Validation of the echocardiographic assessment of epicardial adipose tissue thickness at the Rindfleisch fold for the prediction of coronary artery disease.
[en] BACKGROUND AND AIM: Echocardiography is a promising technique for the assessment of epicardial adipose tissue (EAT). Increased EAT thickness is associated with different cardiac diseases, including; coronary artery disease (CAD). Since several different echocardiographic approaches have been proposed to measure EAT, the identification of a standardized method is needed. We propose the assessment of EAT maximal thickness at the Rindfleisch fold, the reproducibility of this measurement and its correlation with EAT thickness and volume assessed at cardiac magnetic resonance (CMR). Finally, we will test the predictive role of this measurement on the presence of significant CAD. METHODS AND RESULTS: In 1061 patients undergoing echocardiography, EAT thickness was measured at the level of the Rindfleisch fold. In 70 patients, we tested the relationship between echo-EAT thickness and EAT thickness and volume assessed at CMR. In 499 patients with suspected CAD, undergoing coronary artery angiography, we tested the predictive value of EAT on the presence of significant CAD. Echo-EAT thickness measurements had an excellent reliability as indicated by the inter-observer (ICC:0.97; 95% C.I. 0.96 to 0.98) and intra-observer (ICC:0.99; 95% C.I. 0.98 to 0.99) reliability rates. Echo-EAT thickness significantly correlated with CMR-EAT thickness and volume (p < 0.001). An EAT thickness value >10 mm discriminated patients with significant CAD at coronary angiography (p < 0.001). At multivariable analysis, including demographic data and cardiovascular risk factors, EAT thickness was an independent predictor of significant CAD and showed an additive predictive value over common atherosclerotic risk factors. CONCLUSIONS: Echocardiographic assessment of EAT thickness at the level of the Rindfleisch fold represents a simple and trustworthy method. An increased EAT thickness shows an additive predictive value on CAD over common atherosclerotic risk factors, thus suggesting its potential clinical use for CAD risk stratification.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Parisi, Valentina
Petraglia, Laura
Formisano, Roberto
Caruso, Aurelio
Grimaldi, Maria G.
Bruzzese, Dario
Grieco, Fabrizio V.
Conte, Maddalena
Paolillo, Stefania
Scatteia, Alessandra
Dellegrottaglie, Santo
Iavazzo, Annarita
Campana, Pasquale
Pilato, Emanuele
Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
Validation of the echocardiographic assessment of epicardial adipose tissue thickness at the Rindfleisch fold for the prediction of coronary artery disease.
Publication date :
2019
Journal title :
Nutrition, Metabolism, and Cardiovascular Diseases
ISSN :
0939-4753
eISSN :
1590-3729
Peer reviewed :
Peer reviewed
Commentary :
Copyright (c) 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.
Bibliography
Ahn, S.G., Lim, H.S., Joe, D.Y., Kang, S.J., Choi, B.J., Choi, S.Y., et al. Relationship of epicardial adipose tissue by echocardiography to coronary artery disease. Heart, 94, 2008, e7.
Nishio, S., Kusunose, K., Yamada, H., Hirata, Y., Ise, T., Yamaguchi, K., et al. Echocardiographic epicardial adipose tissue thickness is associated with symptomatic coronary vasospasm during provocative testing. J Am Soc Echocardiogr 30 (2017), 1021–1027.
Eroglu, S., Sade, L.E., Yildirir, A., Bal, U., Ozbicer, S., Ozgul, A.S., et al. Epicardial adipose tissue thickness by echocardiography is a marker for the presence and severity of coronary artery disease. Nutr Metab Cardiovasc Dis 19 (2009), 211–217.
Parisi, V., Rengo, G., Pagano, G., D'Esposito, V., Passaretti, F., Caruso, A., et al. Epicardial adipose tissue has an increased thickness and is a source of inflammatory mediators in patients with calcific aortic stenosis. Int J Cardiol 186 (2015), 167–169.
Batal, O., Schoenhagen, P., Shao, M., Ayyad, A.E., Van Wagoner, D.R., Halliburton, S.S., et al. Left atrial epicardial adiposity and atrial fibrillation. Circ Arrhythm Electrophysiol 3 (2010), 230–236.
Shin, S.Y., Yong, H.S., Lim, H.E., Na, J.O., Choi, C.U., Choi, J.I., et al. Total and interatrial epicardial adipose tissues are independently associated with left atrial remodeling in patients with atrial fibrillation. J Cardiovasc Electrophysiol 22 (2011), 647–655.
Thanassoulis, G., Massaro, J.M., O'Donnell, C.J., Hoffmann, U., Levy, D., Ellinor, P.T., et al. Pericardial fat is associated with prevalent atrial fibrillation: the Framingham Heart Study. Circ Arrhythm Electrophysiol 3 (2010), 345–350.
Iacobellis, G., Lonn, E., Lamy, A., Singh, N., Sharma, A.M., Epicardial fat thickness and coronary artery disease correlate independently of obesity. Int J Cardiol 146 (2011), 452–454.
Jeong, J.W., Jeong, M.H., Yun, K.H., Oh, S.K., Park, E.M., Kim, Y.K., et al. Echocardiographic epicardial fat thickness and coronary artery disease. Circ J 71 (2007), 536–539.
