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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

Correlation of multiple parameters in steroid-treated patients and matched steroid-naïve controls. a, b Epicardial and pericardial fat with BMI in patients with steroid therapy. c, d Epicardial and pericardial fat in age, sex and BMI matched steroid-naïve controls. e, f Epicardial and pericardial fat with BMI in the low-dose steroid group (<7.5 mg prednisone equivalent daily). g, h Epicardial and pericardial fat with BMI in the high-dose steroid group (>7.5 mg prednisone equivalent daily)
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Fig3: Correlation of multiple parameters in steroid-treated patients and matched steroid-naïve controls. a, b Epicardial and pericardial fat with BMI in patients with steroid therapy. c, d Epicardial and pericardial fat in age, sex and BMI matched steroid-naïve controls. e, f Epicardial and pericardial fat with BMI in the low-dose steroid group (<7.5 mg prednisone equivalent daily). g, h Epicardial and pericardial fat with BMI in the high-dose steroid group (>7.5 mg prednisone equivalent daily)

Mentions: We found a correlation between epicardial and pericardial fat and the BMI of patients in the steroid group, see Fig. 3. This holds also true for epicardial fat and BMI in the high-dose steroid group (p < 0.001), as well as for pericardial fat in the low-dose steroid group, p < 0.05. Furthermore, statistical analysis revealed a trend for pericardial fat in the high-dose steroid group to be related to BMI (p = 0.06), and also for epicardial fat in the low-dose steroid group (p = 0.1). No correlation of epicardial or pericardial fat deposition with BMI could be detected in the control group, see Fig. 3.Fig. 3


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)

Correlation of multiple parameters in steroid-treated patients and matched steroid-naïve controls. a, b Epicardial and pericardial fat with BMI in patients with steroid therapy. c, d Epicardial and pericardial fat in age, sex and BMI matched steroid-naïve controls. e, f Epicardial and pericardial fat with BMI in the low-dose steroid group (<7.5 mg prednisone equivalent daily). g, h Epicardial and pericardial fat with BMI in the high-dose steroid group (>7.5 mg prednisone equivalent daily)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig3: Correlation of multiple parameters in steroid-treated patients and matched steroid-naïve controls. a, b Epicardial and pericardial fat with BMI in patients with steroid therapy. c, d Epicardial and pericardial fat in age, sex and BMI matched steroid-naïve controls. e, f Epicardial and pericardial fat with BMI in the low-dose steroid group (<7.5 mg prednisone equivalent daily). g, h Epicardial and pericardial fat with BMI in the high-dose steroid group (>7.5 mg prednisone equivalent daily)
Mentions: We found a correlation between epicardial and pericardial fat and the BMI of patients in the steroid group, see Fig. 3. This holds also true for epicardial fat and BMI in the high-dose steroid group (p < 0.001), as well as for pericardial fat in the low-dose steroid group, p < 0.05. Furthermore, statistical analysis revealed a trend for pericardial fat in the high-dose steroid group to be related to BMI (p = 0.06), and also for epicardial fat in the low-dose steroid group (p = 0.1). No correlation of epicardial or pericardial fat deposition with BMI could be detected in the control group, see Fig. 3.Fig. 3

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