignificant increase in odds of death (OR = 1.9, p = 0.36). Furthermore, extensive lung involvement was positively associated with elevated CTR and increased PA/A (p = 0.001).ConclusionCT-measured cardiac indices might have predictive value regarding survival and extent of lung involvement in hospitalized patients with COVID-19 and could possibly be used for the risk stratification of these patients and for guiding therapy decision-making. In particular, increased CTR is prevalent in patients with COVID-19 and is a powerful predictor of mortality.

Cardiovascular Risk and Quality of Life in Autosomal Dominant Polycystic Kidney Disease Patients on Therapy With Tolvaptan: A Pilot Study.

Cardiovascular (CV) complications are the most frequent cause of morbidity and mortality in autosomal dominant polycystic kidney disease (ADPKD) patients. In 2017, the Italian Medicines Agency authorised tolvaptan, a vasopressin V2 receptor antagonist, for the treatment of ADPKD, based on the Tolvaptan Phase 3 Efficacy and Safety Study in ADPKD (TEMPO 3: 4), TEMPO 4: 4 and Replicating Evidence of Preserved Renal Function: An Investigation of Tolvaptan Safety and Efficacy (REPRISE) studies. The aim of the study was to assess the impact of tolvaptan on CV risk and quality of life, evaluated by nutritional, inflammatory, metabolic, instrumental parameters and psychocognitive tests on ADPKD patients. We evaluated 36 patients with ADPKD; 10 patients (7 males, mean age 42.5±7.0 years) treated with tolvaptan and 26 controls (11 males, mean age 36.7±9.1 years). They underwent, at T0, monthly, and at T1 (1 year) clinical, laboratory and instrumental evaluation, in addition to psychocognitive tests. In ADPKD patients treated with tolvaptan, we found at T1, a decrease in carotid intima-- media thickness (p=0.048), epicardial adipose tissue thickness (p=0.002), C-reactive protein (p=0.026), sympathovagal balance during night (p=0.045) and increased flow-mediated dilation (p=0.023) with a reduction in depression (Hamilton and Beck tests, p=0.008 and p=0.002, respectively) compared with controls. These preliminary results suggest that treatment with tolvaptan could improve early atherosclerosis and endothelial dysfunction markers and improve mood in ADPKD patients (probably by acting on endothelial cell and adipocyte V2 receptors).

The relationship of the epicardial fat and adipo-fibrokines in myocardial infarction.

Analysis of the relationship between the epicardial fat with adipokine and system ST2/IL-33 in-hospital period, and also with the extent of fibrosis of the atrial myocardium through the year after myocardial infarction in patients with visceral obesity. Examined 88 patients with myocardial infarction (MI). Visceral obesity (VO) is established by computed tomography. In fact the presence VO the patients divided into two groups. Determined the concentration of leptin, adiponectin, stimulating growth factor (ST-2) and interlekin-33 (IL-33) in serum on 1st, 12-day in-hospital period and 1 year after MI. Thickness epicardial adipose tissue (EAT) and the percentage of cardiovirus of the myocardium was measured by the method MRI, respectively, on the 12th day of hospitalization and a year after MI. The control group consisted of 30 people. Statistical analysis of data was performed using nonparametric tests. Patients with MI is associated with an increase in the thickness of EAT, imbalance of adipokines with increased leptin, decreased adiponectin in early in-hospital period and development of cardiovirus. Higher values of IL-33 and ЅT2 in the early in-hospital period MI patients with no accompanied by a lower prevalence of cardiovirus in the post-hospital period. The thickness of epicardial fat is directly dependent on the prevalence of myocardial fibrosis, the concentrations of IL-33 and in inverse proportion to the concentration of ЅT2. The degree of cardiovirus is in inverse proportion to the concentration of IL-33 and directly dependent on the concentration of ST2. The increase in EAT closely linked to the development of fibrosis of the atrial myocardium after year. The thickness of EAT more patients MI, which is most pronounced imbalance of adipokines. The metabolic activity of EAT correlated with increased IL-33 and ST2 decrease.

