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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

Values of epicardial and pericardial fat deposition in steroid-treated patients and matched steroid-naïve controls. a The high-dose steroid group (>7.5 mg prednisone equivalent daily) showed significant higher amounts of epicardial fat than the low-dose steroid group (<7.5 mg prednisone equivalent daily) and the age, sex and BMI matched steroid-naïve controls. In addition, the amount of epicardial fat was not significant different between low-dose steroid patients and the control group. b Likewise, these results could be confirmed for pericardial fat
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Fig2: Values of epicardial and pericardial fat deposition in steroid-treated patients and matched steroid-naïve controls. a The high-dose steroid group (>7.5 mg prednisone equivalent daily) showed significant higher amounts of epicardial fat than the low-dose steroid group (<7.5 mg prednisone equivalent daily) and the age, sex and BMI matched steroid-naïve controls. In addition, the amount of epicardial fat was not significant different between low-dose steroid patients and the control group. b Likewise, these results could be confirmed for pericardial fat

Mentions: Focusing on patients with high-dose steroid therapy (>7.5 mg prednisone equivalent daily during the past 6 months) revealed, that those patients had significantly more epicardial fat compared to matched steroid-naïve controls: 7.2 [4.2-11.1] cm2 vs. 4.4 [1.0–6.0] cm2, p < 0.001. Furthermore, patients on high-dose steroid therapy also had significantly more epicardial fat compared to patients on low-dose steroid therapy (<7.5 mg prednisone equivalent daily during the past 6 months): 7.2 [4.3–11] cm2 vs. 4.7 [2.1–7.5] cm2, p < 0.01, see Fig. 2.Fig. 2


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)

Values of epicardial and pericardial fat deposition in steroid-treated patients and matched steroid-naïve controls. a The high-dose steroid group (>7.5 mg prednisone equivalent daily) showed significant higher amounts of epicardial fat than the low-dose steroid group (<7.5 mg prednisone equivalent daily) and the age, sex and BMI matched steroid-naïve controls. In addition, the amount of epicardial fat was not significant different between low-dose steroid patients and the control group. b Likewise, these results could be confirmed for pericardial fat
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Values of epicardial and pericardial fat deposition in steroid-treated patients and matched steroid-naïve controls. a The high-dose steroid group (>7.5 mg prednisone equivalent daily) showed significant higher amounts of epicardial fat than the low-dose steroid group (<7.5 mg prednisone equivalent daily) and the age, sex and BMI matched steroid-naïve controls. In addition, the amount of epicardial fat was not significant different between low-dose steroid patients and the control group. b Likewise, these results could be confirmed for pericardial fat
Mentions: Focusing on patients with high-dose steroid therapy (>7.5 mg prednisone equivalent daily during the past 6 months) revealed, that those patients had significantly more epicardial fat compared to matched steroid-naïve controls: 7.2 [4.2-11.1] cm2 vs. 4.4 [1.0–6.0] cm2, p < 0.001. Furthermore, patients on high-dose steroid therapy also had significantly more epicardial fat compared to patients on low-dose steroid therapy (<7.5 mg prednisone equivalent daily during the past 6 months): 7.2 [4.3–11] cm2 vs. 4.7 [2.1–7.5] cm2, p < 0.01, see Fig. 2.Fig. 2

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