Russian Heart Failure Journal 2013year Epicardial fat pad and rates of cardiovascular remodeling in normotensive patients with abdominal obesity


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2013/№1

Epicardial fat pad and rates of cardiovascular remodeling in normotensive patients with abdominal obesity

Druzhilov M. A., Otmakhov V. V., Beteleva Yu. E., Korneva V. A., Kuznetsova T. Yu.

Keywords: abdominal obesity, diagnostics, remodeling, epicardial fat pad

DOI: 10.18087/rhfj.2013.1.1768

Relevance. Connection between obesity and CVD is determined not only by overall amount of fatty tissue, but also by a type of its distribution. New method of studying visceral fat has been described, which consists in measurement of epicardial fat pad thickness (EFT) using transtoracal EchoCG. Now, epicardial fat pad is recognized as a new CVD marker. Objective. Echocardiographic quantitative estimation of EFT in CVD-asymptomatic normotensive patients with abdominal obesity and low risk according to risk measuring scales, search for correlation between EFT and indices of cardiovascular remodeling and definition of EFT threshold, associated with strong possibility of subclinical organ lesions. Materials and methods. 95 patients (average age 44.9±5.1 years) were examined. Family history of CVD, smoking habits, Score and Procam risk assessment, lipid specter and blood sugar profile were studied. Triplex scanning of brachiocephalic arteries (BCA), EchoCG, bifunctional 24hour BP monitoring with assessment of arterial stiffness were carried out. Epicardial fat pad was visualized behind RV free wall in В-mode at the parasternal position along LV long axis at the end of systole. Results. Average EFT was 4.6±1.2 mm. Higher values of EFT were noted in patients with subclinical carotid atherosclerosis (5.5±1.1 mm vs. 4.5±1.2 mm; р<0.05), with EchoCG signs of LV diastolic dysfunction (5.8±1.3 mm vs. 4.7±1.2 mm; р<0.05). Medium correlation of EFT with age, waist circumference (WC) and BMI, BCA carotid intimal medial thickness (CIMT), mean pulse wave velocity (PWV) in aorta and augmentation indexes, reflecting increased arterial stiffness, was revealed. EFT more than 6 mm were significantly combined with stronger possibility of subclinical organ lesions, subclinical carotid atherosclerosis and increased vascular stiffness in the first place. Conclusion. Study of EFT with use of EchoCG can become a potentially simple and reproducible low-cost method of estimation of subclinical atherosclerosis probability and high risk.
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Druzhilov M. A., Otmakhov V. V., Beteleva Yu. E. et al. Epicardial fat pad and rates of cardiovascular remodeling in normotensive patients with abdominal obesity. Russian Heart Failure Journal. 2013;14 (1):22-28

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