Limits...
Impact of body mass index on the relationship of epicardial adipose tissue to metabolic syndrome and coronary artery disease in an Asian population.

Park JS, Ahn SG, Hwang JW, Lim HS, Choi BJ, Choi SY, Yoon MH, Hwang GS, Tahk SJ, Shin JH - Cardiovasc Diabetol (2010)

Bottom Line: In the non-high BMI group, the median EAT thickness was significantly increased in patients with MS compared to those without MS (3.5 vs. 1.9 mm, p < 0.001).When compared to patients without CAD, patients with CAD in both the non-high and high BMI groups had a significantly higher median EAT thickness (3.5 vs. 1.5 mm, p < 0.001 and 4.0 vs. 2.5 mm, p = 0.001, respectively).While EAT thickness was significantly increased in patients with MS and CAD, the power of EAT thickness to predict MS and CAD was stronger in patients with BMI < 27 kg/m2.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology, Ajou University School of Medicine, Suwon, Korea.

ABSTRACT

Background: In a previous study, we demonstrated that the thickness of epicardial adipose tissue (EAT), measured by echocardiography, was increased in patients with metabolic syndrome (MS) and coronary artery disease (CAD). Several studies on obese patients, however, failed to demonstrate any relationship between EAT and CAD. We hypothesized that body mass index (BMI) affected the link between EAT and MS and CAD.

Methods: We consecutively enrolled 643 patients (302 males, 341 females; 59 +/- 11 years), who underwent echocardiography and coronary angiography. The EAT thickness was measured on the free wall of the right ventricle at the end of diastole. All patients were divided into two groups: high BMI group, > or = 27 kg/m2 (n = 165), and non-high BMI group, < 27 kg/m2 (n = 478).

Results: The median and mean EAT thickness of 643 patients were 3.0 mm and 3.1 +/- 2.4 mm, respectively. In the non-high BMI group, the median EAT thickness was significantly increased in patients with MS compared to those without MS (3.5 vs. 1.9 mm, p < 0.001). In the high BMI group, however, there was no significant difference in the median EAT thickness between patients with and without MS (3.0 vs. 2.5 mm, p = 0.813). A receiver operating characteristic (ROC) curve analysis predicting MS revealed that the area under the curve (AUC) of the non-high BMI group was significantly larger than that of the high BMI group (0.659 vs. 0.506, p = 0.007). When compared to patients without CAD, patients with CAD in both the non-high and high BMI groups had a significantly higher median EAT thickness (3.5 vs. 1.5 mm, p < 0.001 and 4.0 vs. 2.5 mm, p = 0.001, respectively). However, an ROC curve analysis predicting CAD revealed that the AUC of the non-high BMI group tended to be larger than that of the high BMI group (0.735 vs. 0.657, p = 0.055).

Conclusions: While EAT thickness was significantly increased in patients with MS and CAD, the power of EAT thickness to predict MS and CAD was stronger in patients with BMI < 27 kg/m2. These findings showed that the measurement of EAT thickness by echocardiography might be especially useful in an Asian population with a non-high BMI, less than 27 kg/m2.

Show MeSH

Related in: MedlinePlus

Echocardiographic measurement of epicardial adipose tissue thickness. Parasternal long-axis view at the mitral valve level. EAT, epicardial adipose tissue; RV, right ventricle
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2913996&req=5

Figure 1: Echocardiographic measurement of epicardial adipose tissue thickness. Parasternal long-axis view at the mitral valve level. EAT, epicardial adipose tissue; RV, right ventricle

Mentions: Two-dimensional transthoracic echocardiography was performed. Recordings of six cycles of the two-dimensional parasternal long-axis were obtained. We enlarged each view for better visualization and accurate measurement of EAT thickness. The measurement of EAT thickness was done offline through the DICOM system and performed on the free wall of the right ventricle (RV) in the still image of a 2-D echocardiogram at end diastole on the parasternal long-axis. We preferred the area of above the RV to measure EAT thickness, because this area is recognized as having the thickest EAT layer. In addition, the parasternal long-and short-axis views allow the most accurate measurement of EAT thickness with optimal cursor beam orientation in each view. We measured the thickest point of EAT in each cycle. The average value of the EAT thickness was calculated (Figure 1).


