Epicardial Fat Volume in Patients With Left Ventricular Systolic Dysfunction

Khawaja, Tuba; Greer, Christine; Chokshi, Aalap; Chavarria, Nelson; Thadani, Samir R.; Jones, Meaghan; Schaefle, Kenneth J.; Bhatia, Ketan; Collado, Jose; Shimbo, Daichi; Einstein, Andrew J.; Schulze, P. Christian

doi:10.1016/j.amjcard.2011.03.058

Cited by 75 publications

(68 citation statements)

References 13 publications

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“…Thus, it is not possible to directly compare our results to the previous studies that focused mainly on the relationship between EAT mass and CAD extent 10,13,30,34,35,37,41, 42 or which consisted of different study populations. 2,19,39, 40 Our present study findings showed that with decreasing LVEF, there was a linear decrease of the EAT mass in patients with CAD. Interestingly, patients with CAD and preserved LVEF revealed even more EAT than healthy controls, indicating that different amounts of EAT reflect different stages of CAD.…”

Section: Discussionsupporting

confidence: 54%

Impact of Functional, Morphological and Clinical Parameters on Epicardial Adipose Tissue in Patients With Coronary Artery Disease

Doesch

Haghi

Süselbeck

et al. 2012

Circ J

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Section: Discussionsupporting

confidence: 54%

Impact of Functional, Morphological and Clinical Parameters on Epicardial Adipose Tissue in Patients With Coronary Artery Disease

Doesch

Haghi

Süselbeck

et al. 2012

Circ J

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“…Also the negative consequences of increased fat deposits in the extraor intra-pericardial regions and inside the heart (intraand inter-myocyte cells) on the coronary circulation and on the cardiac function have been reported by previous researchers (14)(15)(16). Epicardial and mediastinal adipose tissue can mechanically and functionally compromise the systolic and diastolic function of the cardiac ventricles (17). These evidences explain the importance of a quantitative measurement of the fat volume and the efforts in obtaining tools for diagnostic interpretation and monitoring the relationship between visceral fat and atherosclerotic process.…”

Section: Resultsmentioning

confidence: 88%

Quantitative analysis of epicardial fat volume: effects of scanning protocol and reproducibility of measurements in non-contrast cardiac CT vs. coronary CT angiography

D’Errico

Salituri

Ciardetti

et al. 2017

Quant. Imaging Med. Surg.

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Background: Several studies have focused on the role of epicardial fat in the pathogenesis of cardiovascular disease (CVD). The main purpose of the study was to evaluate a computerized method for the quantitative analysis of epicardial fat volume (EFV) by non-contrast cardiac CT (NCT) for coronary calcium scan and coronary CT angiography (coronary CTA). Conclusions: Both NCT and coronary CTA can be used with low intra-and inter-observer variability for computer-assisted measurements of EFV. Cardiac CT may allow a fast and reliable computation of EFV in clinical setting.

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“…210,214 However, preliminary studies have demonstrated low epicardial adipose tissue in patients with HF compared with healthy subjects. 215 Furthermore, a recent study found low epicardial adipose tissue in HF to be associated with increased HF mortality, possibly representing a novel component of the obesity paradox in HF. 212,216 Taken as a whole, these data suggest that higher body mass, whether fat or lean mass, is associated with improved outcomes in the syndrome of HF.…”

Section: Other Medicationsmentioning

confidence: 99%

“…The underlying explanatory reasons for this counterintuitive relationship between obesity and improved HF outcomes are not fully understood, although several plausible hypotheses have been put forth. 213,214,217,218 Importantly, HF is known to be a catabolic state, 215,219 and thus, obesity and increased fat or lean mass likely represent a beneficial greater metabolic reserve in HF. It is also well recognized that cardiac cachexia or unintentional weight loss is associated with advanced HF state and increased mortality.…”

Section: Other Medicationsmentioning

confidence: 99%

Contributory Risk and Management of Comorbidities of Hypertension, Obesity, Diabetes Mellitus, Hyperlipidemia, and Metabolic Syndrome in Chronic Heart Failure: A Scientific Statement From the American Heart Association

Bozkurt¹,

Aguilar²,

Deswal³

et al. 2016

Circulation

368

220

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CLINICAL STATEMENTS AND GUIDELINESfailed to show a significant reduction of SBP in patients with resistant hypertension. 81 Other strategies such as targeting excessive sympathetic nerve activity by carotid body denervation are awaiting clinical validation in the hypertension and HF populations. Drugs to Avoid in Patients With HFSeveral classes of drugs should be avoided in patients with HFrEF with a history of hypertension. Because of their negative inotropic properties and the increased likelihood of worsening HF symptoms, the nondihydropyridine calcium channel blockers such as diltiazem and verapamil should be avoided. 8 The dihydropyridine calcium channel blocker amlodipine appeared to be safe in patients with severe HFrEF in the PRAISE trial (Prospective Randomized Amlodipine Survival Evaluation), 82 as was felodipine. 73 In the current 2013 HF guidelines, most calcium channelblocking drugs except amlodipine are not recommended. 8Although clonidine is an effective antihypertensive agent, a similar centrally acting drug, moxonidine, was associated with increased mortality in patients with HF; thus, centrally acting norepinephrine-depleting agents may need to be avoided or used with caution in patients with HFrEF. 83In the ALLHAT trial, the α-blocker doxazosin arm of the trial was discontinued because of a 2-fold increase in the risk of developing HF compared with chlorthalidone treatment. 45 Although the ALLHAT study excluded patients with established HF and there are caveats about extrapolating these data to the management of hypertension in patients with established HF, the safety and efficacy of α-blockers in the management of patients with HF with hypertension are currently unclear. Potent direct-acting vasodilators such as minoxidil should also be avoided because of their renin-related salt and fluid-retaining effects. Nonsteroidal anti-inflammatory agents should be used with caution in these patients, given their effects on BP, volume status, and renal function. Treatment of Hypertension in Patients With HF With Preserved LVEFMost patients with HF and preserved LVEF (HFpEF), especially elderly women, have hypertension. A significant proportion of these patients also have evidence of LV hypertrophy, and some may have atrial dilatation, cardiac enlargement, and wall motion abnormalities without LV systolic dysfunction. Patients with HFpEF may respond particularly well to the treatment of hypertension with regression of hypertrophy 84 and improvement in filling pressures. 84,85 Most patients with HFpEF require treatment with cardiac medications for the comorbidities of hypertension, diabetes mellitus, coronary artery disease, and atrial fibrillation. The 2013 HF guidelines suggest that the use of β-blocking agents, ACE inhibitors, and ARBs in patients with hypertension is reasonable to control BP in patients with HFpEF. 8 The use of ARBs might also be considered to decrease hospitalizations for patients with HFpEF. recommendations Harmonized With Existing Guidelines for the recognition and Treatment of pa...

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Epicardial Fat Volume in Patients With Left Ventricular Systolic Dysfunction

Cited by 75 publications

References 13 publications

Impact of Functional, Morphological and Clinical Parameters on Epicardial Adipose Tissue in Patients With Coronary Artery Disease

Impact of Functional, Morphological and Clinical Parameters on Epicardial Adipose Tissue in Patients With Coronary Artery Disease

Quantitative analysis of epicardial fat volume: effects of scanning protocol and reproducibility of measurements in non-contrast cardiac CT vs. coronary CT angiography

Contributory Risk and Management of Comorbidities of Hypertension, Obesity, Diabetes Mellitus, Hyperlipidemia, and Metabolic Syndrome in Chronic Heart Failure: A Scientific Statement From the American Heart Association

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