Peculiarities of myocardial remodeling and functions in patients with epicardial obesity
Veselovskaya N. G., Chumakova G. A., Ott A. V., Gritsenko O. V., Trubina E. V.
Keywords: myocardial remodeling, risk factors, CHF, epicardial obesi
Background. Mechanisms of lipotoxic myocardial injury and remodeling in epicardial obesity (EO) are understudied. Aim. Studying the interrelation between the epicardial adipose tissue thickness (EATt) and myocardial structure and function parameters. Materials and methods. The study included 104 male patients (54.8±8.2 years) with IHD, II–III class exertional angina and underlying obesity (BMI 34.26±2.80 kg / m²). The following groups were isolated: group 1 with EATt ≥7 mm (n=49) and group 2 with EATt <7 mm (n=55). Visceral adipose tissue adipokines (leptin, adiponectin, resistin) were measured in all patients. EO degree was evaluated using echoCG (measurement of linear EATt behind the RV free wall in the end of systole). Results. In group 1, mean EDV and ESV values were 132.67±15.67 and 51.89±8.31 ml. These values were significantly greater than for group 2 patients, 124.45±12.69 ml (р=0.005) and 43.76±6.54 ml (р=0.002), respectively. In addition, left atrial (LA) and RV EDR dimensions were greater in patients with EATt ≥7 mm than in patients with EATt <7 mm (44.37±4.97 mm and 29.31±3.48 mm vs. 40.54±2.98 mm, р=0.001 and 25.43±3.12 mm, respectively, р=0.001). Type 1 diastolic dysfunction (DD) was observed in 28.5 % (n=14) of group 1 patients and in 14 % (n=8) of group 2 patients. In addition, type 2 DD was found in two patients (4 %) of group 1; in patients of group 2, this DD type was not observed. Conclusion. EO is an important pathogenetic mechanism of myocardial remodeling and a modifiable RF for CHF development and progression.
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Veselovskaya N.G., Chumakova G.A., Ott A.V. et al. Peculiarities of myocardial remodeling and functions in patients with epicardial obesity. Russian Heart Failure Journal. 2013;14 (5):247-251