The Relationship between Epicardial Adipose Tissue Thickness with Severity of Coronary Artery Disease in Indonesia
Keywords:
epicardial adipose tissue, coronary artery disease, echocardiography, Indonesia.Abstract
Epicardial adipose tissue (EAT), which is thought to be a componentof visceral adiposity, is associated with the metabolic syndrome and considered as an indicator of cardiovascular risk.Correlation of EAT with coronary artery disease (CAD) in Indonesia is unknown. To address this issue, we examined the relationship between EAT thickness with severity of coronary lesion in Indonesian patients with CAD. Results revealed that one hundred and thirty one consecutive patients who underwent transthoracic echocardiography (TTE) anddiagnostic coronary angiography were studied. The EAT thickness on the free wall of the right ventriclewas measured at end-diastole from the parasternal long-axis views. Coronary angiogramswere analyzed for severity of coronary artery disease using modified Gensini score. Accordingly, we classified the study population into two angiographic groups: patients with non-severe CAD (Gensini score ?13) and patients with severe CAD (Genisini score >13). There were no significant differences between the groups with respect to anthropometric measurements, including body mass index and waist circumference (p=0.473 and 0.947, respectively).
The patients in severe CAD group had greater EAT thickness compared with non-severe CAD group (mean EAT thickness was 8.5
References
Global status report on noncommunicable disease 2010. Geneva, World Health Organization, 2011.
Global atlas on cardiovascular disease prevention and control. Geneva, World Health Organization, 2011.
Rutter MK, Meigs JB, Sullivan LM, et al. C-reactive protein, the metabolic syndrome, and prediction of cardiovascular events in the Framingham Offspring Study. Circulation 2004;110:380-5.
Nesto R. C-reactive protein, its role in inflammation, Type 2 diabetes and cardiovascular disease, and the effects of insulin-sensitizing treatment with thiazolidinediones. Diabet Med 2004;21:810-7.
Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 2005;352:1685-95.
Sacks HS, Fain JN. Human epicardial adipose tissue: a review. Am Heart J 2007;153:907-17.
Shirani J, Berezowski K, Roberts WC. Quantitative measurement of normal and excessive (coradiposum) subepicardial adipose tissue, its clinical significance, and its effect on electrocardiographic QRS voltage. Am J Cardiol 1995;76:414-8.
Nelson AJ, Worthley MI, Psaltis PJ, et al. Validation of cardiovascular magnetic resonance assessment of pericardial adipose tissue volume. J CardiovascMagnReson 2009;11:15.
Wang TD, Lee WJ, Shih FY, et al. Association of epicardial adipose tissue with coronary atherosclerosis is region-specific and independent of conventional risk factors and intra-abdominal adiposity. Atherosclerosis2010;213(1):279-87.
Bettencourt N, Toschke AM, Leite D, et al. Epicardial adipose tissue is an independent predictor of coronary atherosclerotic burden. Int J Cardiol 2012;28:26-32.
Alexopoulos N, McLean DS, Janik M, et al.Epicardial adipose tissue and coronary artery plaque characteristics. Atherosclerosis2010;210(1):150-4.
Oka T, Yamamoto H, Ohashi N, et al. Association between epicardial adipose tissue volume and characteristics of noncalcified plaques assessed by coronary computed tomographic angiography. Int J Cardiol2012;161(1):45-9.
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. NutrMetabCardiovasc Dis 2009;19(3):211-7.
Rexrode KM, Buring JE, Manson JE. Abdominal and total adiposity and risk of coronary heart disease in men. IntJ ObesRelatMetabDisord 2001;25:1047-56.
Iacobellis G, Assael F, Ribaudo MC, et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res 2003;11:304-10.
Iacobellis G, Ribaudo MC, Assael F, et al. Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab 2003;88:5163e8.
Reardon MF, Nestel PK, Craig IH, et al. Lipoprotein predictors of the severity coronary artery disease in men and women. Circulation 1985;71:881-8.
Feng-lian MA, Xiao-lin LI, Jun LI, et al. Correlation of red cell distribution width with the severity of coronary artery disease: a large Chinese cohort study from a single centre. Chin Med J 2013;126(6):1053-7.
Sullivan DR, Marwick TH, Freedman SB. A new method of scoring coronary angiograms to reflect extent of coronary atherosclerosis and improve correlation with major risk factors. Am Heart J 1990;119:1262-7.
Peiris AN, Sothmann MS, Hoffmann RG, et al. Adiposity, fat distribution, and cardiovascular risk. Ann Intern Med 1989;110:867e72.
Folsom AR, Kushi LH, Anderson KE, et al. Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women
Pierdomenico SD, Pierdomenico AM, Cuccurullo F, et al. Meta-analysis of the relation of echocardiographic epicardial adipose tissue thickness and the metabolic syndrome. Am J Cardiol 2013;111(1):73-8.
Wang CP, Hsu HL, Hung WC, et al. Increased epicardial adipose tissue (EAT) volume in type 2 diabetes mellitus and association with metabolic syndrome and severity of coronary atherosclerosis. ClinEndocrinol (Oxf ) 2009;70(6):876-82.
Kocaman SA, Durakoglugil ME, Cetin M, et al. The independent relationship of epicardial adipose tissue with carotid intima-media thickness and endothelial functions: the association of pulse wave velocity with the active facilitated arterial conduction concept. Blood PressMonit 2013;18(2):85-93.
Doesch C, Haghi D, Suselbeck T, et al. Impact of functional, morphological and clinical parameters on epicardial adipose tissue in patients with coronary artery disease. Circ J 2012;76(10):2426-34.
Sengul C, Ozveren O. Epicardial adipose tissue: a review of physiology, pathophysiology, and clinical applications. AnadoluKardiyolDerg 2013;13(3):261-5.
Spiroglou SG, Kostopoulos CG, Varakis JN, et al. Adipokines in periaortic and epicardial adipose tissue: differential expression and relation to atherosclerosis. J AtherosclerThromb 2010;17(2):115-30.
Eiras S, Teijeira-Fernandez E, Shamagian LG, et al. Extension of coronary artery disease is associated with increased IL-6 and decreased adiponectin gene expression in epicardial adipose tissue. Cytokine 2008;43(2):174-80.
Gokdeniz T, Turan T, Aykan AC, et al. Relation of epicardial fat thickness and cardio-ankle vascular index to complexity of coronary artery disease in nondiabetic patients. Cardiology 2013;124(1):41-8.
Downloads
Published
How to Cite
Issue
Section
License
Authors who submit papers with this journal agree to the following terms.
