Valentina Parisi1, Laura Petraglia2, Roberto Formisano3, Aurelio Caruso4, Maria G Grimaldi4, Dario Bruzzese5, Fabrizio V Grieco6, Maddalena Conte6, Stefania Paolillo7, Alessandra Scatteia8, Santo Dellegrottaglie8, Annarita Iavazzo9, Pasquale Campana6, Emanuele Pilato10, Patrizio Lancellotti11, Vincenzo Russo12, Emilio Attena13, Pasquale P Filardi9, Dario Leosco2. 1. Department of Translational Medical Sciences, University Federico II, Naples, Italy; Italian Society of Gerontology and Geriatrics, Italy. Electronic address: valentina.parisi@unina.it. 2. Department of Translational Medical Sciences, University Federico II, Naples, Italy; Italian Society of Gerontology and Geriatrics, Italy. 3. Fondazione Salvatore Maugeri, IRCCS, Telese Terme, BN, Italy. 4. Casa di Cura San Michele, Maddaloni, CE, Italy. 5. Department of Public Health, University Federico II, Naples, Italy. 6. Department of Translational Medical Sciences, University Federico II, Naples, Italy. 7. Italy SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy. 8. Clinica Villa dei Fiori, Acerra, Naples, Italy. 9. Dipartimento di Scienze, Biomediche Avanzate, University Federico II, Naples, Italy. 10. Dipartimento di Emergenze Cardiovascolari, Medicina Clinica e dell'Invecchiamento, University Federico II, Naples, Italy. 11. University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium; Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy. 12. University of Campania "Luigi Vanvitelli", Monaldi Hospital, Naples, Italy. 13. Rizzoli Hospital, Ischia, Italy.
Abstract
BACKGROUND AND AIM: Echocardiography is a promising technique for the assessment of epicardial adipose tissue (EAT). Increased EAT thickness is associated with different cardiac diseases, including; coronary artery disease (CAD). Since several different echocardiographic approaches have been proposed to measure EAT, the identification of a standardized method is needed. We propose the assessment of EAT maximal thickness at the Rindfleisch fold, the reproducibility of this measurement and its correlation with EAT thickness and volume assessed at cardiac magnetic resonance (CMR). Finally, we will test the predictive role of this measurement on the presence of significant CAD. METHODS AND RESULTS: In 1061 patients undergoing echocardiography, EAT thickness was measured at the level of the Rindfleisch fold. In 70 patients, we tested the relationship between echo-EAT thickness and EAT thickness and volume assessed at CMR. In 499 patients with suspected CAD, undergoing coronary artery angiography, we tested the predictive value of EAT on the presence of significant CAD. Echo-EAT thickness measurements had an excellent reliability as indicated by the inter-observer (ICC:0.97; 95% C.I. 0.96 to 0.98) and intra-observer (ICC:0.99; 95% C.I. 0.98 to 0.99) reliability rates. Echo-EAT thickness significantly correlated with CMR-EAT thickness and volume (p < 0.001). An EAT thickness value >10 mm discriminated patients with significant CAD at coronary angiography (p < 0.001). At multivariable analysis, including demographic data and cardiovascular risk factors, EAT thickness was an independent predictor of significant CAD and showed an additive predictive value over common atherosclerotic risk factors. CONCLUSIONS: Echocardiographic assessment of EAT thickness at the level of the Rindfleisch fold represents a simple and trustworthy method. An increased EAT thickness shows an additive predictive value on CAD over common atherosclerotic risk factors, thus suggesting its potential clinical use for CAD risk stratification.
BACKGROUND AND AIM: Echocardiography is a promising technique for the assessment of epicardial adipose tissue (EAT). Increased EAT thickness is associated with different cardiac diseases, including; coronary artery disease (CAD). Since several different echocardiographic approaches have been proposed to measure EAT, the identification of a standardized method is needed. We propose the assessment of EAT maximal thickness at the Rindfleisch fold, the reproducibility of this measurement and its correlation with EAT thickness and volume assessed at cardiac magnetic resonance (CMR). Finally, we will test the predictive role of this measurement on the presence of significant CAD. METHODS AND RESULTS: In 1061 patients undergoing echocardiography, EAT thickness was measured at the level of the Rindfleisch fold. In 70 patients, we tested the relationship between echo-EAT thickness and EAT thickness and volume assessed at CMR. In 499 patients with suspected CAD, undergoing coronary artery angiography, we tested the predictive value of EAT on the presence of significant CAD. Echo-EAT thickness measurements had an excellent reliability as indicated by the inter-observer (ICC:0.97; 95% C.I. 0.96 to 0.98) and intra-observer (ICC:0.99; 95% C.I. 0.98 to 0.99) reliability rates. Echo-EAT thickness significantly correlated with CMR-EAT thickness and volume (p < 0.001). An EAT thickness value >10 mm discriminated patients with significant CAD at coronary angiography (p < 0.001). At multivariable analysis, including demographic data and cardiovascular risk factors, EAT thickness was an independent predictor of significant CAD and showed an additive predictive value over common atherosclerotic risk factors. CONCLUSIONS: Echocardiographic assessment of EAT thickness at the level of the Rindfleisch fold represents a simple and trustworthy method. An increased EAT thickness shows an additive predictive value on CAD over common atherosclerotic risk factors, thus suggesting its potential clinical use for CAD risk stratification.
Authors: Gijs van Woerden; Dirk J van Veldhuisen; Thomas M Gorter; Bob Ophuis; Huitzilihuitl Saucedo-Orozco; Vanessa P M van Empel; Tineke P Willems; Bastiaan Geelhoed; Michiel Rienstra; Berend Daan Westenbrink Journal: ESC Heart Fail Date: 2022-02-11
Authors: Anne Ruth van Meijeren; Daan Ties; Marie-Sophie L Y de Koning; Randy van Dijk; Irene V van Blokland; Pablo Lizana Veloz; Gijs van Woerden; Rozemarijn Vliegenthart; Gabija Pundziute; Daan B Westenbrink; Pim van der Harst Journal: Int J Cardiol Heart Vasc Date: 2022-03-29
Authors: Valentina Parisi; Serena Cabaro; Vittoria D'Esposito; Laura Petraglia; Maddalena Conte; Pasquale Campana; Gerardo Gerundo; Marianna Abitabile; Andrea Tuccillo; Maria Accadia; Giuseppe Comentale; Emanuele Pilato; Mario Sansone; Dario Leosco; Pietro Formisano Journal: Front Physiol Date: 2020-10-15 Impact factor: 4.566