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Pericardial adipose tissue may play an important role in the course of coronary artery disease

Session Poster Session III - Friday 08:30 - 12:30

Speaker Jan Henzel

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2015

  • Topic : preventive cardiology
  • Sub-topic : Obesity
  • Session type : Poster Session

Authors : J Henzel (Warsaw,PL), R Pracon (Warsaw,PL), K Kryczka (Warsaw,PL), M Marczak (Warsaw,PL), M Demkow (Warsaw,PL)

Authors:
J Henzel1 , R Pracon1 , K Kryczka1 , M Marczak2 , M Demkow1 , 1National Institute of Cardiology, Coronary Artery and Structural Heart Diseases Dept. - Warsaw - Poland , 2National Institute of Cardiology, Cardiovascular MRI Laboratory - Warsaw - Poland ,

Citation:

Purpose. Obesity is associated with greater prevalence of coronary artery disease (CAD), however, lower mortality was noted in obese patients with CAD ('obesity paradox'). It may be hypothesized that metabolically active pericardial adipose tissue (PEAT) impacts coronary collateral circulation development by secreting wide range of vasoactive cytokines, and thus may influence the course and prognosis of CAD. In this study we sought to compare quantity of PEAT as well as body mass index (BMI) between patients presenting with chronically occluded left anterior descending coronary artery (LAD) and acute anterior myocardial infarction with ST-segment elevation (STEMI).

Methods. Consecutive patients presenting between 2008 and 2013 with chronically occluded LAD (CTO) or anterior STEMI with LAD as culprit artery and who also had myocardial viability assessed by means of MRI were retrospectively enrolled. Myocardial viability assessment with cardiac MRI was performed within 1 month of coronary anatomy assessment. PEAT quantity was obtained from MRI images by manually tracing EAT area in 4 chambers view and expressed in cm². Traditional cardiovascular risk factors were collected by telephone and medical records review. 

Results. 57 patients (mean age 62.9 ± 9.9 yrs, 12.1% women) were included in the CTO group and 33 patients (mean age 59.8 ± 10.6 yrs, 27.3% women) were included in the STEMI group. There was no significant difference in BMI between the CTO and STEMI groups (27.2 ± 0.5kg/m² vs. 27.2 ± 5.0kg/m² respectively, p=0.99). However, average PEAT quantity was significantly higher in CTO compared to STEMI group (50.3 ± 23.0 cm² vs. 36.9 ± 16.1 cm² respectively, p=0.004). This association remained significant after adjustment for age, sex, BMI and traditional cardiovascular risk factors such as hypertension, diabetes, dyslipidaemia, tobacco use and family history (p=0.014, OR 1.04).

Conclusions. Despite comparable BMI scores, patients presenting with anterior STEMI had less PEAT compared to those with chronically occluded LAD. Pericardial distribution of adipose tissue may therefore play an important role in the course of CAD.

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