Association between Epicardial Adipose Tissue Thickness and Left Ventricular Diastolic Functions

Yıl 2020, , 390 - 396, 15.09.2020

Sabiye Yılmaz , Saadet Demirtas Inci , Kahraman Coşansu , Huseyin Gündüz , Harun Kılıç

https://doi.org/10.31832/smj.732042

Öz

Objective: Epicardial adipose tissue (EAT) has been found to be associated
with the diastolic dysfunction in recent years, but this relationship has not
been fully elucidated. Echocardiography is a non-invasive, simple, cost
effective and accessible approach to assess EAT thickness, which can be performed easily.
The aim of this study was to evaluate the effectiveness of EAT on prediction of
diastolic dysfunction.

Materials
and Methods: A total of 138
patients without any cardiovascular,
inflammatory, autoimmune and cancer disease, were enrolled. Our study was performed in the Cardiology clinic of
Sakarya University Training and Research Hospital between May 2019 and December
2019. Subjects were divided into two groups, those with and without
diastolic dysfunctions. Conventional echocardiography parameters
and tissue Doppler imaging (TDI) were performed to evaluate left ventricular
functions. EAT thickness on the free wall
of the right ventricle in parasternal long-axis view were measured using
transthoracic echocardiography.

Results: In
comparison with the non- diastolic
dysfunction group, patients with diastolic dysfunction had
significantly higher epicardial fat thickness (5.98±1.52 mm vs 4.32±1.03 mm; p<0.001).
The multivariate regression analysis indicated that EAT independently predicts diastolic dysfunction (OR, 0.278, 95%CI
0.396 to 1.400)

Conclusions:
According to the findings of this study, EAT thickness is an independent
predictor for the development of diastolic
dysfunction in patients without cardiovascular disease.

