Increased echocardiographic epicardial fat thickness and high-sensitivity CRP level indicate diastolic dysfunction in patients with newly diagnosed essential hypertension

Turak, Osman; Özcan, Fırat; Canpolat, Uğur; İşleyen, Ahmet; Cebeci, Muhammet; Öksüz, Fatih; Mendi, Mehmet Ali; Cagli, Kumral; Gölbaşı, Zehra; Aydoğdu, Sinan

doi:10.1097/mbp.0b013e3283651d19

Cited by 30 publications

(26 citation statements)

References 36 publications

(49 reference statements)

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“…21 The CRP level in hypertensive patients with left ventricular dysfunction was found to be higher than the others. 25,26 Despite normal levels in the WCH and HT groups, compared with the NT group, CRP and ESR levels in the HT group and CRP levels in the WCH group were significantly higher. It was declared that the increase in CRP levels was accompanied with an increase in CIMT, as the period of the disease increased.…”

Section: Discussionmentioning

confidence: 73%

Procalcitonin and Pentraxin-3: Current biomarkers in inflammation in white coat hypertension

et al. 2015

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An association has been described between inflammation and the progression of hypertension (HT) and is shown with several biochemical parameters. Our aim was to examine the distribution of the serum procalcitonin (PCT), pentraxin (PTX)-3 and interleukin (IL)-33 levels and their relationship with carotid intima-media thickness (CIMT) in subjects with white coat HT (WCH), HT and normotension (NT) groups. Thirty-three patients with HT, 33 patients with WCH and 33 healthy subjects were enrolled in this study. PCT, PTX-3 and C-reactive protein (CRP) levels significantly increased in the HT group compared with the NT group. In addition, PCT and CRP levels were significantly higher in the WCH group than in the NT group. CIMT measurements were significantly higher in the WCH and HT groups than in the NT group. In the HT and WCH groups, there were significant positive correlations between PTX-3, PCT and CRP. In the WCH group, PTX-3 and PCT levels were significantly positively correlated with CIMT. PCT had area under the curve value of 0.817 which demonstrates its sufficiency to distinguish WCH from NT individuals. Our results suggest that in subjects with WCH and HT, which are characterized by increased cardiovascular risk, PTX-3 and PCT levels in the HT group and PCT levels in the WCH group are significantly and consistently higher than normotensives. Systemic inflammation moderately occurs in the WCH and HT groups. PCT monitoring may be a useful biomarker in inflammation related to atherosclerosis and early stage HT.

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Section: Discussionmentioning

confidence: 73%

Procalcitonin and Pentraxin-3: Current biomarkers in inflammation in white coat hypertension

et al. 2015

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“…Epicardial fat serves a number of important physiologic functions including acting as a buffer for coronary arteries against torsion, regulation of fatty acid metabolism for coronary arteries, thermogenesis, and protection of the cardiac autonomic ganglia and nerves . The association of increased epicardial fat with diastolic dysfunction has been consistently demonstrated in various studies . A recent meta‐analysis of studies using relatively simple indicators of diastolic dysfunction, mitral valve E/A ratio or E/e′, showed a significant correlation between the amount of epicardial fat and diastolic dysfunction (Figure ).…”

Section: Epicardial Fatmentioning

confidence: 96%

Hypoxia‐inducible factor 1‐alpha (HIF‐1α) as a factor mediating the relationship between obesity and heart failure with preserved ejection fraction

