Epicardial fat thickness regression with continuous positive airway pressure therapy in patients with obstructive sleep apnea: assessment by two-dimensional echocardiography

Çetin, Süha; Vural, Mutlu; Gündüz, Hüseyin; Akdemir, Ramazan; Fırat, Hikmet

doi:10.1007/s00508-016-0975-z

Cited by 17 publications

(16 citation statements)

References 34 publications

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“…A similar study was conducted by Lubrano et al in 171 obese patients with and without metabolic syndrome, in which EFT rather than BMI was the best predictor of OSA(184). Treatment of OSA with continuous positive airway pressure (CPAP) during 24 weeks significantly reduced EFT in 28 symptomatic OSA patients with AHI > 15, without significant change in BMI or waist circumference(36). Shorter-term of CPAP treatment (3 months) in 25 compliant OSA patients also reduced EFT(159), but in another study EAT remained higher in CPAP treated OSA obese patients (n=19, mean BMI The prognostic impact of EAT reduction by CPAP therapy on cardiovascular outcomes need to be further explored by large prospective studies.…”

mentioning

confidence: 64%

Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?

Gaborit

Sengenès

Ancel

et al. 2017

Comprehensive Physiology

122

109

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Epicardial adipose tissue (EAT) is a small but very biologically active ectopic fat depot that surrounds the heart. Given its rapid metabolism, thermogenic capacity, unique transcriptome, secretory profile, and simply measurability, epicardial fat has drawn increasing attention among researchers attempting to elucidate its putative role in health and cardiovascular diseases. The cellular crosstalk between epicardial adipocytes and cells of the vascular wall or myocytes is high and suggests a local role for this tissue. The balance between protective and proinflammatory/profibrotic cytokines, chemokines, and adipokines released by EAT seem to be a key element in atherogenesis and could represent a future therapeutic target. EAT amount has been found to predict clinical coronary outcomes. EAT can also modulate cardiac structure and function. Its amount has been associated with atrial fibrillation, coronary artery disease, and sleep apnea syndrome. Conversely, a beiging fat profile of EAT has been identified. In this review, we describe the current state of knowledge regarding the anatomy, physiology and pathophysiological role of EAT, and the factors more globally leading to ectopic fat development. We will also highlight the most recent findings on the origin of this ectopic tissue, and its association with cardiac diseases. © 2017 American Physiological Society. Compr Physiol 7:1051-1082, 2017.

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mentioning

confidence: 64%

Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?

Gaborit

Sengenès

Ancel

et al. 2017

Comprehensive Physiology

122

109

View full text Add to dashboard Cite

show abstract

“…Epicardial fat thickness, an indirect marker of visceral adiposity, is significantly higher in patients with moderate or severe OSA (AHI>15). Furthermore, 24 weeks of CPAP treatment induces a significant regression of epicardial fat thickness, even in the absence of any significant changes in BMI or waist circumference [38]. These results are supported by a more recent study that included patients with heart failure (LV-EF <45%) and showed that epicardial adipose thickness was significantly greater in subjects with sleep-disordered breathing than in patients without sleep apnea (10.7 ± 2.8 vs. 8.13 ± 1.8; p =0.001) [39].…”

Section: Introductionmentioning

confidence: 99%

Review of Echocardiographic Findings in Patients with Obstructive Sleep Apnea

Sascău

Zota

Stătescu

et al. 2018

Canadian Respiratory Journal

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Obstructive sleep apnea (OSA) causes recurrent apneas due to upper respiratory tract collapse, leading to sympathetic nervous system hyperactivation and increased cardiovascular risk. Moderate and severe forms of obstructive sleep apnea are associated with increased atrial volumes and affect left ventricular diastolic and then systolic function. Right ventricular ejection fraction can be accurately assessed via three-dimensional echocardiography, while bidimensional imaging can only provide a set of surrogate parameters to characterize systolic function (tricuspid annulus plane systolic excursion, right ventricular fractional area change, and lateral S'). Tissue Doppler imaging is a more sensitive tool in detecting functional ventricular impairment, but its use is limited by angle dependence and the unwanted influence of tethering forces. Two-dimensional speckle tracking echocardiography is considered more suitable for the assessment of ventricular function, as it is able to distinguish between active and passive wall motion. Abnormal strain values, a marker of subclinical myocardial dysfunction, can be detected even in patients with normal ejection fraction and chamber volumes. The left ventricular longitudinal strain is more affected by the presence of obstructive sleep apnea than circumferential strain values. Although the observed OSA-induced changes are subtle, the benefit of a detailed echocardiographic screening for subclinical heart failure in OSA patients on therapy adherence and outcome should be addressed by further studies.

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“…In the same study, each 1 mm increase in EFT resulted in a 2-fold increase for MetS [100]. Furthermore, a positive relationship was found between EFT and the apnoea-hypopnea index (AHI) in 162 COPD patients (β = 0.10; p < 0.001); while continuous positive airway pressure (CPAP) therapy for 24 weeks significantly decreased EFT (from 7.29 ± 1.27 to 6.92 ± 1.26 mm; p = 0.005) [101]. Interestingly, EFT was also reported to be significantly associated with FEV 1 (% predicted), FEV 1 /FVC and airway wall thickness [102].…”

Section: Epicardial Fat and Copdmentioning

confidence: 96%

“…Continuous positive airway pressure (CPAP) therapy was shown to reduce EFT [101]. No data exist on perirenal and peripancreatic fat deposition in OSAS patients.…”

Section: Current Knowledge and Future Perspectivesmentioning

confidence: 99%

Metabolic Syndrome and Abnormal Peri-Organ or Intra-Organ Fat (APIFat) Deposition in Chronic Obstructive Pulmonary Disease: An Overview

et al. 2020

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Chronic obstructive pulmonary disease (COPD) is a common disorder with an increasing prevalence, characterised by persistent respiratory symptoms and airflow limitation. Systemic inflammation is involved in the pathogenesis of COPD and can also predispose to metabolic disorders (e.g., metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD)). Such comorbidities can negatively affect COPD outcomes, cardiovascular risk, and quality of life. Apart from NAFLD, abnormal peri-organ or intra-organ fat (APIFat) could be considered as markers for cardiometabolic diseases and even for COPD. The present narrative review considers the associations of COPD with MetS, NAFLD, and other APIFat, including epicardial, perirenal, peripancreatic, and intramuscular adipose tissue. Further research is needed to define these relationships and identify any potential clinical implications.

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Epicardial fat thickness regression with continuous positive airway pressure therapy in patients with obstructive sleep apnea: assessment by two-dimensional echocardiography

Cited by 17 publications

References 34 publications

Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?

Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?

Review of Echocardiographic Findings in Patients with Obstructive Sleep Apnea

Metabolic Syndrome and Abnormal Peri-Organ or Intra-Organ Fat (APIFat) Deposition in Chronic Obstructive Pulmonary Disease: An Overview

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