Epicardial adipose tissue density and volume are related to subclinical atherosclerosis, inflammation and major adverse cardiac events in asymptomatic subjects

Goeller, Markus; Achenbach, Stephan; Marwan, Mohamed; Doris, Mhairi; Cadet, Sebastien; Commandeur, Frédéric; Chen, Xi; Slomka, Piotr J.; Gransar, Heidi; Cao, Jie J; Wong, Nathan D.; Albrecht, Moritz H.; Rozanski, Alan; Tamarappoo, Balaji; Berman, Daniel S.; Dey, Damini

doi:10.1016/j.jcct.2017.11.007

Cited by 179 publications

(174 citation statements)

References 34 publications

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“…EAT volume, and more recently attenuation have been increasingly investigated in the literature for associations with cardiac disease 8,[11][12][13][14][15] . Several studies have demonstrated significant cross-sectional relationships www.nature.com/scientificreports www.nature.com/scientificreports/ between EAT and cardiac disease, however a lack of longitudinal data prevents understanding of what therapies or targets may be a modulating factor for EAT.…”

Section: Discussionmentioning

confidence: 99%

“…EATd is hypothesised to be a marker of adipose tissue activity, and may even represent a marker of vascular inflammation 8 . As EAT is present in all human anatomy and differentially distributed around the myocardium, it is possible that the activity of EAT may have a greater effect on cardiac and coronary dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…As EAT is universal to human anatomy, it is important to evaluate its natural evolution in this cohort to better understand what cardiovascular risk factors may influence its change, as it thus far remains simply an associative marker of cardiac risk that is thought to be modulated by other metabolic markers or obesity measures. As EAT has been increasingly described as a marker of adipose tissue activity and inflammation which can be gauged by the attenuation of fat, the density of EAT is also of interest to investigate as an alternative marker of risk beyond the total volume of EAT alone 8 . The long-term natural history of EAT has not been assessed in general cohorts of suspected coronary artery disease that comprise the vast majority of patients undergoing coronary assessment on CT coronary angiography, most of whom will have non-obstructive CAD 9 .…”

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confidence: 99%

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The Natural history of Epicardial Adipose Tissue Volume and Attenuation: A long-term prospective cohort follow-up study

Nerlekar

Thakur

Lin

et al. 2020

Sci Rep

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epicardial adipose tissue (eAt) is associated with cardiovascular risk. the longitudinal change in eAt volume (eAtv) and density (eAtd), and potential modulators of these parameters, has not been described. We prospectively recruited 90 patients with non-obstructive coronary atherosclerosis on baseline computed tomography coronary angiography (ctcA) performed for suspected coronary artery disease to undergo a repeat research CTCA. EATv in millilitres (mL) and EATd in Hounsfield units (HU) were analysed and multivariable regression analysis controlling for traditional cardiovascular risk factors (cVRf) performed to assess for any predictors of change. Secondary analysis was performed based on statin therapy. The median duration between CTCA was 4.3years. Mean EATv increased at follow-up (72 ± 33 mL to 89 ± 43 mL, p < 0.001) and mean EATd decreased (baseline −76 ± 6 HU vs. −86 ± 5 HU, p < 0.001). There were no associations between baseline variables of body mass index, age, sex, hypertension, hyperlipidaemia, diabetes or smoking on change in EATv or EATd. No difference in baseline, follow-up or delta EATv or EATd was seen in patients with (60%) or without baseline statin therapy. in this select group of patients, eAtv consistently increased and eAtd consistently decreased at long-term follow-up and these changes were independent of cVRf, age and statin use. together with the knowledge of strong associations between EAT and cardiac disease, these findings may suggest that eAt is an independent parameter rather than a surrogate for cardiovascular risk. open Scientific RepoRtS | (2020) 10:7109 | https://doi.org/10.1038/s41598-020-63135-z www.nature.com/scientificreports www.nature.com/scientificreports/ Scientific RepoRtS | (2020) 10:7109 | https://doi.org/10.1038/s41598-020-63135-zwww.nature.com/scientificreports www.nature.com/scientificreports/ however, this is reflective of the current literature in examining relevant associations of EAT. Finally, there is potential for error in using delta EAT values with potential overlap from test-retest variability. Our previous work has demonstrated limits of agreement up to 10 mL higher or lower between observers with a mean bias however of only 1 mL, however our inter-observer correlation was excellent at 0.98 with assessors blinded to scan timing and patient details. conclusion Epicardial adipose tissue volume and density demonstrate significant longitudinal changes in patients with non-obstructive coronary artery disease with a consistent increase in EAT volume and consistent decrease in EAT density. There are no clinical risk factors that appear to associate with the change in EAT parameters and this effect is also independent of statin therapy. This finding may suggest that EAT is an independent marker, rather than surrogate of cardiovascular risk.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The Natural history of Epicardial Adipose Tissue Volume and Attenuation: A long-term prospective cohort follow-up study

