Relación entre el volumen de grasa epicárdica y enfermedad coronaria en pacientes con indicaciones de coronariografía por tomografía multicortes.
Resumen
Introducción: La enfermedad arterial coronaria (EAC) es una de las primeras causas de morbi-mortalidad en Cuba y el mundo. Se conoce la asociación de varios factores de riesgo con la probabilidad de sufrir eventos cardiovasculares mayores. Actualmente se sugiere la asociación entre la grasa epicárdica y la EAC, pero aún existen contradicciones que motivan a poner en práctica nuevos métodos y asociaciones que ayuden a refutar o apoyar este planteamiento. Objetivo: Determinar la relación entre el volumen de grasa epicárdica (VGE) con la EAC en pacientes con indicación de coronariografía por Tomografía Multicortes. Método: Se realizó un estudio observacional, analítico, transversal en el Instituto de Cardiología y Cirugía Cardiovascular entre enero de 2014 y marzo de 2017. Se analizaron las imágenes de 100 pacientes que acudieron al servicio de tomografía para realizarse un estudio de coronariografía por este método diagnóstico. Se evaluaron las arterias coronarias y se midió el volumen de grasa epicárdica. Se realizó prueba de Wilcoxon comparando las medias de VGE con la presencia de EAC. Se determinó la asociación entre variables mediante regresión lineal utilizando el coeficiente de Spearman. Resultados: El promedio de edad fue de 54 años con predominio entre 50 y 59 años para ambos sexos. La mediana del VGE fue de 87.7cm3 y sus valores fueron mayores en pacientes sobrepeso y obesos. 47% de los pacientes presentaron EAC y no hubo asociación significativa entre su presencia y el VGE. Conclusión: En la población estudiada no se encontró asociación entre el VGE y la presencia de EAC.
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Referencias
- Djaberi R, Schuijf JD, van Werkhoven JM, Nucifora G, Wouter Jukema J, Bax J J. Relation of Epicardial Adipose Tissue to Coronary Atherosclerosis. The American Journal of Cardiology [Internet].2008 Dec [cited] 2016 Mar 9;102(12):1602-07. Available from: http://www.sciencedirect.com/science/journal/00029149/102/12
- Lee HY, Sup Song I, Min Yoo S, Young Rho J, Youn Moon J, White H S. Can the extent of epicardial adipose tissue thickness or the presence of descending thoracic aortic calcification predict significant coronary artery stenosis in patients with a zero coronary calcium score on multi-detector CT? Atherosclerosis [Internet]. 2010 Oct [cited] 2016 Mar 10;212(2):495-500. Available from: http://www.sciencedirect.com/science/journal/00219150/212
- Natale F, Tedesco MA, Mocerino R, De Simone V, Di Marco GM, Aronne L 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. European Journal of Echocardiography [Internet].2009 Feb [cited] 2016 Mar 10;10(4):549-55. Available from: https://www.researchgate.net/profile/Michele_Tedesco/publication/24002662_Visceral_adiposity_and_arterial_stiffness_Echocardiographic_epicardial_fat_thickness_reflects_better_than_waist_circumference_carotid_arterial_stiffness_in_a_large_population_of_hypertensives/links/0c96052a21f48799d9000000.pdf
-Demircelik MB, Yilmaz OC, Gurel OM, Selcoki Y, Atar IA, Bozkurt A et al. Epicardial adipose tissue and pericoronary fat thickness measured with 64-multidetector computed tomography: potential predictors of the severity of coronary artery disease. Clinics [Internet].2014 Jun [cited] 2016 Feb 3 ;69(6): About 4p. Available from:
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322014000600388&lng
- Mahabadi A, Lehmann N, Kälsch H, Robens T, Bauer M, Dykun I, et al. Association of Epicardial Adipose Tissue With Progression of Coronary Artery Calcification Is More Pronounced in the Early Phase of Atherosclerosis. J Am Coll Cardiol Img. [Internet].2014 Sep [cited] 2016 Oct 19;7(9):909-16. Available from: http://imaging.onlinejacc.org/mobile/article.aspx?articleid=1901861
- Eroglu S, Sade LE, Yildirir A, Bal U, Ozbicer S, Ozgul AS et al. Epicardial adipose tissue thickness by echocardiography is a marker for the presence and severity of coronary artery disease.Nutr Metab Cardiovasc Dis [Internet].2009 Mar [cited] 2016 Mar 10;19(3):211–17. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18718744
- Clément K, Basdevant A, Dutour A. Weight of pericardial fat on coronaropathy. Arterioscler Thromb Vasc Biol [Internet].2009 [cited] 2016 Mar 10;29:615-616. Available from: http://atvb.ahajournals.org/content/29/5/615.full
- Nelson AJ, Worthley MI, Psaltis PJ, Carbone A, Dundon BK, Duncan RF. Validation of cardiovascular magnetic resonance assessment of pericardial adipose tissue volumen. J Cardiovasc Magn Reson[Internet].2009 May;11:15–18. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19416534
