Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-18T06:21:14.029Z Has data issue: false hasContentIssue false

Epicardial fat thickness, an emerging cardiometabolic risk factor, is increased in young adults born preterm

Published online by Cambridge University Press:  03 June 2016

P. P. Bassareo*
Affiliation:
Department of Medical Sciences ‘M. Aresu’, University of Cagliari, Cagliari, Italy
V. Fanos
Affiliation:
Department of Pediatrics and Clinical Medicine, Section of Neonatal Intensive Care Unit, University of Cagliari, Cagliari, Italy
M. Puddu
Affiliation:
Department of Pediatrics and Clinical Medicine, Section of Neonatal Intensive Care Unit, University of Cagliari, Cagliari, Italy
S. Marras
Affiliation:
Department of Medical Sciences ‘M. Aresu’, University of Cagliari, Cagliari, Italy
G. Mercuro
Affiliation:
Department of Medical Sciences ‘M. Aresu’, University of Cagliari, Cagliari, Italy
*
*Address for correspondence: P. P. Bassareo, Department of Medical Sciences ‘M.Aresu’, University of Cagliari, Policlinico Universitario, S.S. 554, bivio di Sestu, 09042 Monserrato (Cagliari), Italy. (Email [email protected])

Abstract

Preterm birth and epicardial fat thickness (EFT) constitute novel risk factors for the onset of future adverse cardiovascular events. In total, 30 ex-extremely low birth weight (ex-ELBW) subjects (10 males, 20 females, aged 17–28) were enrolled and compared with 30 healthy peers. EFT was significantly higher (8.7±0.7 mm v. 5.6±0.9 mm; P<0.001) in ex-ELBW than in controls and was correlated with birth weight (r=−0.47, P=0.0009), gestational age (r=−0.39, P=0.03) and cardiac left ventricular mass (r=0.51, P=0.004). When excluding the influence of body mass index, birth weight was the sole remaining determinant of EFT, irrespective of gestational age (r=−0.37, P=0.04). The same findings when excluding the possible influence of blood pressure values on the cardiac structures (r=−0.40, P=0.028). In conclusion, EFT is significantly higher in former preterm subjects and is likewise associated with an increase in left ventricular mass. In view of the acknowledged correlation between the latter and an increased incidence of cardiovascular diseases, EFT appears to be an easy-to-measure tool capable of predicting the likely development of future adverse cardiovascular events in these subjects.