Anahtar Kelimeler

adipose tissue, echocardiography, epicardium, left ventricular function

Kaynakça

• References
• 1.1. Lam CS, Donal E, Kraigher-Krainer E, Vasan RS. Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur J Heart Fail 2011;13:18–28.
• 2. Halley CM, Houghtaling PL, Khalil MK, Thomas JD, Jaber WA. Mortality rate in patients with diastolic dysfunction and normal systolic function. Arch Intern Med 2011;171:1082–7.
• 3. Sacks HS, Fain JN. Human epicardial adipose tissue: a review. Am Heart J 2007; 153: 907 –917. 4. Ouwens DM, Sell H, Greulich S, Eckel J. The role of epicardial and perivascular adipose tissue in the pathophysiology of cardiovascular disease. J Cell Mol Med 2010; 14: 2223–2234.
• 5. Venteclef N, Guglielmi V, Balse E, Gaborit B, Cotillard A, Atassi F, et al. Human epicardial adipose tissue induces fibrosis of the atrial myocardium through the secretion of adipo-fibrokines. Eur Heart J 2015; 36: 795–805a.
• 6. Park HK, Kwak MK, Kim HJ, Ahima RS. Linking resistin, inflammation, and cardiometabolic diseases. Korean J Intern Med 2017;32:239–247.
• 7. Iacobellis G. Local and systemic effects of the multifaceted epicardial adipose tissue depot. Nat Rev Endocrinol 2015;11:363–371.
• 8. Gaborit B, Sengenes C, Ancel P, Jacquier A, Dutour A. Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat? Compr Physiol 2017; 7(3): 1051-82.
• 9. Talman AH, Psaltis PJ, Cameron JD, Meredith IT, Seneviratne SK, Wong DT. Epicardial adipose tissue: far more than a fat depot. Cardiovasc Diagn Ther 2014; 4(6): 416-29.
• 10. Bertaso AG, Bertol D, Duncan BB, Foppa M. Epicardial fat: definition, measurements and systematic review of main outcomes. Arq Bras Cardiol 2013; 101: e18-28.
• 11. Cheitlin MD, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, Davis JL, et al. Guideline update for the clinical application of echocardiography: summary article. J Am Soc Echocardiogr 2003; 16: 1091-110
• 12. Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation 1977; 55: 613-8
• 13. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J AmSocEchocardiogr 2009; 22:107–133.
• 14. Paulus WJ, Tschöpe C, Sanderson JE, RusconiC, Flachskampf FA, Rademakers FE, et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J 2007; 28: 2539–2550.
• 15. Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American society of Echocardiography Committee on Standards Subcommittee on Quantitation of Two-Dimensional Echocardiography. J Am Soc Echocardiogr 1989;2:358-67.
• 16. Haffar T, Akoumi A, Bousette N. Lipotoxic palmitate impairs the rate of beta-oxidation and citric acid cycle flux in rat neonatal cardiomyocytes. Cell Physiol Biochem 2016;40:969–981.
• 17. Fitzgibbons TP, Czech MP. Epicardial and perivascular adipose tissues and their influence on cardiovascular disease: basic mechanisms and clinical associations. J Am Heart Assoc 2014;3:e000582.
• 18. Shimabukuro M, Hirata Y, Tabata M, Dagvasumberel M, Sato H, Kurobe H, et al. Epicardial adipose tissue volume and adipocytokine imbalance are strongly linked to human coronary atherosclerosis. Arterioscler Thromb Vasc Biol 2013;33:1077– 1084.
• 19.Turak O, Ozcan F, Canpolat U, Isleyen A, Cebeci M, Oksuz F, et al. Increased echocardiographic epicardial fat thickness and high-sensitivity CRP level indicate diastolic dysfunction in patients with newly diagnosed essential hypertension. Blood Press Monit 2013;18:259–64.
• 20. Fontes-Carvalho R, Fontes-Oliveira M, Sampaio F, Mancio J, Bettencourt N, Teixeira M,et al. Influence of epicardial and visceral fat on left ventricular diastolic and systolic functions in patients after myocardial infarction. Am J Cardiol 2014; 114:1663–1669.
• 21. Ng ACT, Goo SY, Roche N, van der Geest RJ, Wang WYS. Epicardial adipose tissue volume and left ventricular myocardial function using 3-dimensional speckle tracking echocardiography. Can J Cardiol 2016;32:1485–1492
• 22. Fenk S, Fischer M, Strack C, Schmitz G, Loew T, Lahmann C, et al. Successful weight reduction improves left ventricular diastolic function and physical performance in severe obesity. Int Heart J 2015;56:196–202. 23. Tae-Min Rhee, Hack-Lyoung Kim, Woo-Hyun Lim, Jae-Bin Seo, Sang-Hyun Kim, Joo-Hee Zo, et al. Association between epicardial adipose tissue thickness and parameters of target organ damage in patients undergoing coronary angiography. Hypertension Research 2019; 42:549–557.
• 24. Konishi M, Sugiyama S, Sugamura K, Nozaki T, Matsubara J, Akiyama E, et al. Accumulation of pericardial fat correlates with left ventricular diastolic dysfunction in patients with normal ejection fraction. J Cardiol 2012;59:344–51.
• 25. Cavalcante JL, Tamarappoo BK, Hachamovitch R, Kwon DH, Alraies MC, Halliburton S, et al. Association of epicardial fat, hypertension, subclinical coronary artery disease, and metabolic syndrome with left ventricular diastolic dysfunction. Am J Cardiol 2012;110:1793–8.
• 26. Iacobellis G, Leonetti F. Epicardial adipose tissue and insulin resistance in obese subjects. J Clin Endocrinol Metab 2005;90:6300-2.
• 27. Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med 2006; 355:251– 259. 28. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, et al. ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 2013; 128:1810–1852.
• 29. Lai YH, Hou CJY, Yun CH, Sung KT, Su CH, Wu TH, et al. The association among MDCT-derived three-dimensional visceral adiposities on cardiac diastology and dyssynchrony in asymptomatic population. BMC Cardiovasc Dis-ord 2015;15:142–153.
• 30. Fontes-Carvalho R, Fontes-Oliveira M, Sampaio F, Mancio J, Betten- court N, Teixeira M, et al. Influence of epicardial and visceral fat on left ventricular diastolic and systolic functions in patients after myocardial infarction. Am J Cardiol 2014;114:1663–1669.
• 31. Hung CL, Yun CH, Lai YH, Sung KT, Bezerra HG, Kuo JY, et al. An observational study of the association among interatrial adiposity by computed tomography measure, insulin resistance, and left atrial electromechanical disturbances in heart failure. Medicine 2016;95:e3912.
• 32. Jennifer Mancio, Diana Azevedo, Mariana Fragao-Marques, Ines Falcao-Pires, Adelino Leite-Moreira, Nuno Lunet, et al. Meta-Analysis of Relation of Epicardial Adipose Tissue Volume to Left Atrial Dilation and to Left Ventricular Hypertrophy and Functions. Am J Cardiol 2019;123:523−531.
• 33. Fox CS, Gona P, Hoffmann U, Porter SA, Salton CJ, Massaro JM, et al. Pericardial fat, intrathoracic fat, and measures of left ventricular structure and function: the Framingham Heart Study. Circulation 2009;119:1586–1591.
• 34. Liu J, Fox CS, Hickson DA, May WL, Ding J, Carr JJ, et al. Pericardial fat and echocardiographic measures of cardiac abnormalities: the Jackson Heart Study. Diabetes Care 2011;34:341–346.
• 35. Wu FZ, Chou KJ, Huang YL, Wu MT. The relation of locationspecific epicardial adipose tissue thickness and obstructive coronary artery disease: systemic review and meta-analysis of observational studies. BMC Cardiovasc Disord 2014;14:62.