Association between Epicardial Adipose Tissue Thickness and Left Ventricular Diastolic Functions

Objective: Epicardial adipose tissue (EAT) has been found to be associated with the diastolic dysfunction in recent years, but this relationship has not been fully elucidated. Echocardiography is a non-invasive, simple, cost effective and accessible approach to assess EAT thickness, which can be performed easily. The aim of this study was to evaluate the effectiveness of EAT on prediction of diastolic dysfunction . Materials and Methods: A total of 138 patients without any cardiovascular, inflammatory, autoimmune and cancer disease, were enrolled. Our study was performed in the Cardiology clinic of Sakarya University Training and Research Hospital between May 2019 and December 2019. Subjects were divided into two groups, those with and without diastolic dysfunctions . Conventional echocardiography parameters and tissue Doppler imaging (TDI) were performed to evaluate left ventricular functions. EAT thickness on the free wall of the right ventricle in parasternal long-axis view were measured using transthoracic echocardiography. Results: In comparison with the non- diastolic dysfunction group, patients with diastolic dysfunction had significantly higher epicardial fat thickness (5.98±1.52 mm vs 4.32±1.03 mm; p<0.001). The multivariate regression analysis indicated that EAT independently predicts diastolic dysfunction (OR, 0.278, 95%CI 0.396 to 1.400) Conclusions: According to the findings of this study, EAT thickness is an independent predictor for the development of diastolic dysfunction in patients without cardiovascular disease.

Increased Epicardial Adipose Tissue is Associated with the Extent of Aortic Dissection

BackgroundEpicardial adipose tissue (EAT) is a biologically active organ that has endocrine and paracrine functions. Endothelial dysfunction, systemic, and local inflammatory response, due to bio-active molecules produced by EAT, may affect aortic dissection propagation and extent. We investigated the association between EAT thickness and the extent of aortic dissection.MethodsWe retrospectively enrolled 78 patients with aortic dissection diagnosed by thoracoabdominal Computerized Tomography (CT). EAT was measured from the thickest part of the perpendicular plane between the pericardium and free wall of the right ventricle using CT. Aortic dissection length was measured from the beginning to the end of the dissection flap at sagittal images.ResultsWe included 78 patients with the mean age of 63.9 ± 11.7 and 57 (73.5%) patients were male. Dissection length was correlated positively with EAT (r = 0.409, p < 0.001), body mass index (r = 0.408, p = 0.018), and admission systolic blood pressure (r = 0.830, p = 0.026) whereas an inverse correlation existed between age and dissection length (r = −0.318, p = 0.005). Multivariate analysis identified age and EAT as independent predictors of dissection length.ConclusionIncreased EAT was independently associated with the extent of aortic dissection. We think that either paracrine and endocrine functions of EAT might have contributed to the extent of aortic dissection.

Macrophage Accumulation and Angiogenesis in Epicardial Adipose Tissue in Cardiac Patients with or without Chronic Heart Failure

Routinely measuring epicardial fat had become a novel tool for cardiovascular risk stratification. Structural changes in epicardial adipose tissue (EAT), including fat thickness, inflammation, and angiogenesis, have been described in coronary artery disease (CAD) patients. We proposed to measure EAT thickness and characterize inflammatory infiltrate and angiogenesis in epicardial adipose tissue in CAD patients with and without chronic heart failure (CHF), established by cardiac dysfunction on echocardiography (left ventricular ejection fraction, LVEF ≤ 50%) and symptoms of heart failure (New York Heart Association (NYHA) functional class II or III).The study included 15 patients with CAD (demonstrated by coronary angiography),, who underwent right atrial appendages (RAA) excision during coronary artery bypass graft (CABG). The study was performed by histopathological, immunohistochemical (IHC), and morphometrical analysis. EAT thickness was assessed by using morphometry applied on routine histological stains. Inflammatory cell infiltration and angiogenesis were investigated immunohistochemically by using antibodies against CD68 and CD34 markers. Diminished EAT thickness in the CAD patients with CHF was associated with increased macrophage infiltration and reduced angiogenesis of the EAT as compared to CAD patients without CHF. In conclusion, the present study on epicardial fat samples of the RAA suggested that high expression of CD68 appeared to be associated with severe deterioration of heart function in CAD patients who underwent myocardial revascularization consisting of CABG.

