Epicardial fat thickness in risk stratification of patients with coronary artery disease and cardiometabolic disorders
Abstract
Background. To study the possibility of using epicardial fat thickness (EFT) as an additional non-invasive diagnostic criteria and risk stratification in patients with coronary artery disease and cardiometabolic disorders in uzbek population.
Materials and methods. The study included 224 patients diagnosed with IHD, stable angina pectoris FC III and metabolic syndrome (IDF, 2005). The following were assessed: biochemical parameters and imaging markers, including EFT thickness, intima-media thickness, carotid artery stenosis.
Results. During a 2-year follow-up, 87 patients who had undergone MCE (Group I) and 137 without (Group II) were identified. Group I had higher age (P < 0.05), diabetes mellitus rate (P < 0.05), coronary revascularization in anamnesis (P < 0.05). Significant differences in clinical and biochemical parameters, including a higher epicardial fat thickness (p < 0.01), were also identified. Based on the study results, a multiple logistic regression model was constructed using 4 significant variables - epicardial fat, age, Lp(a), and BMI.
Conclusion. Epicardial fat thickness measured by echocardiography is an important prognostic factor in risk stratification of patients with coronary artery disease and cardiometabolic syndrome.
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List of references
[1] Lawler P.R., Bhatt D.L., Godoy L.C., Targeting Cardiovascular Inflammation: Next Steps in Clinical Translation, European Heart Journal, 42, 113–131, 2021, 10.1093/eurheartj/ehaa099.
[2] Drapkina O.M., Shepel R.N., Deeva T.A., The thickness of the epicardial fat is the "visit card"of metabolic syndrome, Obesity and Metabolism, 15, 2, 29–34, 2018, 10.14341/omet9295.
[3] Mustafina I.A., Ionin V.A., Dolganov A.A., Ishmetov V.Sh., Pushkareva A.E., Yagudin T.A., Danilko K.V., Zagidullin N.Sh., Role of epicardial adipose tissue in the development of cardiovascular diseases, Russian Journal of Cardiology, 27, 1S, 4872, 2022, 10.15829/1560-4071-2022-4872.
[4] Drapkina O.M., Ivashkin V.T., Abdominal pain, Russian Journal of Gastroenterology, Hepatology, Coloproctology, 12, 4, 8–15, 2002, In Russian: Драпкина О.М., Ивашкин В.Т. Абдоминальный болевой синдром. Российский Журнал Гастроэнтерологии, Гепатологии, Колопроктологии 2002;12(4):8–15.
[5] Tsao H.M., Hu W.C., Wu M.H., Quantitative analysis of quantity and distribution of epicardial adipose tissue surrounding the left atrium in patients with atrial fibrillation and effect of recurrence after ablation, American Journal of Cardiology, 107, 10, 1498–1503, 2011, 10.1016/j.amjcard.2011.01.027.
[6] Nakanishi K., Fukuda S., Tanaka A., Otsuka K., Jissho S., Taguchi H., Yoshikawa J., Shimada K., Persistent epicardial adipose tissue accumulation is associated with coronary plaque vulnerability and future acute coronary syndrome in non-obese subjects with coronary artery disease, Atherosclerosis, 237, 353–360, 2014, 10.1016/j.atherosclerosis.2014.09.015.
[7] Chicherina E.N., Lobanova N.Yu., Role of coronary artery calcium scores in the diagnosis of subclinical coronary artery atherosclerosis in patients with cardiovascular risk factors, Russian Journal of Preventive Medicine, 22, 03, 101–106, 2019, 10.17116/profmed201922031101.
[8] Napoli G., Pergola V., Basile P., De Feo D., Bertrandino F., Baggiano A., Mushtaq S., Fusini L., Fazzari F., Carrabba N., Rabbat M.G., Motta R., Ciccone M.M., Pontone G., Guaricci A.I., Epicardial and Pericoronary Adipose Tissue, Coronary Inflammation, and Acute Coronary Syndromes, J Clin Med, 12, 023, 7212, 2023, 10.3390/jcm12237212, 38068263, PMC10707039.
[9] Jehn S., Roggel A., Dykun I., Balcer B., Al-Rashid F., Totzeck M., Risse J., Kill C., Rassaf T., Mahabadi A.A., Epicardial adipose tissue and obstructive coronary artery disease in acute chest pain: the EPIC-ACS study, European Heart Journal Open, 3, 03, oead041, 2023, 10.1093/ehjopen/oead041.
[10] Yu W., Liu B., Zhang F., Wang J., Shao X., Yang X., Shi Y., Wang B., Xu Y., Wang Y., Journal of the American Heart Association, 10, 06, 10.1161/JAHA.120.018080.
[11] Recommendations for the treatment of patients with metabolic syndrome, Clinical guidelines, Moscow, 2013, 43 p..
[12] Visseren F. L. J., Mach F., Smulders Y. M., Carballo D., Koskinas K. C., Ba¨ck M., Benetos A., Biffi A., Boavida J.-M., Capodanno D., Cosyns B., Crawford C., Davos C. H., Desormais I., Di Angelantonio E., Franco O. H., Halvorsen S., Hobbs F. D. R., Hollander M., Jankowska E. A., Michal M., Sacco S., Sattar N., Tokgozoglu L., Tonstad S., Tsioufis K. P., van Dis I., van Gelder I. C., Wanner C., Williams B., ESC Scientific Document Group, 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC), European Heart Journal, 42, 34, 3227–3337, 2021, 10.1093/eurheartj/ehab484.
[13] Mach F., Windecker S., Nibouche D., 2019 ESC/EAS guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk, Atherosclerosis, 290, 140–205, 2019.
[14] Iacobellis G., Assael F., Ribaudo M., Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction, Obes Res, 11, 304–310, 2003.
[15] Grandl G., Wolfrum C., Hemostasis, endothelial stress, inflammation, and the metabolic syndrome, Seminars in Immunopathology, 40, 02, 215–224, 2018.
[16] Han M.S., White A., Perry R.J., Regulation of adipose tissue inflammation by interleukin 6, Proceedings of the National Academy of Sciences, 117, 06, 2751–2760, 2020, 10.1073/pnas.1920004117.
[17] Tesche C., Bauer M.J., Straube F., Rogowski S., Baumann S., Renker M., Fink N., Schoepf U.J., Hoffmann E., Ebersberger U., Association of epicardial adipose tissue with coronary CT angiography plaque parameters on cardiovascular outcome in patients with and without diabetes mellitus, Atherosclerosis, 363, 78–84, 2022.
[18] Sequeira D.I., Ebert L.C., Flach P.M., Ruder T.D., Thali M.J., Ampanozi G., The correlation of epicardial adipose tissue on postmortem CT with coronary artery stenosis as determined by autopsy, Forensic science, medicine, and pathology, 11, 186–192, 2015.
[19] Douglass E., Greif S., Frishman W.H., Epicardial Fat, Cardiol Rev, 25, 5, 230–235, 2017, 10.1097/CRD.0000000000000153.
[20] Park S.S., Jung J., Mintz G.S., Jin U., Park J.S., Park B., Shin, H.B., Seo K.W., Yang H.M., Lim H.S., Choi B.J., Yoon M.H., Shin J.H., Tahk S.J., Choi S.Y., Epicardial Adipose Tissue Thickness Is Related to Plaque Composition in Coronary Artery Disease, Diagnostics, 12, 11, 2836, 2022, 10.3390/diagnostics12112836.
Copyright (c) 2025 А.Р. Ким , Р.Б. Алиева , А.Б. Шек , Ш.С. Ахмедова , Л.Э. Кан (Автор)
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