- Iacobellis G, Willens HJ. Echocardiographic Epicardial Fat: A Review of Research and Clinical Applications. Journal of the American Society of Echocardiography [Internet].2009 [cited] 2016 Mar 10;22(12):1417-18.Available from: http://www.onlinejase.com/article/S0894-7317%2809%2900996-1/pdf
- Marchington JM, Mattacks CA, Pond CM. Adipose tissue in the mammalian heart and pericardium; structure, foetal development and biochemical properties. Comp Biochem Physiol B [Internet].1989 [cited] 2016 Mar 10;94(2):225–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2591189
-Chechi K, Richard D. Thermogenic potential and physiological relevance of human
epicardial adipose tissue. Int J of Obes Suppl [Internet] .2015 Aug [cited] 2016 Nov 5(Suppl 1): S28–S34. Available from: www.ncbi.nlm.nih.gov/pmc/articles/PMC4850577/pdf/ijosup20158a.pdf
- Ditomasso D, Carnethon MR, Wright CM, Allison MA. The associations between visceral fat and calcified atherosclerosis are stronger in women than men. Atherosclerosis [Internet] 2010 Feb [cited] 2016 Mar 10;208(2):531-36. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19765708
- Alexopoulos N, McLean DS, Janik M, Arepalli ChD, Stillman AE, Raggi P. Epicardial adipose tissue and coronary artery plaque characteristics. Atherosclerosis [Internet] 2010 May [cited] 2016 Mar 10;210(1):150-4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20031133
-Doesch C, Haghi D, Flüchter S, Suselbeck T, Schoenberg SO,Michaely M, et al. Epicardial adipose tissue in patients with heart failure. J Cardiovasc Magn Reson [Internet].2010 Jul [cited] 16 Feb 2016];12 (1):40. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20624277
- Iacobellis G, Assael F, Ribaudo MC, et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res [Internet] 2003 Feb [cited] 2016 Mar 10;11(2):304–10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12582228
- Abbara S, Desai JC, Cury RC, Butler J, Nieman K, Reddy V. Mapping epicardial fat with multi-detector computed tomography to facilitate percutaneous transepicardial arrhythmia ablation. Eur J Radiol [Internet] 2006 Mar [cited] 2016 Mar 10;57(3):417–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16434161
- Luaces Méndez M, Cristóbal A JA Hernández-Tamames, Cachofeiro V, Martínez E, et al. Cuantificación de grasa epicárdica mediante Resonancia Magnética cardiaca en pacientes obesos mórbidos. Cambios tras Cirugía bariátrica. Rev Esp Cardiol. 2013;66 Supl 1:723. Disponible en http://www.revespcardiol.org/controladores/congresos-erramientas.php?idCongreso=5&idSesion=625
- Miao C, Chen S, Ding J, Liu K, Li D, Macedo R, et al. The Association of Pericardial Fat with Coronary Artery Plaque Index at MR Imaging: The Multi-Ethnic Study of Atherosclerosis (MESA).Radiology.[Internet] 2011 Oct; 261(1): 109–15. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3176423/pdf/110346.pdf
- Detrano R, Guerci AD, Carr JJ, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med [Internet] 2008 Mar [cited] 2016 Mar 10;358(13):1336–45. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18367736
- Coppini G, Favilla.R , Marraccini P , Moroni D, Pieri G. Quantification of Epicardial Fat by Cardiac CT Imaging. Open Med Inform J [Internet] 2010 Jul [cited] 2016 Mar 10;4:126-135. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3095114/
- Raggi P. Epicardial Adipose Tissue and Progression of Coronary Artery Calcium
Cause and Effect or Simple Association?. JACC: Cardiovascular Imaging [Internet] 2014 Sept [cited] Feb 2017;7(9):917–9. Available from: http://www.sciencedirect.com/science/article/pii/S1936878X14005385
- López-Jiménez F, Sochor O. Grasa epicárdica, mala regulación metabólica y riesgo cardiovascular: cómo encajar las piezas. Rev Esp Cardiol. 2014;67:425-7. Disponible en: http://www.revespcardiol.org/es/grasa-epicardica-mala-regulacion-metabolica/articulo/90323393
- Basurto Acevedo M et al. Grasa epicárdica y factores de riesgo cardiometabólico en la post-menopausia. Prog Obstet Ginecol. [Internet] May 2015 [citedado] Oct 6 2017;58(8):350—5. Disponible en: http://dx.doi.org/10.1016/j.pog.2015.03.011
- Dagvasumberel M et al. Gender disparities in the association between epicardial adipose tissue volume and coronary atherosclerosis: A 3-dimensional cardiac computed tomography imaging study in Japanese subjects. Cardiovasc Diabet [Internet] 201211:106. Available from: http://doi:10.1186/1475-2840-11-106
-Anuario Estadístico de Salud 2015. República de Cuba. La Habana 2016. ISSN 1561-4433.Disponible en: http://files.sld.cu/dne/files/2016/04/Anuario_2015_electronico-1.pdf
- Ding J, Hsu F-C, Harris TB, et al. The association of pericardial fat with incident coronary heart disease: the multi-ethnic study of atherosclerosis (MESA). Am J Clin Nutr 2009; 90:499-504.
