Increased epicardial adipose tissue is associated with coronary artery disease and major adverse cardiovascular events

Hajsadeghi, Fereshteh; Nabavi, Vahid; Bhandari, Ajay; Choi, Andrew; Vincent, Hunter; Flores, Ferdinand; Budoff, Matthew J.; Ahmadi, Naser

doi:10.1016/j.atherosclerosis.2014.09.037

Cited by 47 publications

(44 citation statements)

References 10 publications

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“…This observation is in line with the majority of previous studies of EAT thickness in SCH [10][11][12][13]. These data suggest that increased EAT thickness in SCH is not just an observational coincidence, but mostly related the effects of thyroid hormones on the heart and adipose tissue [11][12][13].…”

Section: Discussionsupporting

confidence: 91%

“…Increased EAT is independently related to the presence and angiographic severity of CAD [8], a well as MACE [10]. Inflammatory infiltrations have been found in EAT in the areas near coronary lesions.…”

Section: Discussionmentioning

confidence: 92%

“…Increased EAT is related to the presence and angiographic severity of CAD [8] and coronary plaque vulnerability [9], and independently predicts major adverse cardiovascular events (MACE) [10].…”

Section: Introductionmentioning

confidence: 99%

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Thickening of the epicardial adipose tissue can be alleviated by thyroid hormone replacement therapy in patients with subclinical hypothyroidism

et al. 2016

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A b s t r a c tBackground: Subclinical hypothyroidism (SCH) is a common disorder which has adverse cardiovascular effects. Epicardial adipose tissue (EAT), a novel marker of cardiovascular risk, is increased in SCH. Aim:We aimed to investigate whether L-thyroxine treatment can reverse the thickening of EAT in SCH. Methods:Forty-four patients with SCH and 42 euthyroid control subjects were included. EAT thickness was measured using transthoracic echocardiography at baseline and after restoration of the euthyroid status with 3 months of L-thyroxine treatment.Results: At baseline, mean EAT thickness was significantly greater in the SCH group when compared to the control group (6.3 ± 1.7 mm vs. 4.1 ± 0.9 mm, respectively, p < 0.001). There was a significant positive correlation between baseline serum thyroid stimulating hormone (TSH) level and EAT thickness in the SCH group. There was a significant reduction in mean EAT thickness in response to L-thyroxine treatment (6.3 ± 1.7 mm vs. 5.1 ± 1.4 mm, p < 0.001). The decrease in EAT thickness after L-thyroxine treatment when compared to baseline (DEAT) significantly correlated to the difference in TSH levels before and after treatment (DTSH; r = 0.323; p = 0.032). Conclusions:Epicardial adipose tissue thickness is increased in patients with SCH. This thickening was alleviated with restoration of the euthyroid status with L-thyroxine treatment in our study population of predominantly male, relatively old subjects with greater baseline EAT thickness.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 92%

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Thickening of the epicardial adipose tissue can be alleviated by thyroid hormone replacement therapy in patients with subclinical hypothyroidism

et al. 2016

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“…A study by Nakanishi et al has shown that in patients followed up with MDCT, increased EAT volume was associated with increased long-term ACS outcomes [25]. Moreover, an association between EAT volume and fatal and non-fatal coronary events, independent from the cardiovascular risk factors, has been reported in recent studies [5,15]. In accordance with these studies, we have also detected a moderate correlation between EAT volume and the number of vulnerable plaques, such as mixed and non-calcified plaques.…”

Section: Discussionmentioning

confidence: 95%

“…In the subanalysis of Multi-Ethnic Study of Atherosclerosis (MESA), EAT volume was associated with risk of acute myocardial infarction, resuscitated cardiac arrest, angina, and fatal coronary heart disease based upon 5 years of follow-up [5]. Similarly, in another study, increased EAT volume was directly associated with CAD and predicted major adverse cardiac events (MACE) independent of the age, gender, and conventional risk factors [15]. Recent studies have investigated the relationship between epicardial fat volume and CAD in diabetic patients.…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Epicardial Adipose Tissue Volume and Coronary Plaque Structure in Diabetics

