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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.

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ROC curve analysis to demonstrate the discriminatory power of the thickness of epicardial adipose tissue in the diagnosis of coronary artery disease according to body mass index. AUC, the area under the curve
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Figure 6: ROC curve analysis to demonstrate the discriminatory power of the thickness of epicardial adipose tissue in the diagnosis of coronary artery disease according to body mass index. AUC, the area under the curve

Mentions: The median EAT thickness was significantly increased in patients with CAD compared to patients without CAD (1.7 vs. 3.5 mm, p < 0.001). When compared to subjects without CAD, patients with CAD in both the non-high and high BMI groups had a median EAT thickness that was significantly increased (3.5 vs. 1.5 mm, p < 0.001 and 4.0 vs. 2.5 mm, p = 0.001, respectively, Figure 5). In addition to well-known CAD risk factors, such as age, smoking, hypertension, and diabetes, EAT thickness was an independent factor associated with CAD in both groups (Table 2). The ROC curves of the EAT thickness in predicting CAD yielded an AUC of 0.657 in the non-high BMI group and 0.735 in the high BMI group. When comparing the AUC of the 2 groups, the ROC curve analysis predicting CAD revealed that the AUC of the BMI < 27 kg/m2 group tended to be larger than that of the BMI ≥27 kg/m2 (p = 0.055, Figure 6).


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)

ROC curve analysis to demonstrate the discriminatory power of the thickness of epicardial adipose tissue in the diagnosis of coronary artery disease according to body mass index. AUC, the area under the curve
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 6: ROC curve analysis to demonstrate the discriminatory power of the thickness of epicardial adipose tissue in the diagnosis of coronary artery disease according to body mass index. AUC, the area under the curve
Mentions: The median EAT thickness was significantly increased in patients with CAD compared to patients without CAD (1.7 vs. 3.5 mm, p < 0.001). When compared to subjects without CAD, patients with CAD in both the non-high and high BMI groups had a median EAT thickness that was significantly increased (3.5 vs. 1.5 mm, p < 0.001 and 4.0 vs. 2.5 mm, p = 0.001, respectively, Figure 5). In addition to well-known CAD risk factors, such as age, smoking, hypertension, and diabetes, EAT thickness was an independent factor associated with CAD in both groups (Table 2). The ROC curves of the EAT thickness in predicting CAD yielded an AUC of 0.657 in the non-high BMI group and 0.735 in the high BMI group. When comparing the AUC of the 2 groups, the ROC curve analysis predicting CAD revealed that the AUC of the BMI < 27 kg/m2 group tended to be larger than that of the BMI ≥27 kg/m2 (p = 0.055, Figure 6).

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