-Ríos Mino MA. Relación entre Índice de Masa Corporal y grasa pericárdica en la población adulta de Trujillo. 2013.Trujillo,Perú. Disponible en: http://creativecommons.org/licenses/by-nc-sa/2.5/pe/
- Alves Ramos S, Sabino A, Corrêa Ferreira D, Alvarez-Leite J. Obesity with no metabolic syndrome and adipose tissue expansion based solely on risk factors and inflammatory marker of coronary heart disease in premenopausal women. ALAN [Internet].2012 Sep [citado 2016 Feb 03]; 62(3): 267-274. Disponible en:
http://www.scielo.org.ve/scielo.php?script=sci_arttext&pid=S0004- 06222012000300009&lng=es
- Konishi M el al. El Volumen de la Grasa Pericárdica Aparece como un Nuevo Factor de Riesgo Coronario. Atherosclerosis [Internet] 2010 Apr;209(2):573-578
- Schlett CL. et al. Association of pericardial fat and coronary high-risk lesions as determined by cardiac CT. Atherosclerosis. [Internet] May 2012;222(1):129-34
Available from: https://doi.org/10.1016/j.atherosclerosis.2012.02.029Get rights and content
- Xu Y, Cheng X, Hong K, Huang C, Wan L. How to interpret epicardial adipose tissue as a cause of coronary artery disease: a meta-analysis. [Internet] 2012 Jun;23(4):227-33. Available from: http://doi:10.1097/MCA.0b013e328351ab2c
-Tanami et al. Lack of Association Between Epicardial Fat Volume and Extent of Coronary Artery Calcification, Severity of Coronary Artery Disease, or Presence of Myocardial Perfusion Abnormalities in a Diverse, Symptomatic Patient Population. Circ Cardiovasc Imaging. [Internet] Mar 2015 [cited] Oct 2017;8(3): e002676
- Mahabadi A et al. Association of epicardial fat with cardiovascular risk factors and incident myocardial infarction in the general population: the Heinz Nixdorf Recall Study. J Am Coll Cardiol. 2013;61:1388–1395. Available from: http://doi:10.1016/j.jacc.2012.11.062
-Look C, Morano I, Ehrhart-Bornstein M, Bornstein SR, Lamounier-Zepter V. Adipocyte-derived factors suppress heart contraction. International Journal of Obesity [Internet] 2011 35:84–90. Available from: http://doi:10.1038/ijo
- Enhos A, Sahin I, Can MM, Biter I, inckal H, Serebruany V. Relation of coronary collateral circulation with epicardial fat volume in patients with stable coronary artery disease. Journal of Geriatric Cardiology : JGC. 2013;10(4):344-348. Available from: http://doi:10.3969/j.issn.1671-5411.2013.04.006.
- MM. Hell, S Achenbach, A Schuhbaeck , L Klinghammer, MS. May, M Marwan. CT-based analysis of pericoronary adipose tissue density: Relation to cardiovascular risk factors and epicardial adipose tissue volume. Journal of Cardiovascular Computed Tomography.[Internet] 2016 10 (2016):52-60
-Echavarría-Pinto M, Hernando L , Alfonso F. From the epicardial adipose tissue to vulnerable coronary plaques. World J Cardiol. [Internet] 2013 Apr 26;5(4):68-74. Available from: http://doi10.4330/wjc.v5.i4.68
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