Aksan¹

2017

Ann Clin Anal Med

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Anahtar KelimelerEpikardiyal Yağ Dokusu; Koroner Arter Hastalığı; Koroner Plak Abstract Aim: Epicardial adipose tissue (EAT) contributes to the development and progression of coronary artery disease (CAD). We aimed to evaluate the relationship between EAT volume, coronary atherosclerosis, coronary plaque burden, and plaque structure in diabetic patients. Material and Method: 196 DM patients who were evaluated with 128-slice dual-source coronary computed tomography angiography (CCTA) for suspected CAD were included in the study. The CCTA examination was used to assess the total plaque burden, number of diseased segments, plaque characteristics, and EAT volume. The study population was divided into two groups [a CAD group (Group I) and non-CAD group (Group II)]. The plaque characteristics were analyzed on a per-segment basis. Results: EAT volume was found to be significantly higher among diabetic patients with CAD compared to those without CAD ( 138.7±49.1 ml vs 98.6±34.7 ml, p<0.001). In the correlation analysis, EAT volume showed significant positive correlation with BMI (r=0.369, p<0.001), total plaque burden (r=0.424, p<0.001), mixed plaques (r=0.454, p<0.001), non-calcified plaques (r=0.369, p<0.001), calcified plaques (r=0.191, p=0.007), and number of diseased segments (r=0.449, p<0.001). Also, multivariate logistic-regression analysis revealed that EAT volume to be a significant and independent predictor of the presence of CAD in patients with DM (OR=1.023, 95% CI: 1.014-1.032; p<0.001). Discussion: We have determined that EAT volume is an independent predictor among diabetic patients for the presence of CAD. Moreover, EAT volume showed moderate correlation with total plaque burden and the number of mixed and non-calcified plaques but weak correlation with calcified plaques.

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Contribution of Maladaptive Adipose Tissue Expansion to Development of Cardiovascular Disease

Jia

Sowers

2016

Comprehensive Physiology

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The overweight and obesity epidemic has led to an increase in the metabolic syndrome and associated cardiovascular disease (CVD). These abnormalities include insulin resistance, type 2 diabetes mellitus, vascular stiffness, hypertension, stroke, and coronary heart disease. Visceral white adipocyte tissue (WAT) expansion and associated fibrosis/stiffness of WAT promote insulin resistance and CVD through increases in proinflammatory adipokines, oxidative stress, activation of renin-angiotensin-aldosterone system, dysregulation of adipocyte apoptosis and autophagy, dysfunctional immune modulation, and adverse changes in the gut microbiome. The expansion of WAT is partly determined by activation of peroxisome proliferator-activated receptor gamma and mammalian target of rapamycin/ribosomal S6 kinase signaling pathways. Further, the chronic activation of these signaling pathways may not only induce adipocyte hypertrophy and fibrosis, but also contribute to systemic inflammation, and impairment of insulin metabolic signaling in fat, liver, and skeletal muscle tissue. Therefore, the interplay of adipocyte dysfunction, maladaptive immune and inflammatory responses, and associated metabolic disorders often coexist leading to systemic low-grade inflammation and insulin resistance that are associated with increased CVD in obese individuals. © 2017 American Physiological Society. Compr Physiol 7:253-262, 2017.

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Increased epicardial adipose tissue is associated with coronary artery disease and major adverse cardiovascular events

Cited by 47 publications

References 10 publications

Thickening of the epicardial adipose tissue can be alleviated by thyroid hormone replacement therapy in patients with subclinical hypothyroidism

Thickening of the epicardial adipose tissue can be alleviated by thyroid hormone replacement therapy in patients with subclinical hypothyroidism

The Relationship Between Epicardial Adipose Tissue Volume and Coronary Plaque Structure in Diabetics

Contribution of Maladaptive Adipose Tissue Expansion to Development of Cardiovascular Disease

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