Comparison of Epicardial Fat Thickness in Patients with Acute Coronary Syndrome or Chronic Stable Angina and Normal Individuals

Document Type : Original Article (s)

Authors

1 Resident, Department of Cardiology, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 General Practitioner, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Epidemiologist, Department of Epidemiology and Statistics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

5 Resident, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

6 General Practitioner, Researcher, Isfahan, Iran

Abstract

Background: Epicardial fat tissue is known as a risk factor in cardiovascular diseases. This study was designed to compare the epicardial fat thickness in patients with cardiovascular diseases and normal patients. It also tried to find a correlation between epicardial fat thickness and severity of coronary stenosis.Methods: This study was conducted from September 2010 to April 2011 at two university hospitals (Noor and Chamran Referral centers) associated to Isfahan University of Medical Sciences, Isfahan, Iran. A total number of 196 subjects were allocate to three groups of control (n = 68), acute coronary syndrome (n = 64) and chronic stable angina (n = 64). After registering demographic data, all individuals underwent echocardiography in diastolic subcostal view to determine the epicardial fat thickness. Angiography was also conducted to assess the severity of coronary stenosis. The thickness of epicardial fat was compared between groups and its correlations with age, sex, hypertension, hypercholesterolemia, diabetes, waist circumference, body mass index and severity of coronary stenosis were evaluated.Findings: The mean age of participants was 59.54 ± 11.01 years. There were statistical differences between age, sex, smoking and severity of coronary stenosis (P < 0.001, P = 0.03, P = 0.04, and P < 0.001, respectively). The mean of epicardial fat thickness in acute coronary syndrome, chronic stable angina and control groups were 5.7 ± 2.1, 6.2 ± 2.0 and 4.6 ± 1.9 mm (P < 0.001). There were no independent correlation between predicting factors and epicardial fat thickness (P > 0.05). Conclusion: This study indicated the thickness of epicardial fat to be more in cardiovascular diseases compared with normal persons. Future studies for evaluating the sensitivity and specificity of this diagnostic method are warranted.