Nerlekar

Thakur

Lin

et al. 2020

Sci Rep

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“…18,21-23 Goeller M et al, observed that lower EAT and increased EAT volume were associated with coronary calcification, serum levels of plaque inflammatory markers and adverse cardiovascular events, suggesting that dysfunctional EAT may be linked to early plaque formation and inflammation. 24 Several studies suggest the association of epicardial fat with CAD. 25,26 Mahabadi AA et al, nconcluded that epicardial fat is associated with fatal and nonfatal coronary events in the general population independent of traditional cardiovascular risk factors and complements information from cardiac computed tomography above the CAC score.…”

Section: Discussionmentioning

confidence: 99%

Study of the correlation of epicardial adipose tissue with left ventricular mass and left ventricular mass index in patients with essential hypertension

Goswami¹,

Keswani²,

Chaturvedi³

et al. 2020

Int J Res Med Sci

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Background: Epicardial Adipose Tissue (EAT) is recognized to be a cardiovascular risk factor. In addition to providing fuel to heart, it plays a pivotal role in the pathogenesis of atherosclerosis though the secretion of adipokines. This study aims to find the correlation of EAT with Left Ventricular Mass (LVM) and Left Ventricular Mass Index (LVMI) in patients with essential hypertension. Increasing LVM and LVMI are predictors of poor cardiovascular outcome. So, if we find a positive correlation, we can say that measurement of epicardial fat in essential hypertension may help us identify high risk hypertensive patients.Methods: This study was carried out in SMS Hospital, Jaipur, after approval from the Ethics Committee. 100 consecutive eligible patients were included in the study after application of inclusion and exclusion criteria and taking proper informed consent. After history, examination and routine laboratory investigations, all patients underwent transthoracic 2D and Doppler echocardiography. EAT thickness, LVM and LVMI were measured and correlated using Spearman correlation coefficient.Results: The mean LVM was 139±42.12 g and mean LVMI was 35.76±11.28 g/m2.7. The spearman correlation coefficient (r) was calculated to be 0.691 between EAT and LVM and 0.677 between EAT and LVMI, indicating strong positive correlation between EAT and both LVM and LVMI. This implies that as; EAT increases, LVM and LVMI increases significantly.Conclusions: Thus, authors have found that EAT is positively correlated with LVM and LVMI. So, we can say that increase in EAT may lead to adverse cardiovascular outcome in patients with essential hypertension.

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“…6 As reported, increased volume and inflammation of EAT are associated with the progression of cardiac dysfunction in obese individual. [16][17][18] However, the alterations of metabolic and functional alterations in EAT have been considered clinically important but are yet to be systematically investigated. Accordingly, in this study, we described Amongst the differentially expressed proteins, we believe that Serpina3 make a prominent link between EAT and HF.…”

Section: Discussionmentioning

confidence: 99%

Proteomics of epicardial adipose tissue in patients with heart failure

Zhao

Guo

Wang

et al. 2019

J Cellular Molecular Medi

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Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot closely linked to the pathogenesis of heart failure (HF). But the molecular signatures related to the mechanism of HF have not been systematically explored. Here, we present comprehensive proteomic analysis of EAT in HF patients and non‐HF patients as controls. A total of 771 proteins were identified in liquid chromatography‐tandem mass spectrometry experiments. Amongst them, 17 increased in abundance in HF and seven decreased. They were involved in HF‐related processes including inflammation and oxidative stress response and lipid metabolism. Of these proteins, serine proteinase inhibitor A3 (Serpina3) levels in EAT were highly up‐regulated in HF, with HF/non‐HF ratio of 4.63 (P = .0047). Gene expression of Serpina3 via quantitative polymerase chain reaction was significantly increased in the HF group. ELISA analysis confirmed a significant increase in circulating plasma Serpina3 levels in the HF group (P = .004). In summary, for the first time, we describe that parts of EAT proteome may be reactive and work as modulators of HF. Our profiling provides a comprehensive basis for linking EAT with pathogenesis of HF. Understanding the role of EAT may offer new insights into the treatment of HF.

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Epicardial adipose tissue density and volume are related to subclinical atherosclerosis, inflammation and major adverse cardiac events in asymptomatic subjects

Cited by 179 publications

References 34 publications

The Natural history of Epicardial Adipose Tissue Volume and Attenuation: A long-term prospective cohort follow-up study

The Natural history of Epicardial Adipose Tissue Volume and Attenuation: A long-term prospective cohort follow-up study

Study of the correlation of epicardial adipose tissue with left ventricular mass and left ventricular mass index in patients with essential hypertension

Proteomics of epicardial adipose tissue in patients with heart failure

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