Warbrick

Rabkin

2019

Obesity Reviews

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Summary Heart failure with preserved ejection fraction (HFpEF), a common condition with an increased mortality, is strongly associated with obesity and the metabolic syndrome. The latter two conditions are associated with increased epicardial fat that can extend into the heart. This review advances the proposition that hypoxia‐inhibitory factor‐1α (HIF‐1α) maybe a key factor producing HFpEF. HIF‐1α, a highly conserved transcription factor that plays a key role in tissue response to hypoxia, is increased in adipose tissue in obesity. Increased HIF‐1α expression leads to expression of a potent profibrotic transcriptional programme involving collagen I, III, IV, TIMP, and lysyl oxidase. The net effect is the formation of collagen fibres leading to fibrosis. HIF‐1α is also responsible for recruiting M1 macrophages that mediate obesity‐associated inflammation, releasing IL‐6, MCP‐1, TNF‐α, and IL‐1β with increased expression of thrombospondin, pro α2 (I) collagen, transforming growth factor β, NADPH oxidase, and connective tissue growth factor. These factors can accelerate cardiac fibrosis and impair cardiac diastolic function. Inhibition of HIF‐1α expression in adipose tissue of mice fed a high‐fat diet suppressed fibrosis and reduces inflammation in adipose tissue. Delineation of the role played by HIF‐1α in obesity‐associated HFpEF may lead to new potential therapies.

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“…EAT has received much attention recently due to its metabolically active nature and relation with several bioactive adipokines [1-4]. Studies have shown an association between EAT and traditional cardiovascular risk factors, coronary atherosclerosis, coronary artery plaque burden, and major adverse cardiovascular events [5-7].…”

Section: Introductionmentioning

confidence: 99%

Association of epicardial fat with left ventricular diastolic function in subjects with metabolic syndrome: assessment using 2-dimensional echocardiography

Park

Choi

Kim

2014

BMC Cardiovasc Disord

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BackgroundMetabolic syndrome (MetS) is related with left ventricular diastolic dysfunction (LVDD) and poor cardiovascular outcome. Epicardial adipose tissue (EAT) thickness, measured by echocardiography, is increased in subjects with MetS. However, the association of EAT with LV diastolic function has not been evaluated in subjects with MetS.MethodsIn this retrospective study, EAT thickness was measured in 1,486 consecutive asymptomatic patients with no known heart disease who had transthoracic echocardiography during a self-referred healthcare exam. Subjects with a history of ischemic heart disease, cardiomyopathy or significant valvular heart disease were excluded. LVDD was defined as E/e’ ratio ≥ 15. Subjects were grouped into two groups, those with MetS and those without.ResultsMetS was present in 346 subjects. There was no difference in LV systolic function between the two groups. However compared to patients without MetS, patients with MetS had larger left atrium (LA) size and higher E/e’ ratio (38 ± 5 versus 35 ± 5 mm for LA and 10.0 ± 3.3 versus 8.7 ± 2.7 for E/e’ ratio in subjects with versus without MetS both p < 0.001). LVDD was found in 27 (7.8%) subjects with MetS, compared to 30 (2.6%) subjects without MetS (p < 0.001). In subjects with MetS, EAT was significantly correlated with LVDD, even after adjusting for other cardiometabolic risk factors such as age, systolic blood pressure, BMI, blood glucose and LDL cholesterol (OR 1.845, 95% CI 1.153-2.951, p = 0.011).ConclusionGreater EAT is found in subjects with MetS. EAT is significantly associated with LVDD in subjects with MetS, even after adjusting for other risk factors.

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Increased echocardiographic epicardial fat thickness and high-sensitivity CRP level indicate diastolic dysfunction in patients with newly diagnosed essential hypertension

Abstract: In patients with newly diagnosed and untreated essential HT, increased EFT thickness and hs-CRP level are significantly related to impaired LV diastolic function independent from other factors, including age, waist circumference, and 24-h systolic blood pressure.

Cited by 30 publications

References 36 publications

Procalcitonin and Pentraxin-3: Current biomarkers in inflammation in white coat hypertension

Procalcitonin and Pentraxin-3: Current biomarkers in inflammation in white coat hypertension

Hypoxia‐inducible factor 1‐alpha (HIF‐1α) as a factor mediating the relationship between obesity and heart failure with preserved ejection fraction

Association of epicardial fat with left ventricular diastolic function in subjects with metabolic syndrome: assessment using 2-dimensional echocardiography

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