Epicardial adipose tissue volume and cardiovascular disease in hemodialysis patients

• Published in: Atherosclerosis 2013-01, Vol.226 (1), p.129-133
• Main Authors: Turan, Mehmet Nuri, Gungor, Ozkan, Asci, Gulay, Kircelli, Fatih, Acar, Turker, Yaprak, Mustafa, Ceylan, Naim, Demirci, Meltem Sezis, Bayraktaroglu, Selen, Toz, Huseyin, Ozkahya, Mehmet, Ok, Ercan
• Format: Article
• Language: English
• Subjects: adipose tissue; Adipose Tissue - pathology; albumins; Arterial stiffness; Atherosclerosis; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; body mass index; calcification; Cardiology. Vascular system; Cardiovascular; Cardiovascular Diseases - pathology; carotid arteries; cholesterol; computed tomography; coronary vessels; correlation; cross-sectional studies; diabetes; Epicardial adipose tissue; Female; gender; Hemodialysis; Humans; kidney diseases; Male; Medical sciences; Middle Aged; patients; Pericardium - pathology; Renal Dialysis; risk; risk factors; risk profile; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; ultrasonography; Vascular calcification
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2012.10.061

Abstract Objective Epicardial adipose tissue (EAT) is proposed as a cardiovascular risk marker in non-uremic subjects. However, little is known about its role in patients with higher cardiovascular risk profile such as chronic kidney disease. The aim of this study was to investigate the relationship between EAT and several cardiovascular surrogate markers (coronary artery calcification (CAC), arterial stiffness and atherosclerosis) in patients on maintenance hemodialysis. Methods A total of 191 prevalent hemodialysis patients were enrolled in this cross-sectional study. EAT and CAC scores (CACs) were determined by multi-slice computerized tomography, arterial stiffness by carotid-femoral pulse wave velocity (PWV), and carotid artery intima-media thickness (CA-IMT) by B-mode doppler ultrasonography. Results Mean age was 59 ± 13 years and time on hemodialysis 75 ± 44 months. Twenty percent of the patients had diabetes. Mean EAT volume was 62.6 ± 26.8 cm3 /m2 . Mean CA-IMT and PWV values increased across the EAT tertiles. EAT was correlated with age, female gender, body mass index, albumin and lipid parameters. Additionally, CA-IMT and PWV values were positively correlated with EAT. EAT volume was significantly higher in patients with CACs >10 compared to the patients with CACs ≤10. Despite the univariate associations between EAT and cardiovascular surrogate markers, only age, body mass index and total cholesterol levels were associated with EAT in adjusted models. Conclusions In prevalent hemodialysis patients, EAT is correlated with atherosclerosis, arterial stiffness and the presence of CAC. However, this correlation is not independent of other risk factors.