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Impact of long-term steroid therapy on epicardial and pericardial fat deposition: a cardiac MRI study.

Kitterer D, Latus J, Henes J, Birkmeier S, Backes M, Braun N, Sechtem U, Dominik Alscher M, Mahrholdt H, Greulich S - Cardiovasc Diabetol (2015)

Bottom Line: Metabolic syndrome is associated with increased cardiac fat deposition.In addition, we sought to investigate if this effect might be dose-dependent.Furthermore, this accumulation of cardiac fat seems to be dose-dependent, pointing towards a cumulative effect of steroids.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Internal Medicine, Robert-Bosch-Medical Center, Auerbachstrasse 110, 70376, Stuttgart, Germany. Daniel.Kitterer@rbk.de.

ABSTRACT

Background: Increased cardiac fat has been identified as a risk factor for coronary artery disease. Metabolic syndrome is associated with increased cardiac fat deposition. Steroids are known to imitate some effects of metabolic syndrome and are frequently used in patients with rheumatic disorders. Primary aim was to evaluate the impact of long-term steroid use on cardiac fat deposition in patients with rheumatic disorders. In addition, we sought to investigate if this effect might be dose-dependent.

Methods: Patients were enrolled as follows: (1) rheumatic disorder; and (2) long-term steroid therapy, and (3) underwent cardiovascular magnetic resonance (CMR) imaging. Patients were stratified in a high-dose (>7.5 mg prednisone equivalent/day for at least 6 months) and a low-dose steroid group (<7.5 mg prednisone equivalent/day) and compared to steroid-naïve controls without rheumatic disorders.

Results: 122 patients were included (n = 61 steroid patients, n = 61 controls). N = 36 were classified as high-dose, n = 25 as low-dose steroid group. Steroid patients showed larger epicardial 5.7 [3.5-9.1] cm(2) and pericardial 13.0 [6.1-26.8] cm(2) areas of fat than controls 4.2 [1.3-5.8] cm(2)/6.4 [1.6-15.4] cm(2), p < 0.001, p < 0.01, respectively. High-dose steroid patients had more epi- and pericardial fat both than controls: 7.2 [4.2-11.1] cm(2) vs. 4.4 [1.0-6.0] cm(2), p < 0.001; 18.6 [8.9-38.2] cm(2) vs. 10.7 [4.7-26.8] cm(2), p < 0.05, and patients in the low-dose steroid group (p < 0.01, p < 0.001, respectively).

Conclusion: The present data suggest increased cardiac fat deposition in steroid-treated patients with rheumatic disorders. Furthermore, this accumulation of cardiac fat seems to be dose-dependent, pointing towards a cumulative effect of steroids.

No MeSH data available.


Related in: MedlinePlus

Determination of epicardial and pericardial adipose tissue: Epicardial (shown in red) and pericardial (shown in blue) contours were drawn in the end-diastolic image in a CMR 4-chamber view
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Fig1: Determination of epicardial and pericardial adipose tissue: Epicardial (shown in red) and pericardial (shown in blue) contours were drawn in the end-diastolic image in a CMR 4-chamber view

Mentions: A single cine four-chamber view of each patient was used for quantification (in cm2) of epicardial and pericardial fat layer (definitions see below), as described elsewhere [3, 12]. In brief, after careful examination of all phases of the cine four-chamber view image, epicardial and pericardial fat layers were outlined in the end-diastolic image with commercially available Siemens Argus software (Siemens-Healthcare, Germany), also see Fig. 1. Intra- and inter-observer variability was evaluated in 30 patients (15 steroid-treated patients, 15 steroid-naïve controls) on separate occasions.Fig. 1


Impact of long-term steroid therapy on epicardial and pericardial fat deposition: a cardiac MRI study.

Kitterer D, Latus J, Henes J, Birkmeier S, Backes M, Braun N, Sechtem U, Dominik Alscher M, Mahrholdt H, Greulich S - Cardiovasc Diabetol (2015)

Determination of epicardial and pericardial adipose tissue: Epicardial (shown in red) and pericardial (shown in blue) contours were drawn in the end-diastolic image in a CMR 4-chamber view
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4588496&req=5

Fig1: Determination of epicardial and pericardial adipose tissue: Epicardial (shown in red) and pericardial (shown in blue) contours were drawn in the end-diastolic image in a CMR 4-chamber view
Mentions: A single cine four-chamber view of each patient was used for quantification (in cm2) of epicardial and pericardial fat layer (definitions see below), as described elsewhere [3, 12]. In brief, after careful examination of all phases of the cine four-chamber view image, epicardial and pericardial fat layers were outlined in the end-diastolic image with commercially available Siemens Argus software (Siemens-Healthcare, Germany), also see Fig. 1. Intra- and inter-observer variability was evaluated in 30 patients (15 steroid-treated patients, 15 steroid-naïve controls) on separate occasions.Fig. 1

Bottom Line: Metabolic syndrome is associated with increased cardiac fat deposition.In addition, we sought to investigate if this effect might be dose-dependent.Furthermore, this accumulation of cardiac fat seems to be dose-dependent, pointing towards a cumulative effect of steroids.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Internal Medicine, Robert-Bosch-Medical Center, Auerbachstrasse 110, 70376, Stuttgart, Germany. Daniel.Kitterer@rbk.de.

ABSTRACT

Background: Increased cardiac fat has been identified as a risk factor for coronary artery disease. Metabolic syndrome is associated with increased cardiac fat deposition. Steroids are known to imitate some effects of metabolic syndrome and are frequently used in patients with rheumatic disorders. Primary aim was to evaluate the impact of long-term steroid use on cardiac fat deposition in patients with rheumatic disorders. In addition, we sought to investigate if this effect might be dose-dependent.

Methods: Patients were enrolled as follows: (1) rheumatic disorder; and (2) long-term steroid therapy, and (3) underwent cardiovascular magnetic resonance (CMR) imaging. Patients were stratified in a high-dose (>7.5 mg prednisone equivalent/day for at least 6 months) and a low-dose steroid group (<7.5 mg prednisone equivalent/day) and compared to steroid-naïve controls without rheumatic disorders.

Results: 122 patients were included (n = 61 steroid patients, n = 61 controls). N = 36 were classified as high-dose, n = 25 as low-dose steroid group. Steroid patients showed larger epicardial 5.7 [3.5-9.1] cm(2) and pericardial 13.0 [6.1-26.8] cm(2) areas of fat than controls 4.2 [1.3-5.8] cm(2)/6.4 [1.6-15.4] cm(2), p < 0.001, p < 0.01, respectively. High-dose steroid patients had more epi- and pericardial fat both than controls: 7.2 [4.2-11.1] cm(2) vs. 4.4 [1.0-6.0] cm(2), p < 0.001; 18.6 [8.9-38.2] cm(2) vs. 10.7 [4.7-26.8] cm(2), p < 0.05, and patients in the low-dose steroid group (p < 0.01, p < 0.001, respectively).

Conclusion: The present data suggest increased cardiac fat deposition in steroid-treated patients with rheumatic disorders. Furthermore, this accumulation of cardiac fat seems to be dose-dependent, pointing towards a cumulative effect of steroids.

No MeSH data available.


Related in: MedlinePlus