Epicardial fat thickness correlates with P-wave duration, left atrial size and decreased left ventricular systolic function in morbid obesity

Cardoso, Acácio Fernandes; Santos-Furtado, Meive; Grindler, José; Ferreira, LA; Andrade, J.; Santo, Marco Aurélio

doi:10.1016/j.numecd.2017.05.009

Cited by 15 publications

(14 citation statements)

References 49 publications

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“…In the present study, EAT correlated with LVMI, e ′, and GLS. Our findings collaborate to involve EAT with the pathogenic mechanism of myocardial remodeling and subclinical myocardial dysfunction in middle-aged subjects without cardiovascular disease [ 22 , 28 ]. As EAT thickness is thought to reflect the amount of VAT, the effect of EAT on atherosclerotic cardiovascular disease is considered a consequence of enhanced insulin resistance and abnormal lipid metabolism.…”

Section: Discussionsupporting

confidence: 75%

Association between epicardial adipose tissue, high-sensitivity C-reactive protein and myocardial dysfunction in middle-aged men with suspected metabolic syndrome

Cho

Joo

Kim

et al. 2018

Cardiovasc Diabetol

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BackgroundAs body fat composition and metabolism differ between men and women, we evaluated sex-related differences in the association among epicardial adipose tissue (EAT), secretome profile, and myocardial function of subjects with suspected metabolic syndrome.MethodsWe evaluated 277 participants (men, n = 140; 56.1 ± 4.7 years) who underwent conventional echocardiography and two-dimensional speckle tracking from the Seoul Metabolic Syndrome cohort. EAT was measured from the right ventricular free wall perpendicular to the aortic annulus at end systole. Global longitudinal strain (GLS) was obtained from 18 apical segments. Apolipoprotein A1, apolipoprotein B, adiponectin, and high-sensitivity C-reactive protein (hs-CRP) levels were measured using immunoturbidimetry assay.ResultsMean age, body mass index, and hs-CRP level did not differ by sex. Waist circumference, fasting blood glucose level, and triglyceride/high-density lipoprotein cholesterol ratio were higher, and apolipoprotein AI and adiponectin levels were lower in men. No significant difference in mean EAT thickness was found (7.02 ± 1.81 vs. 7.13 ± 1.70 mm, p = 0.613). Men had a higher left ventricular (LV) mass index and lower GLS. EAT thickness was associated with hs-CRP level in men alone (ß = 0.206, p = 0.015). LV mass index (ß = 2.311, p = 0.037) and function represented by e′ (ß = − 0.279, p = 0.001) and GLS (ß = − 0.332, p < 0.001) were independently associated with EAT thickness in men alone.ConclusionsIn middle-aged subjects with suspected metabolic syndrome, EAT was associated with inflammation represented by hs-CRP level, LV mass, and subclinical myocardial dysfunction only in men, suggesting that the inflammatory activity of EAT induced myocardial remodeling and dysfunction in middle-aged subjects but was attenuated in women.Trial registration NCT02077530 (date of registration: November 1, 2013)

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Section: Discussionsupporting

confidence: 75%

Association between epicardial adipose tissue, high-sensitivity C-reactive protein and myocardial dysfunction in middle-aged men with suspected metabolic syndrome

Cho

Joo

Kim

et al. 2018

Cardiovasc Diabetol

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“…A higher prevalence of obesity has been reported in HFpEF (51%) vs. HFrEF (37%88). LA enlargement correlates with epicardial fat thickness90 and visceral fat mass 91. In patients undergoing AF ablation ( n = 236), low‐voltage areas suggestive of atrial fibrosis were much more common (46% of patients) in patients with metabolic syndrome than in those without (8%92).…”

Section: Risk Factors and Pathophysiology Of Atrial Remodelling In Hementioning

confidence: 98%

Atrial remodelling in heart failure: recent developments and relevance for heart failure with preserved ejection fraction

et al. 2018

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“…The duration of the P wave in electrocardiograms (ECG) is admittedly a marker of atrial remodeling and is associated with a higher risk of atrial fibrillation 9 . Recently, our group demonstrated that, in morbidly obese individuals, EF thickness was independently associated with a longer duration of the P wave, reinforcing the negative impact of EF on atrial remodeling 10 . The objective of the present study was to evaluate the effects of the reduction of EF on the P wave duration after weight loss induced by bariatric surgery.…”

Section: Introductionmentioning

confidence: 71%

“…In a population similar to our study, Iacobellis et al demonstrated a correlation between the dimensions of the left atrium (LA) measured by echocardiography and the EF thickness 17 . In analyses involving ECG and different imaging methods, the P wave duration was associated with the EF thickness and volume [10][11][12][13][14][15][16][17][18] .…”

Section: Discussionmentioning

confidence: 99%

Effects of epicardial fat reduction on P-wave duration of morbidly obese patients submitted to bariatric surgery: an observational study

Cardoso

Santos-Furtado

Grindler

et al. 2019

J Cardiac Arrhtythmias

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Introduction: Epicardial fat (EF) is biologically active and, through its paracrine effect, interacts with the atrial myocardium and may be involved in the atrial remodeling observed in obese individuals. P-wave duration (PWD) is a non-invasive marker of atrial conduction time and reflects changes related to atrial remodeling. The effects of the reduction of EF induced by bariatric surgery on PWD have not yet been defined. Methods: We prospectively recruited 22 morbidly obese patients with no other comorbidities at the Unidade de Cirurgia Bariátrica (Bariatric Surgery Unit) of Unviversidade de São Paulo’s Hospital das Clínicas. The patients were submitted to clinical and laboratorial evaluations, 12-lead eletrocardiography (ECG), two-dimensional echocardiogram and 24 h Holter. The same evaluation was performed 12 months after bariatric surgery. In order to make a comparison of the continuous variables, we used the paired and Wilcoxon T tests. To evaluate the association between independent variables, a regression model was used for repeated measures. Results: A total of 20 patients completed the protocol (age: 36.35 ± 10.26 years, 18 women). There was a significant reduction of PWD, body mass index (BMI) and EF after bariatric surgery (p<0.05). There was also an average reduction of 11.55 ± 8.49 ms in PWD. In the multiple regression analysis, an association was observed between the reduction of PWD and the reduction of EF and BMI. Conclusions: In morbidly obese patients with no other comorbidities, the reduction of EF after bariatric surgery was associated with an improvement in atrial remodeling indicated by a significant reduction in PWD.

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Epicardial fat thickness correlates with P-wave duration, left atrial size and decreased left ventricular systolic function in morbid obesity

Cited by 15 publications

References 49 publications

Association between epicardial adipose tissue, high-sensitivity C-reactive protein and myocardial dysfunction in middle-aged men with suspected metabolic syndrome

Association between epicardial adipose tissue, high-sensitivity C-reactive protein and myocardial dysfunction in middle-aged men with suspected metabolic syndrome

Atrial remodelling in heart failure: recent developments and relevance for heart failure with preserved ejection fraction

Effects of epicardial fat reduction on P-wave duration of morbidly obese patients submitted to bariatric surgery: an observational study

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