Epicardial Fat Tissue Predicts Increased Long-Term Major Adverse Cardiac Event in Patients With Moderate Cardiovascular Risk

Ulucan, Şeref; Kaya, Zeynettin; Efe, Duran; Keser, Ahmet; Katlandur, Hüseyin; Aygün, Fatih; Ülgen, Mehmet Sıddık; Avcı, Ahmet; Çalapkorur, Bekir; Kaya, Mehmet

doi:10.1177/0003319714548211

Cited by 11 publications

(15 citation statements)

References 30 publications

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“…29 Epicardial fat predicts increased long-term major adverse cardiac events in patients with moderate CV risk. 30 The role of cardiac adiposity in fatty liver has not been thoroughly explored. Studies with inconsistent results exist in the literature.…”

Section: Epicardial Adipose Tissue In Nafldmentioning

confidence: 99%

Epicardial Fat in Nonalcoholic Fatty Liver Disease

et al. 2015

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Nonalcoholic fatty liver disease (NAFLD) is closely related to insulin resistance and the metabolic syndrome and might be an important cardiovascular (CV) risk factor. Epicardial adipose tissue (EAT) has been implicated in the pathogenesis of obesityrelated CV disease. In an NAFLD population, we investigated EAT thickness and its possible relations to NAFLD and cardiac structure and function. This was an observational study of 57 patients with NAFLD and 48 age-matched controls. Patients with NAFLD had significantly higher body mass index (P < .0001), waist circumference (P < .0001), and high-sensitivity C-reactive protein (P ¼ .005), whereas high-density lipoprotein cholesterol (P ¼ .01) and adiponectin (P ¼ .005) levels were significantly lower. The EAT was not thicker in NAFLD but was positively related to indices of impaired glucose tolerance and inflammation, with diabetes being an independent predictor of EAT thickness (b* ¼ 0.29, P ¼ .04). No relations were found between EAT and cardiac structure and function. In conclusion, this study confirms a pathologic phenotype of NAFLD. Epicardial fat was not significantly related to NAFLD per se, but diabetes, glucose metabolism, and inflammation were closely related to its thickness.

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Section: Epicardial Adipose Tissue In Nafldmentioning

confidence: 99%

Epicardial Fat in Nonalcoholic Fatty Liver Disease

et al. 2015

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“…In 8 studies, the parameters required to enter meta-analysis were not reported ( 27 – 34 ). In 2 studies, the findings related to epicardial thickness had been reported in groups other than CAD and non-CAD, such as coronary artery spasm ( 35 ) or carotid stenosis ( 36 ). In 8 studies, the numerical values of EFT had not been reported ( 31 , 36 – 42 ).…”

Section: Resultsmentioning

confidence: 99%

Is echocardiographic epicardial fat thickness increased in patients with coronary artery disease? A systematic review and meta-analysis

et al. 2018

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BackgroundThe relation of epicardial fat thickness (EFT) to coronary artery disease (CAD) has recently been reported in multiple studies. Echocardiography is a safe and relatively inexpensive and accessible approach to assess regional EFT, which can be performed easily in many centers.ObjectiveTo determine the association between echocardiographic EFT and the presence or the absence of CAD.MethodsThis was a systematic review and meta-analysis conducted on literature available in electronic databases up to March 2018. The articles measuring EFT by echocardiography in the right ventricular (RV) free wall were included in the study. The quality of the enrolled items was assessed using the Methodological Index for Non-Randomized Studies (MINORS) checklist. The analyses were performed using the Comprehensive Meta-Analysis version 2 software. Cochran’s Q test and I2 index were used to evaluate heterogeneity.ResultsThis meta-analysis was performed on 13 studies involving 2,436 patients (1,622 with CAD, and 814 without CAD). The maximum EFT reported by echocardiography was 12.9±2.7 mm in the CAD group and 8.4±2.5 mm in the non-CAD group. The minimum EFT reported by echocardiography was 2.2±1.8 mm in the CAD group and 1.8±1.4 mm in the non-CAD group. The heterogeneity was found among the researched studies (I2=91.8%, p=0.000, Q-value=146.43, df [Q] =12) using the random effect model. The patients with CAD had a significantly higher echocardiographic EFT than those without CAD (SMD=1.03, 95% CI= 0.70–1.37, p=0.000).ConclusionAccording to the findings of this meta-analysis, the echocardiographic EFT in the subjects with CAD was significantly higher than that of those without CAD. The measurement of echocardiographic EFT seems to be an acceptable strategy for risk stratification of heart diseases considering ease of use, cost-effectiveness and non-exposure characteristics, compared to other imaging interventions.

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“…Further, inconsistent measurement parameters hinder comparisons with preexisting literature. The prognostic value of EATV to diagnostic imaging has been shown in patients with moderate risk [11], those presenting with acute chest pain [10] and as part of the MESA study [20]. Clinical application of EAT volumetry without the use of automated means is cumbersome and time consuming, yet in direct comparison automated volumetry has demonstrated comparable results to manual segmentation [18,21].…”

Section: Discussionmentioning

confidence: 99%

“…Immunohistochemically, EAT has been shown to differ from other fat tissue in concentration and production of inflammatory mediators resulting in infiltration by inflammatory cells and thus promoting the development of atherosclerosis [9]. Clinical application of EAT volumetry has been proven feasible and is expected to be of prognostic value by risk stratification of coronary artery disease (CAD) [8] and prediction of major adverse cardiac events [10,11].…”

Section: Introductionmentioning

confidence: 99%