Quantitative measurement of normal and excessive (cor adiposum) subepicardial adipose tissue, its clinical significance, and its effect on electrocardiographic QRS voltage

Shirani, Jamshid; Berezowski, Katherine; Roberts, William C.

doi:10.1016/s0002-9149(99)80116-7

Cited by 164 publications

(105 citation statements)

References 10 publications

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“…In an autopsy study, a significant but weak correlation with BMI has been reported in normal or ischemic hearts (r ¼ 0.28; Po0.05), but not with hypertrophied hearts. 22 We detected a significant correlation (mean BMI: 39.5±4.7, r ¼ 0.394, P ¼ 0.031) between SAT thickness and BMI values, which were calculated by us from the given data, in the autopsy study performed by Shirani et al 23 In the medical literature, there has been some controversy whether there is an increase in SAT with age. Tansey et al 24 measured the SAT thicknesses of 148 patients who died of non-cardiac causes.…”

Section: Discussionmentioning

confidence: 54%

Threshold value of subepicardial adipose tissue to detect insulin resistance in obese children

et al. 2009

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Aim: Until now, the association between subepicardial adipose tissue (SAT), insulin resistance and intima-media thickness (IMT) has not been evaluated in obese children. In this study, we evaluated whether echocardiographic SAT is related to insulin resistance and IMT in obese children. Subjects and Methods: A total of 46 obese subjects (10.2 ± 2.5 years of age, 25 male patients) and 30 age-and gendermatched lean subjects (10.8±3.1 years of age, 13 male patients) were included in this study. The criterion for diagnosing obesity was defined as the body mass index (BMI) being over 97% percentile of the same gender and age. Serum triglyceride (TG), low-and high-density lipoprotein, cholesterol, glucose and insulin levels were measured during the fasting state. Each subject underwent a transthoracic echocardiogram and the SAT thickness was measured during end-diastole from the parasternal long-axis views. Results: The obese subjects had significantly higher SAT thickness and IMT values compared with the subjects in the control group (5.7±1.4 vs 3.0±0.7 mm, 0.78±0.15 vs 0.51±0.11 mm, P ¼ 0.001, respectively). Simple linear regression analysis showed no significant correlation between SAT and insulin resistance (r ¼ 0.170, P ¼ 0.253), whereas there was significant correlation between SAT and BMI, age and IMT (r ¼ 0.625, P ¼ 0.02, r ¼ 0.589, P ¼ 0.001, r ¼ 0.343, P ¼ 0.02, respectively). As an optimal cutoff point, a SAT thickness of 4.1 mm determined insulin resistance with 90% sensitivity and 61% specificity. Conclusions: Our study showed that SAT was significantly correlated with age, BMI and IMT, but not insulin resistance. However, our findings suggest that a 4.1 mm cutoff of SAT thickness might be used as a simple, inexpensive and non-invasive screening method because of its ability to predict insulin resistance with high sensitivity in obese children.

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Section: Discussionmentioning

confidence: 54%

Threshold value of subepicardial adipose tissue to detect insulin resistance in obese children

et al. 2009

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“…8 The designation of a purely fatty form of ARVC is problematic, however, because it has long been appreciated (and recently documented by quantitative study) that significant fat infiltration of the right ventricle occurs in >50% of normal hearts in elderly patients. 9 - 10 Morphometric analysis of biopsy sections showed a greater amount of fibrous tissue in young patients and a greater prevalence of fatty tissue in adults. 11 The presence of fatty tissue and fibrous tissue exceeding 3.21% and 40.38%, respectively, has been considered highly suspect for arrhythmogenic right ventricular cardiomyopathy in right ventricular endomyocardial biopsy.…”

Section: See Page 1532mentioning

confidence: 99%

Arrhythmogenic Right Ventricular Cardiomyopathy and Fatty Replacement of the Right Ventricular Myocardium

et al. 1998

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“…The coronary artery calcification score (CACS) in patients with ESRD reflects the severity of atherosclerotic vascular disease and predicts cardiovascular events (9,10). Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart that accounts for approximately 20% of total heart weight, covers 80% of the cardiac surfaces, and is mostly in the grooved segments along the paths of coronary arteries (11)(12)(13). Recent studies showed a close relationship between coronary artery disease (CAD) and EAT using multidetector computed tomography (MDCT) and echocardiography in healthy subjects and patients at a high risk of CAD (14 -17).…”

Section: Introductionmentioning

confidence: 99%

The Relationship between Epicardial Adipose Tissue and Malnutrition, Inflammation, Atherosclerosis/Calcification Syndrome in ESRD Patients

Türkmen

Kayıkçıoğlu²,

Özbek³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Malnutrition, inflammation, atherosclerosis/calcification (MIAC) and endothelial dysfunction are the most commonly encountered risk factors in the pathogenesis of cardiovascular disease in ESRD patients. Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between CAD and EAT was shown in patients with high risk of coronary artery disease. In this study, we aimed to investigate the relationship between EAT and MIAC syndrome in ESRD patients.Design, setting, participants, & measurements Eighty ESRD patients and 27 healthy subjects enrolled in this cross-sectional study. EAT and coronary artery calcification score were measured by a multidetector computed tomography (MDCT) scanner. Patients with serum albumin Ͻ3.5 mg/dl were defined as patients with malnutrition; those with serum C-reactive protein level Ͼ10 ng/dl (normal range, 0 -5 ng/dl) had inflammation; and those with CACS Ͼ10 had atheroscleosis/calcification.Results Total CACS and EAT measurements were significantly higher in ESRD patients when compared with healthy subjects. There was a statistically significant relationship between EAT and CACS in ESRD patients (r ϭ 0.48). EAT measurements were higher in PD patients than HD patients. Twenty-four of the patients had no component, 31 had one component, 17 had two components, and nine had all of the MIAC components. EAT was found to be significantly increased when the presence of MIAC components increased. EAT was positively correlated with age, body mass index, and presence of MIAC. These parameters were also found as independent predictors of increased EAT.Conclusions We found a relationship between EAT and components of MIAC syndrome in ESRD patients.

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Quantitative measurement of normal and excessive (cor adiposum) subepicardial adipose tissue, its clinical significance, and its effect on electrocardiographic QRS voltage

Cited by 164 publications

References 10 publications

Threshold value of subepicardial adipose tissue to detect insulin resistance in obese children

Threshold value of subepicardial adipose tissue to detect insulin resistance in obese children

Arrhythmogenic Right Ventricular Cardiomyopathy and Fatty Replacement of the Right Ventricular Myocardium

The Relationship between Epicardial Adipose Tissue and Malnutrition, Inflammation, Atherosclerosis/Calcification Syndrome in ESRD Patients

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