Environmental Tobacco Smoke Exposure Estimated Using the SHSES Scale and Epicardial Adipose Tissue Thickness in Hypertensive Patients

The aim of the study was to assess the relationship between environmental tobacco smoke exposure (ETS) and epicardial adipose tissue thickness (EATT) in hypertensive patients. A total of 96 patients with essential hypertension were recruited for this study. The group consisted of 48 females and 48 males with the mean age of 69.32 ± 9.54 years. ETS was assessed with The Secondhand Smoke Exposure Scale (SHSES). EATT was assessed in 128-slice dual source coronary computed tomography angiography. In accordance to SHSES scale patients were divided into subgroups: subgroup A—no ETS exposure (SHSES = 0 points, n = 48), subgroup B—low ETS exposure (SHSES = 1–3 points, n = 11), subgroup C—medium ETS exposure (SHSES = 4–7 points, n = 20) and subgroup D—high ETS exposure (SHSES = 8–11 points, n = 17). Within the study group the mean EATT was 5.75 ± 1.85 mm and the mean SHSES score was 3.05 ± 3.74. EATT was statistically significantly higher in subgroup D than in subgroups A and B (A: 5.28 ± 1.64 mm, B: 5.04 ± 2.64 mm, D: 7.04 ± 2.64 mm, pA–D and pB–D < 0.05). There was a positive linear correlation between the exposure to ETS expressed by the SHSES scale and EATT (r = 0.44, p < 0.05). Regression analysis showed that higher SHSES score, higher BMI, and higher systolic and diastolic blood pressure are independent risk factors for higher EATT values. Contrary, the use of ACE inhibitors and β-blockers appeared to be independent protecting factor against higher EATT values. There is an unfavorable positive relationship between ETS exposure estimated using the SHSES scale and EATT in hypertensive patients.

Thickness of epicardial and pericoronary adipose tissue measured using 128-slice MSCT as predictors for risk of significant coronary artery diseases

AimDetermination the relationship between the epicardial adipose tissue thickness (EATT) and pericoronary adipose tissue thickness (PATT) and the risk of significant coronary artery diseases (CAD) using the coronary artery calcium score (CACS).Materials and methodsThe study group consisted of 80 patients. The risk of significant CAD was estimated based on CACS. Adipose tissue thickness was measured based on multiplanar reformation (MPR), left ventricle short axis and mid-chamber level. EATT in the middle of the length of the right ventricular free wall, PATT around the left anterior descending (LAD), around the left circumflex (LCX) and around the right coronary artery in the posterior interventricular sulcus (RCA).ResultsThe median (IQR) values of CACS and EATT were 12.00 (97.90) and 8.65 (3.90) mm. It was found that in the subgroup CACS = 0 statistically significantly lower than in the subgroup CACS > 0 were mean values EATT and PATT RCA. Based on the regression analysis, it was demonstrated that higher CACS is associated with higher EATT, independent of older age and higher BMI. On the basis the ROC curve analysis, the highest prediction sensitivity of 98.4% was demonstrated for EATT ≥ 16.7 mm as a predictor of high risk of significant CAD and the highest specificity of 61.5% for the criterion EATT ≤ 8.7 mm as a predictor of practically no risk of significant CAD.ConclusionThere is a positive relationship between the risk of a significant CAD estimated based on the coronary artery calcium score and the epicardial adipose tissue thickness.