Keywords

References

  1. Calvet D, Touze E, Varenne O, Sablayrolles JL, Weber S, Mas JL. Prevalence of asymptomatic coronary artery disease in ischemic stroke patients: the PRECORIS study. Circulation 2010; 121(14): 1623-9.
  2. Rabkin SW. Epicardial fat: properties, function and relationship to obesity. Obes Rev 2007; 8(3): 253-61.
  3. Sacks HS, Fain JN. Human epicardial adipose tissue: a review. Am Heart J 2007; 153(6): 907-17.
  4. Schejbal V. [Epicardial fatty tissue of the right ventricle--morphology, morphometry and functional significance]. Pneumologie 1989; 43(9): 490-9.
  5. Marchington JM, Mattacks CA, Pond CM. Adipose tissue in the mammalian heart and pericardium: structure, foetal development and biochemical properties. Comp Biochem Physiol B 1989; 94(2): 225-32.
  6. Mazurek T, Zhang L, Zalewski A, Mannion JD, Diehl JT, Arafat H, et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation 2003; 108(20): 2460-6.
  7. Baker AR, Silva NF, Quinn DW, Harte AL, Pagano D, Bonser RS, et al. Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovasc Diabetol 2006; 5: 1.
  8. Rosito GA, Massaro JM, Hoffmann U, Ruberg FL, Mahabadi AA, Vasan RS, et al. Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcification in a community-based sample: the Framingham Heart Study. Circulation 2008; 117(5): 605-13.
  9. Iacobellis G, Assael F, Ribaudo MC, Zappaterreno A, Alessi G, Di MU, et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res 2003; 11(2): 304-10.
  10. Iacobellis G, Barbaro G. The double role of epicardial adipose tissue as pro- and anti-inflammatory organ. Horm Metab Res 2008; 40(7): 442-5.
  11. Marchington JM, Pond CM. Site-specific properties of pericardial and epicardial adipose tissue: the effects of insulin and high-fat feeding on lipogenesis and the incorporation of fatty acids in vitro. Int J Obes 1990; 14(12): 1013-22.
  12. Jeong JW, Jeong MH, Yun KH, Oh SK, Park EM, Kim YK, et al. Echocardiographic epicardial fat thickness and coronary artery disease. Circ J 2007; 71(4): 536-9.
  13. Wang CP, Hsu HL, Hung WC, Yu TH, Chen YH, Chiu CA, et al. Increased epicardial adipose tissue (EAT) volume in type 2 diabetes mellitus and association with metabolic syndrome and severity of coronary atherosclerosis. Clin Endocrinol (Oxf) 2009; 70(6): 876-82.
  14. Mustelier JV, Rego JO, Gonzalez AG, Sarmiento JC, Riveron BV. Echocardiographic parameters of epicardial fat deposition and its relation to coronary artery disease. Arq Bras Cardiol 2011; 97(2): 122-9.
  15. Bettencourt N, Toschke AM, Leite D, Rocha J, Carvalho M, Sampaio F, et al. Epicardial adipose tissue is an independent predictor of coronary atherosclerotic burden. Int J Cardiol 2011.
  16. Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, et al. ACC/AHA guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction--2002: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina). Circulation 2002; 106(14): 1893-900.
  17. Andersson B. Echocardiography The normal Exam and Echocardiographic Measurement. London: Wiley Blackwell; 2002.
  18. Oh JK, Seward JB, Tajik AJ. The Echo Manual. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2006.
  19. Baim DS. Grossman's Cardiac Catheterization, Angiography, and Intervention. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2005.
  20. Baker AR, Silva NF, Quinn DW, Harte AL, Pagano D, Bonser RS, et al. Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovasc Diabetol 2006; 5: 1.
  21. Kremen J, Dolinkova M, Krajickova J, Blaha J, Anderlova K, Lacinova Z, et al. Increased subcutaneous and epicardial adipose tissue production of proinflammatory cytokines in cardiac surgery patients: possible role in postoperative insulin resistance. J Clin Endocrinol Metab 2006; 91(11): 4620-7.
  22. Silaghi A, Achard V, Paulmyer-Lacroix O, Scridon T, Tassistro V, Duncea I, et al. Expression of adrenomedullin in human epicardial adipose tissue: role of coronary status. Am J Physiol Endocrinol Metab 2007; 293(5): E1443-E1450.
  23. Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med 2005; 2(10): 536-43.
  24. Miyata K, Shimokawa H, Kandabashi T, Higo T, Morishige K, Eto Y, et al. Rho-kinase is involved in macrophage-mediated formation of coronary vascular lesions in pigs in vivo. Arterioscler Thromb Vasc Biol 2000; 20(11): 2351-8.
  25. Harada K, Amano T, Kitagawa K, Shimbo Y, Kunimura A, Kumagai S, et al. Epicardial fat volume over 100ml is an independent risk factor for acute coronary syndrome. Circulation 2010; 122(A13319).
  26. Chaowalit N, Somers VK, Pellikka PA, Rihal CS, Lopez-Jimenez F. Subepicardial adipose tissue and the presence and severity of coronary artery disease. Atherosclerosis 2006; 186(2): 354-9.
  27. Sade LE, Eroglu S, Bozbas H, Ozbicer S, Hayran M, Haberal A, et al. Relation between epicardial fat thickness and coronary flow reserve in women with chest pain and angiographically normal coronary arteries. Atherosclerosis 2009; 204(2): 580-5.
  28. Natale F, Tedesco MA, Mocerino R, de Simone V, Di Marco GM,Aronne L, et al. Visceral adiposity and arterial stiffness: echocardiographic epicardial fat thickness reflects, better than waist circumference, carotid arterial stiffness in a large population of hypertensives. Eur J Echocardiogr 2009; 1094): 549-55.
Journal of Isfahan Medical School
Volume 29, Issue 167 - Serial Number 167
November and December 2012
Pages 2359-2368

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History

  • Receive Date: 12 May 2011
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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