Abstract:
Introduction: Epicardial fat covers about 80% of the heart surface. It is located along the coronary arteries, above the right ventricle, especially along the right border, anterior surface and at the apex. Three quarters of all epicardial fat (EF) is located on the surface of the right ventricle compared to the left. In recent years, epicardial adipose tissue (EAT) has gained great popularity as a marker of visceral obesity and the development of cardiovascular diseases. This is due to the fact that it is an endocrine organ in which a number of biologically active substances are synthesized (tumor necrosis factor - α, chemokines, adipokines, proinflammatory markers, etc.). Thus, patients with metabolic syndrome (MS) have a more pronounced accumulation of EF, unlike patients without MS.
Aim of the study: To study the relationship between EF and clinical parameters in patients with MS.
Materials and methods: The study included 109 pts with one of the components of MS (obesity, arterial hypertension, dyslipidemia) with a confirmed diagnosis of CAD hospitalized in the RSSPMCC. All patients underwent an assessment of lipid and carbohydrate profile, measurement of anthropometric data, and assessment of EF using echocardiography.
Results: Analysis of the obtained data revealed that the average thickness of the EF was 10.9 ± 2.4 mm, which significantly exceeds the norm (5-7 mm), and the average BMI was 29.7 ± 2.7 kg / m2. At the same time, the waist circumference also exceeded the recommended values ????of 100 ± 3.9 cm. The correlation analysis revealed a close relationship between the thickness of the endogenous fat with BMI and WS (r-0.35, p<0.001 and r-0.284, p<0.001). Lipid disorders were detected in the study group of pts: TC-226 dg/ml, LDL-C - 138±21 mg/dl, TG 191 dg/ml. This was also reflected in the relationship between the endogenous fat and apoB, where r-0.254 p<0.005, which only confirms the presence of MS. However, one of the main atherogenic lipoproteins (LDL-C) did not show a reliable correlation with the endogenous fat, as well as with total cholesterol. However, an interesting fact was that a reliable direct relationship was found between EF and TG (r-0.201, p<0.005), which confirms the authors' data on elevated TG levels in the presence of excess weight. Having studied non-standard markers of metabolic disorders, the triglyceride-glucose index, as well as the ratio of triglyceridesTG to HDL-C, a direct relationship was also found with EF (r-0.188 p<0.005 and r-0.234 p<0.005), which may indicate the presence of increased EF in patients with metabolic disorders. Conclusion: In patients with MS, in particular with visceral obesity, the thickness of EF increases, which can serve as an additional diagnostic criterion for MS.
