Russian Heart Failure Journal 2011year Modification of subcutaneous and visceral adipose tissue in patients with CHF and different functional classes


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2011/

Modification of subcutaneous and visceral adipose tissue in patients with CHF and different functional classes

Shavgulidze K. B., Chkhobadze G. D.

Keywords: fatty tissue, CHF

DOI: 10.18087/ rhfj.2011.2.1459

Background. Increased severity of chronic heart failure leads to decrease not only muscles, but body fat. Fatty tissue is a special type of connective tissue with special properties, one of the most important of which is to produce adipokines and cytokines. Objective. To study the mass and structure of visceral and subcutaneous adipose tissue in patients with different classes of CHF. Materials and methods. Mortem examination was carried out in 118 dead patients who had CHF I–IV FC NYHA. Patients were divided into 3 groups: Group 1 – who had CHF FC I–II, Group 2 – CHF III–IV FC without cachexia, Group 3 – CHF III–IV FC with cachexia. Results. In patients with CHF III–IV FC with cachexia thickness of subcutaneous adipose tissue and omentum weight were significantly lower than in patients with CHF III–IV FC without cachexia, which amounted to 2.4±1.1 cm, 164±87 g, compared with patients without cachexia (5.1±2.2 cm, 387±134 g, respectively, p<0.05). Histological material showed lymphocytic infiltration of visceral adipose tissue in patients with CHF III–IV FC with cachexia of 53.4±7.8 % in the omentum and 49.7±8.4 % in the pericardium in patients with cachexia (in comparison with patients without cachexia – 42.1±6.7 % in the omentum and 42.6±8.8 % in the pericardium (p<0.05) and 5.1±2.3 % in the omentum, 4.9±2.6 % in the pericardium in patients with CHF I–II FC (p<0.05). In patients with CHF III–IV FC with cachexia the amount of fibrous tissue was significantly higher than in patients with CHF III–IV FC without cachexia, and was 24.8±3.7 % in the omentum (p<0.05) and 24.3±3.2 % in the pericardium (p<0.05). Thus, the increase of CHF class was accompanied by decrease of subcutaneous fat thickness and omentum weight. The higher CHF class was characterized by greater activity of chronic inflammation, which results in increased lymphocyte infiltration and the amount of fibrous tissue, especially in visceral adipose tissue. In patients with CHF III–IV FC with cachexia these changes were more pronounced.
  1. Быков В. Л. Цитология и общая гистология: Функциональная морфология клеток и тканей человека: Учеб, для студ. мед. ин-тов. – СПб.: Сотис. 2001. – 520 с.
  2. Зайчик А. Ш., Чурилов Л. П. Основы общей патологии: Основы патохимии: Для мед. вузов. – СПб.: ЭЛБИ-СПб, 2000. – 688 с.
  3. Дедов И. И., Мельниченко Г. А., Романцова Т. И. Патогенетические аспекты ожирения. Ожирение и метаболизм. 2004;1:3–9.
  4. Арутюнов Г. П. Кахексия у больных с хронической сердечной недостаточностью. Каков масштаб проблемы? Что мы знаем и что нам делать? Сердечная недостаточность. 2001;2 (3):101–105.
  5. Старкова Н. Т., Летова Е. К. Генерализованная липодистрофия в клинической практике. – М.: Медицина, 2001. – 240c.
  6. Арутюнов Г. П., Костюкевич О. И., Рылова Н. В. Применение сбалансированной смеси «Пептамен» для энтерального питания в лечении больных с ХСН. Журнал Сердечная Недостаточность. 2002;5 (5):221–225.
  7. Арутюнов Г. П., Костюкевич О. И., Хадышьян Г. Г. Немедикаментозные методы коррекции системного воспаления при заболеваниях сердечно-сосудистой системы. Сердце. 2005;4 (5):268–272.
  8. Костюкевич О. И., Хадышьян Г. Г. Коррекция системного воспаления методом нутритивной поддержки у пациентов с ХСН III–IV ФК. Журнал Сердечная недостаточность, 2005;6 (5);186–190.
  9. Мартиросов Э. Г. Технологии и методы определения состава тела человека. Э. Г. Мартиросов, Д. В. Николаев, С. Г. Руднев. – М.: Наука,. 2006. – 248 c
  10. Guzik TJ, Mangalat D, Korbut R et al. Adipocytokines – novel link between inflammation and vascular function? J Physiol Pharmacol. 2006;57 (4):505–528.
  11. Fasshauer M, Paschke R. Regulation of adipocytokines and insulin resistance. Diabetologia. 2003;46 (12):1594–1603.
  12. Tilg H, Moschen AR. Adipocytokines: mediators linking adipose tissue, inflammation and immunity. Nat Rev Immunol. 2006;6 (10):772–783.
  13. Warne JP. Tumour necrosis factor alpha: a key regulator of adipose tissue mass. J Endocrinol. 2003;177 (3):351–355.
  14. Juge-Aubry CE, Henrichot E, Meier CA. Adipose tissue: a regulator of inflammation. Best Pract Res Clin Endocrinol Metab. 2005;19 (4):547–566.
  15. Kintscher U. Does adiponectin resistance exist in chronic heart failure? Eur Heart J. 2007;28 (14):1676–1677.
  16. Ольбинская Л. И., Игнатенко С. Б. Роль цитокиновой агрессии в патогенезе синдрома сердечной кахексии у больных хронической сердечной недостаточностью. Сердечная недостаточность. 2001;2 (3):132–134.
Shavgulidze K. B., Chkhobadze G. D. Modification of subcutaneous and visceral adipose tissue in patients with CHF and different functional classes. Russian Heart Failure Journal. 2011;12(2):79-85.

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