Limits...
Pericardial fat is associated with coronary artery calcification in non-dialysis dependent chronic kidney disease patients.

Harada PH, Canziani ME, Lima LM, Kamimura M, Rochitte CE, Lemos MM, Cuppari L, Kalil Filho R, Draibe SA, Santos RD - PLoS ONE (2014)

Bottom Line: Those presenting CAC were on average 10 years older, had a higher proportion of male gender (78.7% vs. 42.9%, p < 0.001), and had higher values of waist circumference (95.9 ± 10.7 vs. 90.2 ± 13.2 cm, p = 0.02), PF volumes (224.8 ± 107.6 vs. 139.1 ± 85.0 cm3, p<0.01) and AVF areas (109.2 ± 81.5 vs. 70.2 ± 62.9 cm2, p = 0.01).In the multivariate analysis, adjusting for age, gender, diabetes, smoking and, left ventricular concentric hypertrophy, PF was significantly associated with the presence of CAC (OR: 1.88 95% CI: 1.03-3.43 per standard deviation).PF is independently associated with CAC in non-dialysis dependent CKD patients.

View Article: PubMed Central - PubMed

Affiliation: Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medical School, Sao Paulo, Brazil.

ABSTRACT
Pericardial fat (PF) a component of visceral adipose tissue has been consistently related to coronary atherosclerosis in the general population. This study evaluated the association between PF and coronary artery calcification (CAC) in non-dialysis dependent chronic kidney disease (CKD) patients. This is a post-hoc cross sectional analysis of the baseline of a prospective cohort of 117 outward CKD patients without manifest coronary artery disease (age, 56.9 ± 11.0 years, 64.1% males, 95.1% hypertensives, 25.2% diabetics, 15.5% ever smokers, CKD stage 2 to 5 with estimated glomerular filtration rate 36.8 ± 18.1 ml/min). CAC scores, PF volume and abdominal visceral fat (AVF) areas were measured by computed tomography. The association of PF as a continuous variable with the presence of CAC was analyzed by multivariate logistic regression. CAC (calcium score > 0) was present in 59.2% patients. Those presenting CAC were on average 10 years older, had a higher proportion of male gender (78.7% vs. 42.9%, p < 0.001), and had higher values of waist circumference (95.9 ± 10.7 vs. 90.2 ± 13.2 cm, p = 0.02), PF volumes (224.8 ± 107.6 vs. 139.1 ± 85.0 cm3, p<0.01) and AVF areas (109.2 ± 81.5 vs. 70.2 ± 62.9 cm2, p = 0.01). In the multivariate analysis, adjusting for age, gender, diabetes, smoking and, left ventricular concentric hypertrophy, PF was significantly associated with the presence of CAC (OR: 1.88 95% CI: 1.03-3.43 per standard deviation). PF remained associated with CAC even with additional adjustments for estimated glomerular filtration rate or serum phosphorus (OR: 1.85 95% CI: 1.00-3.42, p = 0.05). PF is independently associated with CAC in non-dialysis dependent CKD patients.

Show MeSH

Related in: MedlinePlus

Pericardial fat (PF) volume, cranio-caudal view of internal and external surface of its tridimensional reconstruction.Exclusion of the most cranial axial surface to display the internal cavity of PF volume.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4257663&req=5

pone-0114358-g003: Pericardial fat (PF) volume, cranio-caudal view of internal and external surface of its tridimensional reconstruction.Exclusion of the most cranial axial surface to display the internal cavity of PF volume.

Mentions: The PF was analyzed at the Lipid Clinic of the Heart Institute (InCor) University of Sao Paulo Medical School Hospital (HCFMUSP) with supervision from the Cardiac Tomography and Resonance Service at the same hospital. The images obtained for CAC measurement were recovered and uploaded on an I- Mac Apple computer with and Intel Core i3 processor running MacOSx version 10.6. The Osirix Imaging Software (Pixmeo, Switzerland), open source version 3.9 [22] was used for fat quantification by a semi-automatic process developed at InCor. The PF volume (in cm3) was calculated from measurements of each PF axial slice area (in cm2). In each tomography slice a semi-automatic selection by radiodensity window ranging from −30 to −200 Hounsfield units using the limiar technique (threshold) was made. For the segmentation, a tool from the Osirix software, which detects tissues within the mentioned thresholds surrounding the selection point was used. By this technique fat areas demarked in each axial slice, and fat outside PF borders were manually delimitated to display the final axial area (Figure 1). The PF boundaries were defined as: 1-superior, pericardial reflexion near the pulmonary artery and bellow aortic arch; 2-inferior, diaphragmatic transition; 3-posterior the line between the right and left main bronchi; and 4-anterior, the internal limit of anterior thoracic wall. The PF volume was then obtained by the sum of each axial slice area weighted by its own thickness, from the diaphragm up to the last slice registering mediastinal fat, and calculated automatically by the command “compute volume” (Figures 2 and 3). In each patient, PF was measured by two experienced observers. For accuracy evaluation, intra-observer and inter-observer intra-class correlations were done for each image. The inter-observer intra-class correlation was 0.99 (p<0.01). Indexation of PF by body surface area using the DuBois method was not done due to the high correlation of the former with absolute PF values (r = 0.98 p<0.01).


