Clinical Importance of Epicardial Fat Thickness Defining in Obese Patients
¹Altai State Medical University, Barnaul, Russian Federation
²Research Institute for Complex Issues of Cardiovascular Diseases, Siberian Branch of the RAMS, Kemerovo, Russian Federation,
³Altai State Cardiological Dispensary, Barnaul, Russian Federation
*Corresponding author: Prof. Galina A. Chumakova, PhD, ScD, Department of Hospital and Policlinical Therapy, Altai State Medical University. 40, Lenin ave., Barnaul, 656038, Altai Krai, Russian Federation. E-mail:email@example.com
Obesity is a global epidemic characteristic of the 21st century; therefore, studying the subclinical markers of coronary atherosclerosis in overweight patients is current and relevant. With weight increase, hypertrophy and hyperplasia of adipocytes occur not only in the abdominal area, but also in the ectopic local fat depots, including the epicardial ones. As the myocardium and coronary arteries are anatomically related, hormonally active epicardial fat seems to be a pathologic link between obesity and coronary heart disease (CHD). The objective of this research is to study the relationship between epicardial adiposity and abdominal obesity with metabolic risk factors and visceral fat adipokines. The influence of epicardial fat thickness (EFT) and waist circumference (WC) on the risk of development of significant coronary atherosclerosis in obese patients with CHD was studied (138 men, 55.47±9.07 years and BMI 35.2±5.2 kg/m2). The ROC analysis reveals that EFT is more informative in diagnosing significant stenoses (≥70 %): sensitivity of the given marker constituted 80.4 %, specificity – 67.6 % (cut-off value=6 mm). On comparison of the epicardial and abdominal adiposity as predictors of coronary atherosclerosis, EFT was found to be more significant than WC. In patients with CHD, the increase in EFT is associated with the more serious involvement of the coronary arteries, whereas the WC analysis did not establish similar regularities. Evaluation of EFT in obese patients can be used as a noninvasive marker indicative of the presence of subclinical stenoses of the coronary arteries.
1. Eckel RH, York DA, Rossner S, et al. American Heart Association. Prevention Conference VII: obesity, a worldwide epidemic related to heart disease and stroke: executive summary. Circulation 2004; 110:2968–2975.
2. Enwald HP, Huotari ML. Preventing the Obesity Epidemic by Second Generation Tailored Health Communication: An Interdisciplinary Review. J Med Internet Res 2010; 12: 24-30.
3. Kaidar-Person O, Bar-Sela G, Person B. The Two Major Epidemics of the Twenty-First Century: Obesity and Cancer. Obes Surg 2011; Aug 13 [Epub ahead of print].
4. Douketis JD, Sharma AM. Obesity and cardiovascular disease: pathogenic mechanisms and potential benefits of weight reduction. Semin Vasc Med 2005; 2325: 25–33.
5. Pérez PA, Muñoz YJ, Cortés BV. Obesity and cardiovascular disease. Public Health Nutr 2007; 10:1156-63.
6. Padwal RS, Sharma AM. Prevention of cardiovascular disease: Obesity, diabetes and the metabolic syndrome. Can J Cardiol 2010; 26: 18–20.
7. Gruberg L, Weissman NJ, Waksman R, et al. The impact of obesity on the short-term and long-term outcomes after percutaneous coronary intervention: the obesity paradox? J Am Coll Cardiol 2002; 39:578–584.
8. Juge-Aubry CE, Henrichot E, Meier CA. Adipose tissue: a regulator of inflammation. Best Pract Res Clin Endocrinol Metab 2005; 19:547–566.
9. Brook RD. Obesity, weight loss, and vascular function. Endocrine 2006; 29 (1): 21–25.
10. Iacobellis G, Willens HJ. Echocardiographic Epicardial Fat: A Review of Research and Clinical Applications. JASE 2009; 22:1311-1319.
11. Iacobellis G, Assael F, Ribaudo MC, et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res 2003; 11:304–310.
12. Aydın H, Toprak A, Deyneli O, et al. Epicardial Fat Tissue Thickness Correlates With Endothelial Dysfunction and Other Cardiovascular Risk Factors in Patients With Metabolic Syndrome. Metab Syndr Relat Disord 2010; 8:229-234.
13. Pierdomenico SD, Pierdomenico A.M, Neri M, et al. Epicardial Adipose Tissue and Metabolic Syndrome in Hypertensive Patients With Normal Body Weight and Waist. Circumference Am J Hypertens 2011 Aug 4 [Epub ahead of print].
14. Lofgren I, Herron K, Zern T. Waist Circumference Is a Better Predictor than Body Mass Index of Coronary Heart Disease Risk in Overweight Premenopausal Women. J Nutr 2004;134:1071-1076.
15. Kahn HS. The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison. BMC Cardiovasc Disord 2006; 6:5-26.
16. Mazurek T, Zhang L, Zalewski A, et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation 2003; 108:2460–2466.
17. Eroglu S, Sade LE, Yildirir A, et al. Epicardial adipose tissue thickness by echocardiography is a marker for the presence and severity of coronary artery disease. Nutr Metab Cardiovasc Dis 2009; 19:211–217.
18. Ding J, Hsu FC, Harris TB. The association of pericardial fat with incident coronary heart disease: the Multi-Ethnic Study of Atherosclerosis (MESA) 1, 2, 3. Am J Clin Nutr 2009; 90:499-504.
19. Ahn SG, Lim HS, Joe DY. Relationship of epicardial adipose tissue by echocardiography to coronary artery disease. Heart 2008; 94:7-13.
20. Malavazos AE, Ermetici F, Cereda E, et al. Epicardial fat thickness: relationship with plasma visfatin and plasminogen activator inhibitor-1 levels in visceral obesity. Nutr Metab Cardiovasc Dis. 2008; 18(8):523-530.
The fully formatted PDF version is available.
Int J Biomed. 2012;2(3):161-168.©2012 International Medical Research and Development Corporation. All rights reserved.