Association between echocardiographic epicardial fat thickness and circulating endothelial progenitor cell level in patients with stable angina pectoris

Abstract

Background Epicardial adipose tissue is associated with coronary artery disease (CAD). Circulating endothelial progenitor cell (EPC) level represents a marker of endothelial dysfunction and vascular health. However, the relationship between epicardial fat and circulating EPC remains unknown. This study aimed to investigate association between echocardiographic epicardial fat thickness (EFT) and circulating EPC level. Hypothesis Epicardial fat causes inflammation and contributes to progression of CAD. Methods We enrolled 213 consecutive patients with stable angina, and EFT was determined by echocardiography. Quantification of EPC markers (defined as CD34 +, CD34 + KDR +, CD34 + KDR + CD133 + cells) in peripheral blood samples was used to measure circulating EPCs. All patients were divided into 3 tertiles according to EFT levels: group 1, low tertile of EFT; group 2, middle tertile of EFT; and group 3, high tertile of EFT. Results Among the 3 groups, CAD disease severity determined by SXscore was negatively correlated with EFT, but the difference did not reach statistical significance (P = 0.066). Additionally, patients in the high and middle tertiles of EFT had higher circulating EPC levels than did those in the low tertile of EFT (P = 0.001 and P < 0.001, respectively). In multivariate analysis, EPC level was significantly associated with echocardiographic EFT (standardized β = −0.233, P = 0.001), independent of multiple covariates. Conclusions Epicardial adipose tissue is associated with circulating EPC levels. There was a trend between epicardial fat and severity of CAD, though analysis did not reach statistical significance, and this may be attributed to the interaction between several risk factors of CAD.

Trimethylamine N-Oxide, Circulating Endothelial Progenitor Cells, and Endothelial Function in Patients with Stable Angina

“…Quantification of the circulating EPCs by flow cytometry was performed as described previously 32 . The peripheral blood of patients was incubated with human kinase insert domain receptor (KDR) antibody (R&D, Minneapolis, MN, USA) for 30 min in the dark, and then by allophycocyanin-conjugated secondary antibody, phycoerythrin-conjugated human CD133 antibody (Miltenyi Biotec, Germany), and FITC-conjugated human CD34 antibody (Becton Dickinson Pharmingen, USA).…”

Association of epicardial fat thickness assessed by echocardiography with the severity of coronary artery disease

“…In heart, adipose tissue can be subdivided into intra and extra pericardial fat that is located between the myocardium and visceral pericardium, particularly around subepicardial coronary vessels. 1,2 In physiologic situations, epicardial fat tissue consists 20% of the heart's weight which is mostly deposited in the atrioventricular and interventricular grooves, exactly where the coronary arteries are located that seems to be potential interactions between epicardial fat and myocardium. 1,3 Epicardial fat is necessary for adequate cardiac function because it has an essential role in preserving the equivalence of body energy and metabolic process, but in other hand, it has important impact on heart muscle function because of secretion of adipokines and pre-inflammatory cytokines.…”