Effects of Weight Loss After Bariatric Surgery on Epicardial Fat Measured Using Echocardiography

Willens, Howard J.; Byers, Patricia; Chirinos, Julio A.; Labrador, Eugenio; Hare, Joshua M.; Marchena, Eduardo de

doi:10.1016/j.amjcard.2006.12.042

Cited by 127 publications

(92 citation statements)

References 19 publications

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“…Our data are consistent with recent observation of Willens et al of significant epicardial fat changes after laparoscopic bariatric surgery in severely obese subjects (16). However, we additionally observed a significant difference between the proportion of epicardial fat loss and overall body weight loss.…”

confidence: 93%

“…fat) for each individual patient. Data are presented separately in women (1-12) and men (13)(14)(15)(16)(17)(18)(19)(20) and from lower to higher initial BMI, in women and men, respectively. Epi.…”

Section: Discussionmentioning

confidence: 99%

“…Emerging evidences suggest that epicardial fat may act as therapeutic target during therapeutic interventions modulating the adipose tissue (15). In fact, epicardial fat thickness decreases in severely obese patients who have substantial weight loss after bariatric surgery (16).…”

Section: Introductionmentioning

confidence: 99%

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Substantial Changes in Epicardial Fat Thickness After Weight Loss in Severely Obese Subjects

Iacobellis

Singh

Wharton

et al. 2008

Obesity

208

164

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We sought to evaluate the effect of weight loss on echocardiographic epicardial fat thickness, as index of visceral adiposity, and whether epicardial fat change after the weight loss can be proportionally different from overall body weight changes and related to cardiac parameters changes in severely obese subjects. This was an interventional study in 20 severely obese subjects (12 women, 8 men, BMI 45 ± 5 kg/m 2 , 35 ± 10 years) who underwent 6-month very low calorie diet weight loss program. Baseline and after 6-month weight loss anthropometrics, echocardiographic epicardial fat thickness, left ventricular mass (LVM), and diastolic function parameters were assessed. Subjects lost 20% of original body weight, BMI reduced by 19% of original BMI, waist circumference decreased by 23% of initial waist circumference. Epicardial fat thickness decreased from 12.3 ± 1.8 to 8.3 ± 1 mm P < 0.001 after the 6-month very low calorie diet, as −32% of baseline epicardial fat thickness. LVM and diastolic function changes were better correlated with epicardial fat changes. We showed that significant weight loss can be associated with significant reduction in the epicardial fat thickness, marker of visceral adiposity in severely obese subjects. Epicardial fat decrease, therefore visceral fat decrease, can be proportionally higher than overall adiposity decrease. Epicardial fat changes are significantly associated with obesity-related cardiac morphological and functional changes during weight loss. Measurement of echocardiographic epicardial fat thickness may provide an additional tool in understanding the metabolic risk associated with variation in fat distribution.

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confidence: 93%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Substantial Changes in Epicardial Fat Thickness After Weight Loss in Severely Obese Subjects

Iacobellis

Singh

Wharton

et al. 2008

Obesity

208

164

View full text Add to dashboard Cite

show abstract

“…Changes in pericardial fat mass could be shown after low calorie diet weight loss [30] and bariatric surgery assessed with echocardiography, [31] however echocardiographic measurements lack accuracy due to the reduced spatial resolution of echocardiography compared with CMR. Furthermore there are substantial individual differences in pericardial fat distribution, therefore single point measurements used in echocardiography are unlikely to accurately quantify the absolute amount of fat.…”

Section: Discussionmentioning

confidence: 99%

Effects of Weight Loss on Pericardial Fat and Left Ventricular Mass Assessed with Cardiac Magnetic Resonance Imaging in Morbid Obesity

Schneiter¹,

Warrier²,

Lefkovits³

et al. 2011

IJCM

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“…The same authors indicated that ultrasoundmeasured EAT correlates with the main clinical and anthropometric variables of the metabolic syndrome (MS): circumference of the waist, fasting insulinemia, diastolic hypertension, LDL-cholesterol, plasma adiponectin, HDL-cholesterol, and systolic hypertension [38], as well as with age, C reactive protein (CRP) and Homeostatic Model Assessment score [41]. Clinically significant weight loss resulting from adherence to a hypocaloric diet [42] or bariatric surgery [43] leads to a marked decrease of both VAT and EAT. This is accompanied by improvement not only of the variables of the metabolic syndrome but also of morphologic and functional characteristics of the heart.…”

Section: Relationships Between Epicardial Adipose Tissue Measured By mentioning

confidence: 99%

Epicardial adipose tissue and relationship with coronary artery disease

et al. 2011

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AbstractEpicardial adipose tissue (EAT) is metabolically active tissue that accumulates around the coronary arteries. Epicardial fat is a rich source of free fatty acids and may contribute to local inflammatory load by increased synthesis of inflammatory cytokines. Direct passage of bioactive molecules into the coronary arteries due to close contact with the vascular wall and the lack of fascia may contribute to the pathogenesis of coronary artery disease. Direct correlation between visceral fat and EAT defines the latter as an indirect marker of intra-abdominal visceral adiposity. EAT is related to anthropometric and clinical features of the metabolic syndrome (MS) and to hepatic transaminases as markers of steatohepatitis. An increase in EAT thickness is related to an increase in left ventricular mass and is correlated with atrial enlargement and impairment in diastolic filling in obesity. Echocardiographic study of EAT is an easy and reliable imaging indicator of visceral adiposity and cardiovascular risk. EAT is an independent factor strongly correlated with significant coronary stenosis. A level of EAT above an established average value can be considered a predictive marker of cardiovascular risk. We review the most recent studies proving the specific active role of EAT in the development of cardiac disease.

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Effects of Weight Loss After Bariatric Surgery on Epicardial Fat Measured Using Echocardiography

Cited by 127 publications

References 19 publications

Substantial Changes in Epicardial Fat Thickness After Weight Loss in Severely Obese Subjects

Substantial Changes in Epicardial Fat Thickness After Weight Loss in Severely Obese Subjects

Effects of Weight Loss on Pericardial Fat and Left Ventricular Mass Assessed with Cardiac Magnetic Resonance Imaging in Morbid Obesity

Epicardial adipose tissue and relationship with coronary artery disease

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