Type
Brief Report
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Mercuro, G, Bassareo, PP, Flore, G, et al. Prematurity and low weight at birth as new conditions predisposing to an increased cardiovascular risk. Eur J Prev Cardiol. 2013; 20, 357367.Google Scholar
2. Bassareo, PP, Fanos, V, Puddu, M, Flore, G, Mercuro, G. Advanced intrauterine growth restriction is associated with reduced excretion of asymmetric dimethylarginine. Early Hum Dev. 2014; 90, 173176.Google Scholar
3. Payne, GA, Kohr, MC, Tune, JD. Epicardial perivascular adipose tissue as a therapeutic target in obesity-related coronary artery disease. Br J Pharmacol. 2012; 3, 659669.Google Scholar
4. Lau, DC, Dhillon, B, Yan, H, Szmitko, PE, Verma, S. Adipokines: molecular links between obesity and atherosclerosis. Am J Physiol Heart Circ Physiol. 2005; 288, 20312041.Google Scholar
5. Iacobellis, G, Willens, HJ. Echocardiographic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr. 2009; 22, 13111319.Google Scholar
6. Lang, RM, Bierig, M, Devereux, RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005; 18, 14401463.CrossRefGoogle Scholar
7. Devereux, RB, Reichek, N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation. 1977; 55, 613618.CrossRefGoogle ScholarPubMed
8. European Society of Hypertension-European Society of Cardiology Guidelines Committee. 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens. 2003; 21, 10111053.Google Scholar
9. Iacobellis, G, Assael, F, Ribaudo, MC, et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res. 2003; 11, 304310.Google Scholar
10. Iacobellis, G, Bianco, AC. Epicardial adipose tissue: emerging physiological, pathophysiological and clinical features. Trends Endocrinol Metab. 2011; 22, 450457.Google Scholar
11. Tansey, DK, Aly, Z, Sheppard, NM. Fat in the right ventricle of the normal heart. Histopathology. 2005; 46, 98104.Google Scholar
12. Funahashi, T, Nakamura, T, Shimomura, I, et al. Role of adipocytokines on the pathogenesis of atherosclerosis in visceral obesity. Intern Med. 1999; 38, 202206.Google Scholar
13. Robicsek, F, Thubrikar, MJ. The freedom from atherosclerosis of intramyocardial coronary arteries: reduction of mural stress – a key factor. Eur J Cardiothorac Surg. 1994; 8, 228235.Google Scholar
14. Prati, F, Arbustini, E, Labellarte, A, et al. Eccentric atherosclerotic plaques with positive remodelling have a pericardial distribution: a permissive role of epicardial fat? A three-dimensional intravascular ultrasound study of left anterior descending artery lesions. Eur Heart J. 2003; 24, 329336.Google Scholar
15. Pucci, G, Battista, F, de Vuono, S, et al. Pericardial fat, insulin resistance, and left ventricular structure and function in morbid obesity. Nutr Metab Cardiovasc Dis. 2014; 24, 440446.Google Scholar
16. Iacobellis, G, Ribaudo, MC, Zappaterreno, A, Iannucci, CV, Leonetti, F. Relation between epicardial adipose tissue and left ventricular mass. Am J Cardiol. 2004; 94, 10841087.Google Scholar
17. Sacks, HS, Fain, JN. Human epicardial adipose tissue: a review. Am Heart J. 2007; 153, 907917.Google Scholar
18. Meléndez, GC, McLarty, JL, Levick, SP, et al. Interleukin 6 mediates myocardial fibrosis concentric, hypertrophy, and diastolic dysfunction in rats. Hypertension. 2010; 56, 225231.CrossRefGoogle ScholarPubMed
19. Poirier, P, Giles, TD, Bray, GA, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Arterioscler Thromb Vasc Biol. 2006; 26, 968976.Google Scholar
20. Manzella, D, Barbieri, M, Rizzo, MR, et al. Role of free fatty acids on cardiac autonomic nervous system in noninsulin-dependent diabetic patients: effects of metabolic control. J Clin Endocrinol Metab. 2001; 86, 27692774.Google Scholar
21. Natale, F, Tedesco, MA, Mocerino, R, 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. Eur J Echocardiogr. 2009; 10, 549555.Google Scholar
22. Sicari, R, Sironi, AM, Petz, R, et al. Pericardial rather than epicardial fat is a cardiometabolic risk marker: an MRI vs echo study. J Am Soc Echocardiogr. 2011; 24, 11561162.Google Scholar
23. Crispi, F, Bijnens, B, Figueras, F, et al. Fetal growth restriction results in remodeled and less efficient hearts in children. Circulation. 2010; 121, 24272436.Google Scholar
24. Lewandowski, AJ, Augustine, D, Lamata, P, et al. Preterm heart in adult life: cardiovascular magnetic resonance reveals distinct differences in left ventricular mass, geometry, and function. Circulation. 2013; 127, 197206.Google Scholar
25. Lewandowski, AJ, Bradlow, WM, Augustine, D, et al. Right ventricular systolic dysfunction in young adults born preterm. Circulation. 2013; 128, 713720.Google Scholar
26. Arnott, C, Skilton, MR, Ruohonen, S, et al. Subtle increases in heart size persist into adulthood in growth restricted babies: the Cardiovascular Risk in Young Finns Study. Open Heart. 2015; 2, e000265.Google Scholar
27. Sarr, O, Yang, K, Regnault, TR. In utero programming of later adiposity: the role of fetal growth restriction. J Pregnancy. 2012; 2012, 134758.Google Scholar
28. Thornburg, KL. The programming of cardiovascular disease. J Dev Orig Health Dis. 2015; 6, 366376.Google Scholar
29. Nabati, M, Saffar, N, Yazdani, J, Parsaee, MS. Relationship between epicardial fat measured by echocardiography and coronary atherosclerosis: a single-blind historical cohort study. Echocardiography. 2013; 30, 505511.Google Scholar
30. Wang, SF, Shu, L, Sheng, J, et al. Birth weight and risk of coronary heart disease in adults: a meta-analysis of prospective cohort studies. J Dev Orig Health Dis. 2014; 5, 408419.Google Scholar