Impact of body mass index on the relationship of epicardial adipose tissue to metabolic syndrome and coronary artery disease in an Asian population.

Park JS, Ahn SG, Hwang JW, Lim HS, Choi BJ, Choi SY, Yoon MH, Hwang GS, Tahk SJ, Shin JH - Cardiovasc Diabetol (2010)

Echocardiographic measurement of epicardial adipose tissue thickness. Parasternal long-axis view at the mitral valve level. EAT, epicardial adipose tissue; RV, right ventricle
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2913996&req=5

Figure 1: Echocardiographic measurement of epicardial adipose tissue thickness. Parasternal long-axis view at the mitral valve level. EAT, epicardial adipose tissue; RV, right ventricle
Mentions: Two-dimensional transthoracic echocardiography was performed. Recordings of six cycles of the two-dimensional parasternal long-axis were obtained. We enlarged each view for better visualization and accurate measurement of EAT thickness. The measurement of EAT thickness was done offline through the DICOM system and performed on the free wall of the right ventricle (RV) in the still image of a 2-D echocardiogram at end diastole on the parasternal long-axis. We preferred the area of above the RV to measure EAT thickness, because this area is recognized as having the thickest EAT layer. In addition, the parasternal long-and short-axis views allow the most accurate measurement of EAT thickness with optimal cursor beam orientation in each view. We measured the thickest point of EAT in each cycle. The average value of the EAT thickness was calculated (Figure 1).

Bottom Line: In the non-high BMI group, the median EAT thickness was significantly increased in patients with MS compared to those without MS (3.5 vs. 1.9 mm, p < 0.001).When compared to patients without CAD, patients with CAD in both the non-high and high BMI groups had a significantly higher median EAT thickness (3.5 vs. 1.5 mm, p < 0.001 and 4.0 vs. 2.5 mm, p = 0.001, respectively).While EAT thickness was significantly increased in patients with MS and CAD, the power of EAT thickness to predict MS and CAD was stronger in patients with BMI < 27 kg/m2.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology, Ajou University School of Medicine, Suwon, Korea.

ABSTRACT

Background: In a previous study, we demonstrated that the thickness of epicardial adipose tissue (EAT), measured by echocardiography, was increased in patients with metabolic syndrome (MS) and coronary artery disease (CAD). Several studies on obese patients, however, failed to demonstrate any relationship between EAT and CAD. We hypothesized that body mass index (BMI) affected the link between EAT and MS and CAD.

Methods: We consecutively enrolled 643 patients (302 males, 341 females; 59 +/- 11 years), who underwent echocardiography and coronary angiography. The EAT thickness was measured on the free wall of the right ventricle at the end of diastole. All patients were divided into two groups: high BMI group, > or = 27 kg/m2 (n = 165), and non-high BMI group, < 27 kg/m2 (n = 478).

Results: The median and mean EAT thickness of 643 patients were 3.0 mm and 3.1 +/- 2.4 mm, respectively. In the non-high BMI group, the median EAT thickness was significantly increased in patients with MS compared to those without MS (3.5 vs. 1.9 mm, p < 0.001). In the high BMI group, however, there was no significant difference in the median EAT thickness between patients with and without MS (3.0 vs. 2.5 mm, p = 0.813). A receiver operating characteristic (ROC) curve analysis predicting MS revealed that the area under the curve (AUC) of the non-high BMI group was significantly larger than that of the high BMI group (0.659 vs. 0.506, p = 0.007). When compared to patients without CAD, patients with CAD in both the non-high and high BMI groups had a significantly higher median EAT thickness (3.5 vs. 1.5 mm, p < 0.001 and 4.0 vs. 2.5 mm, p = 0.001, respectively). However, an ROC curve analysis predicting CAD revealed that the AUC of the non-high BMI group tended to be larger than that of the high BMI group (0.735 vs. 0.657, p = 0.055).

Conclusions: While EAT thickness was significantly increased in patients with MS and CAD, the power of EAT thickness to predict MS and CAD was stronger in patients with BMI < 27 kg/m2. These findings showed that the measurement of EAT thickness by echocardiography might be especially useful in an Asian population with a non-high BMI, less than 27 kg/m2.

Show MeSH
Related in: MedlinePlus