2016, Number 3
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Gac Med Mex 2016; 152 (3)
Comparison of epicardial fat thickness in diabetic patients compared to non-diabetics with acute myocardial infarction and ST-segment elevation (AMI-STEMI)
Ojeda-Peña AC, Amador-Licona N, Rodríguez-Salazar E, Carrillo-Torres MÁ, Evangelista-Herrera R, Peraza-Zaldívar JÁ
Language: Spanish
References: 22
Page: 345-349
PDF size: 76.87 Kb.
ABSTRACT
Introduction: Visceral fat has deleterious metabolic effects and has been associated with myocardial ischemia.
Objective: To compare epicardial fat thickness in diabetic versus non-diabetic patients with acute myocardial infarction with ST-segment
elevation.
Material and methods: We performed a cross-sectional study in 60 patients with acute myocardial infarction with
ST-segment elevation (30 diabetic and 30 non-diabetic). Cardiovascular risk factors and Thrombolysis in Myocardial Infarction
(TIMI) score were registered. Using echocardiography, left ventricle ejection fraction and epicardial fat measured in the
interventricular septum, right ventricle outflow tract, apex, and right ventricle free wall was evaluated.
Results: Epicardial fat at the apex (6.1 vs. 5.8 mm; p = 0.038) and in the interventricular septum (7.0 vs. 5.7 mm; p = 0.033) was higher in diabetic versus non-diabetic patients. In diabetic patients, plasmatic glucose correlated with TIMI score (R: 0.49; p = 0.005) and
body mass index (R: –0.50; p = 0.004). The TIMI score (4.5 vs. 3.4; p = 0.04), body mass index (29.3 vs. 26.4; p = 0.008),
epicardial fat in the interventricular septum (6.8 vs. 4.7; p = 0.000004) and in the right ventricle outflow tract (6.8 vs. 5.0; p = 0.000042) were higher in patients with fat in apex ≥ 6 mm.
Conclusions: In diabetic patients with acute myocardial infarction with ST-segment elevation, interventricular septum and apex epicardial fat was higher compared with non-diabetic patients.
REFERENCES
Silink M, Han Cho N, Whiting D, et al. The diabetes atlas, sixth edition. International Diabetes Federation; 2013. p. 19-37.
Chávez-Domínguez R, Ramírez-Hernández JA, Casanova-Garcés JM. La cardiopatía coronaria en México y su importancia clínica, epidemiológica y preventiva. Arch Cardiol Mex. 2003;73:105-14.
Marchington JM, Pond CM. Site-specific properties of pericardial and epicardial adipose tissue: the effects of insulin and high-fat feeding on lipogenesis and the incorporation of fatty acids in vitro. Int J Obes. 1990;14:1013-22.
Rajsheker S, Manka D, Blomkalns AL, Chatterjee TK, Stoll LL, Weintraub NL. Crosstalk between perivascular adipose tissue and blood vessels. Curr Opin Pharmacol. 2010;10:191-6.
Mazurek T, Zhang L, Zalewski A, et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation. 2003;108:2460-6.
Fox CS, Gona P, Hoffman U, et al. Pericardial fat, intrathoracic fat, and measures of left ventricular structure and function: the Framingham Heart Study. Circulation. 2009;119:1586-91.
Iacobellis G, Willens HJ. Echocardiographic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr. 2009;22:1311-9.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2013;36(Suppl. 1):S67-74.
Iacobellis G, Assael F, Ribaudo MC, et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res. 2003;11:304-10.
Borrayo S, Madrid M, Arriaga N, Ramos C, García A, Almeida G. Riesgo estratificado de los síndromes coronarios agudos. Resultados del primer RENASCA-IMSS. Rev Med Inst Mex Seguro Soc. 2010;48:259-64.
Levy BI, Schiffrin EL, Mourad JJ, et al. Impaired tissue perfusion: a pathology common to hypertension, obesity, and diabetes mellitus. Circulation. 2008;118:968-76.
Ouwens M, Sell H, Greulich S, Eckel J. The role of epicardial and perivascular adipose tissue in the pathophysiology of cardiovascular disease. J Cell Mol Med. 2014;4:2223-4.
Sironi AM, Petz R, De Marchi D, et al. Impact of increased visceral and cardiac fat on cardiometabolic risk and disease. Diabet Med. 2012;29: 622-7.
Khan C. The insulin receptor, and the mechanisms of insulin resistance in diabetes and aterosclerosis. New horizons in diabetes and cardiovascular disease. Current Science. 2000;40:109-18.
Cherneva ZV, Denchev SV, Gospodinova MV, Milcheva NP, Petrova MG, Cherneva RV. Clinical significance of hyperglycaemia in acute coronary syndrome patients. Acute Card Care. 2011;13:211–8.
Prakash D, Cair F, Mikhail K, et al. Hyperglycemia and Acute Coronary Syndrome. Circulation. 2008;117:1610-9.
Wang T, Quiang L, Cuixia L, et al. Correlation of echocardiographic epicardial fat thickness with severity of coronary artery disease in patients with acute myocardial infarction. Echocardiography. 2014;31:1177-81.
Graner M, Pentikainen M, Nyman K, et al. Cardiac steatosis in patients with dilated cardiomyopathy. Heart. 2014;100:1007-12.
Greulich S, Herzfeld de Wiza D, Preilowski S, et al. Secretory products of guinea pig epicardial fat induce insulin resistance and impair primary adult rat cardiomyocyte function. J Cell Mol Med. 2011;15(11):2399-410.
Natale F, Tedesco MA, Mocerino R, et al. Visceral adiposity and arterial stiffness: echocardiographic epicardial fat thickness reflects, better than waist circumference, carotid arterial stiffness in a large population of hypertensives. Eur J Echocardiogr. 2009;10:549–55.
Rosito GA, Massaro JM, Hoffmann U. Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcification in a community based sample: The Framingham Heart Study. Circulation. 2008;117:605–13.
Iacobellis G, Leonetti F, Singh N. Relationship of epicardial adipose tissue with atrial dimensions and diastolic function in morbidly obese subjects. Int J Cardiol. 2007;115:272–3.