Kim, S.A., Kim, M.N., Shim, W.J., Park, S.M., Epicardial adipose tissue is related to cardiac function in elderly women, but not in men. Nutr Metab Cardiovasc Dis 27 (2017), 41–47.
Eroğlu, S., How do we measure epicardial adipose tissue thickness by transthoracic echocardiography?. Anatol J Cardiol 15 (2015), 416–419.
Iacobellis, G., Assael, F., Ribaudo, M.C., Zappaterreno, A., Alessi, G., Di Mario, U., et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res 11 (2003), 304–310.
Falkowski, G., Dzigivker, I., Bitran, D., Plica transversae aortae–fold of Rindfleisch. Ann Thorac Surg 71 (2001), 761–762.
Parisi, V., Petraglia, L., D'Esposito, V., Cabaro, S., Rengo, G., Caruso, A., et al. Statin therapy modulates thickness and inflammatory profile of human epicardial adipose tissue. Int J Cardiol 274 (2019), 326–330.
Gaborit, B., Jacquier, A., Kober, F., Abdesselam, I., Cuisset, T., Boullu-Ciocca, S., et al. Effects of bariatric surgery on cardiac ectopic fat lesser decrease in epicardial fat compared to visceral fat loss and No change in myocardial triglyceride content. JACC (J Am Coll Cardiol) 60 (2012), 1381–1389.
Nelson, A.J., Worthley, M.I., Psaltis, P.J., Carbone, A., Dundon, B.K., Duncan, R.F., et al. Validation of cardiovascular magnetic resonance assessment of pericardial adipose tissue volume. J Cardiovasc Magn Reson 5 (2009), 11–15.
Gaborit, B., Kober, F., Jacquier, A., Moro, P.J., Cuisset, T., Boullu, S., et al. Assessment of epicardial fat volume and myocardial triglyceride content in severely obese subjects: relationship to metabolic profile, cardiac function and visceral fat. Int J Obes 36 (2012), 422–430.
Flüchter, S., Haghi, D., Dinter, D., Heberlein, W., Kühl, H.P., Neff, W., et al. Volumetric assessment of epicardial adipose tissue with cardiovascular magnetic resonance imaging. Obesity 15 (2007), 870–878.
Schejbal, V., Epicardial fatty tissue of the right ventricle: morphology, morphometry and functional significance. Pneumologie 43 (1989), 490–499.
Iacobellis, G., Willens, H.J., Echocardiographic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr 22 (2009 Dec), 1311–1319.
Wong, C.X., Ganesan, A.N., Selvanayagam, J.B., Epicardial fat and atrial fibrillation: current evidence, potential mechanisms, clinical implications, and future directions. Eur Heart J 38 (2017), 1294–1302.
Mahajan, R., Kuklik, P., Grover, S., Brooks, A.G., Wong, C.X., Sanders, P., et al. Cardiovascular magnetic resonance of total and atrial pericardial adipose tissue: a validation study and development of a 3 dimensional pericardial adipose tissue model. J Cardiovasc Magn Reson, 15, 2013, 73.
Nerlekar, N., Baey, Y.W., Brown, A.J., Muthalaly, R.G., Dey, D., Tamarappoo, B., et al. Poor correlation, reproducibility, and agreement between volumetric versus linear epicardial adipose tissue measurement: a 3D computed tomography versus 2D echocardiography comparison. JACC Cardiovasc Imaging 11:7 (2018 Jul), 1035–1036.
Parisi, V., Rengo, G., Perrone-Filardi, P., Pagano, G., Femminella, G.D., Paolillo, S., et al. Increased epicardial adipose tissue volume correlates with cardiac sympathetic denervation in patients with heart failure. Circ Res 118 (2016), 1244–1253.
Parisi, V., Paolillo, S., Rengo, G., Formisano, R., Petraglia, L., Grieco, F., et al. Sleep disordered breathing and epicardial adipose tissue in patients with heart failure. Nutr Metab Cardiovasc Dis 28 (2018), 126–132.
Davin, L., Nchimi, A., Ilardi, F., Dulgheru, R., Marchetta, S., Gach, O., et al. Epicardial adipose tissue and myocardial fibrosis in aortic stenosis relationship with symptoms and outcomes: a study using cardiac magnetic resonance imaging. JACC Cardiovasc Imaging, 2018, 10.1016/j.jcmg.2018.06.025 [Epub ahead of print].
Madonna, R., Massaro, M., Scoditti, E., Pescetelli, I., De Caterina, R., The epicardial adipose tissue and the coronary arteries: dangerous liaisons. Cardiovasc Res 115:6 (2019), 1013–1025.
This website uses cookies to improve user experience. Read more
Save & Close
Accept all
Decline all
Show detailsHide details
Cookie declaration
About cookies
Strictly necessary
Performance
Strictly necessary cookies allow core website functionality such as user login and account management. The website cannot be used properly without strictly necessary cookies.
This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.
Performance cookies are used to see how visitors use the website, eg. analytics cookies. Those cookies cannot be used to directly identify a certain visitor.
Used to store the attribution information, the referrer initially used to visit the website
Cookies are small text files that are placed on your computer by websites that you visit. Websites use cookies to help users navigate efficiently and perform certain functions. Cookies that are required for the website to operate properly are allowed to be set without your permission. All other cookies need to be approved before they can be set in the browser.
You can change your consent to cookie usage at any time on our Privacy Policy page.