Pericardial fat is associated with coronary artery calcification in non-dialysis dependent chronic kidney disease patients.

Harada PH, Canziani ME, Lima LM, Kamimura M, Rochitte CE, Lemos MM, Cuppari L, Kalil Filho R, Draibe SA, Santos RD - PLoS ONE (2014)

Pericardial fat (PF) volume, cranio-caudal view of internal and external surface of its tridimensional reconstruction.Exclusion of the most cranial axial surface to display the internal cavity of PF volume.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4257663&req=5

pone-0114358-g003: Pericardial fat (PF) volume, cranio-caudal view of internal and external surface of its tridimensional reconstruction.Exclusion of the most cranial axial surface to display the internal cavity of PF volume.
Mentions: The PF was analyzed at the Lipid Clinic of the Heart Institute (InCor) University of Sao Paulo Medical School Hospital (HCFMUSP) with supervision from the Cardiac Tomography and Resonance Service at the same hospital. The images obtained for CAC measurement were recovered and uploaded on an I- Mac Apple computer with and Intel Core i3 processor running MacOSx version 10.6. The Osirix Imaging Software (Pixmeo, Switzerland), open source version 3.9 [22] was used for fat quantification by a semi-automatic process developed at InCor. The PF volume (in cm3) was calculated from measurements of each PF axial slice area (in cm2). In each tomography slice a semi-automatic selection by radiodensity window ranging from −30 to −200 Hounsfield units using the limiar technique (threshold) was made. For the segmentation, a tool from the Osirix software, which detects tissues within the mentioned thresholds surrounding the selection point was used. By this technique fat areas demarked in each axial slice, and fat outside PF borders were manually delimitated to display the final axial area (Figure 1). The PF boundaries were defined as: 1-superior, pericardial reflexion near the pulmonary artery and bellow aortic arch; 2-inferior, diaphragmatic transition; 3-posterior the line between the right and left main bronchi; and 4-anterior, the internal limit of anterior thoracic wall. The PF volume was then obtained by the sum of each axial slice area weighted by its own thickness, from the diaphragm up to the last slice registering mediastinal fat, and calculated automatically by the command “compute volume” (Figures 2 and 3). In each patient, PF was measured by two experienced observers. For accuracy evaluation, intra-observer and inter-observer intra-class correlations were done for each image. The inter-observer intra-class correlation was 0.99 (p<0.01). Indexation of PF by body surface area using the DuBois method was not done due to the high correlation of the former with absolute PF values (r = 0.98 p<0.01).

Bottom Line: Those presenting CAC were on average 10 years older, had a higher proportion of male gender (78.7% vs. 42.9%, p < 0.001), and had higher values of waist circumference (95.9 ± 10.7 vs. 90.2 ± 13.2 cm, p = 0.02), PF volumes (224.8 ± 107.6 vs. 139.1 ± 85.0 cm3, p<0.01) and AVF areas (109.2 ± 81.5 vs. 70.2 ± 62.9 cm2, p = 0.01).In the multivariate analysis, adjusting for age, gender, diabetes, smoking and, left ventricular concentric hypertrophy, PF was significantly associated with the presence of CAC (OR: 1.88 95% CI: 1.03-3.43 per standard deviation).PF is independently associated with CAC in non-dialysis dependent CKD patients.

View Article: PubMed Central - PubMed

Affiliation: Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medical School, Sao Paulo, Brazil.

ABSTRACT
Pericardial fat (PF) a component of visceral adipose tissue has been consistently related to coronary atherosclerosis in the general population. This study evaluated the association between PF and coronary artery calcification (CAC) in non-dialysis dependent chronic kidney disease (CKD) patients. This is a post-hoc cross sectional analysis of the baseline of a prospective cohort of 117 outward CKD patients without manifest coronary artery disease (age, 56.9 ± 11.0 years, 64.1% males, 95.1% hypertensives, 25.2% diabetics, 15.5% ever smokers, CKD stage 2 to 5 with estimated glomerular filtration rate 36.8 ± 18.1 ml/min). CAC scores, PF volume and abdominal visceral fat (AVF) areas were measured by computed tomography. The association of PF as a continuous variable with the presence of CAC was analyzed by multivariate logistic regression. CAC (calcium score > 0) was present in 59.2% patients. Those presenting CAC were on average 10 years older, had a higher proportion of male gender (78.7% vs. 42.9%, p < 0.001), and had higher values of waist circumference (95.9 ± 10.7 vs. 90.2 ± 13.2 cm, p = 0.02), PF volumes (224.8 ± 107.6 vs. 139.1 ± 85.0 cm3, p<0.01) and AVF areas (109.2 ± 81.5 vs. 70.2 ± 62.9 cm2, p = 0.01). In the multivariate analysis, adjusting for age, gender, diabetes, smoking and, left ventricular concentric hypertrophy, PF was significantly associated with the presence of CAC (OR: 1.88 95% CI: 1.03-3.43 per standard deviation). PF remained associated with CAC even with additional adjustments for estimated glomerular filtration rate or serum phosphorus (OR: 1.85 95% CI: 1.00-3.42, p = 0.05). PF is independently associated with CAC in non-dialysis dependent CKD patients.

Show MeSH
Related in: MedlinePlus