Epicardial fat volume is related to the degree of cardiac allograft vasculopathy.
Cardiac allograft vasculopathy
Coronary artery disease
Coronary computed tomography
Epicardial fat
Heart transplantation
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
received:
20
01
2022
accepted:
13
07
2022
revised:
18
05
2022
pubmed:
21
8
2022
medline:
20
12
2022
entrez:
20
8
2022
Statut:
ppublish
Résumé
Increasing evidence suggests a role for epicardial fat in the development of coronary artery disease in the general population. Heart transplantation patients are at increased risk of developing a specific form of coronary artery disease, cardiac allograft vasculopathy (CAV), which has far-reaching consequences in terms of morbidity and mortality. Until now, the role of epicardial fat volume (EFV) in the development of CAV remains unknown. Hence, we investigated the relationship between EFV and CAV as well as the influence of donor/recipient sex on EFV. Adult heart transplant patients who underwent coronary computed tomography angiography (CCTA) for CAV screening who were four or more years post-HT were included. Using the CT examinations, we quantified the EFV and the degree of CAV. Ordinal and linear regression models were used to assess the association of EFV with CAV. In total, 149 (median age 44.5 years, 36% women) patients were included. The median time between HT and the CT scan was 11.0 (7.3-16.1) years. CAV grade 0, 1, 2 and 3 were seen in 85 (57%), 32 (22%), 14 (9%), and 18 (12%) patients, respectively. The median EFV was 208.4 (128.9-276.0) mL. Larger EFV were related to higher degrees of CAV (median of 164.7 to 290.6 mL for CAV grade 0 and 3, respectively, OR 5.23 (2.47-11.06), p < 0.001). Male recipients had significantly more EFV than female recipients irrespective of the donor sex (232.7 mL vs. 147.2 mL respectively, p < 0.001). Determinants for EFV were recipient sex, number of rejections, donor age, time between HT and CT scan, recipient BMI, and diabetes mellitus. EFV was associated with higher degrees of CAV. The recipient sex influenced the EFV more than the donor sex. • Patients after heart transplantation have a high amount of epicardial fat while larger amounts of epicardial fat are related to higher grades of cardiac allograft vasculopathy. • Determinants of higher epicardial fat volume included recipient sex, number of rejections, donor age, time between HT and CT scan, recipient BMI, and diabetes mellitus. • Longitudinal studies are needed to further disentangle the role of epicardial fat in the development and progression of cardiac allograft vasculopathy. Demonstration of four patients (from CAV grade 0 to CAV grade 3) in whom epicardial fat volume was determined. In red, the voxels identified as epicardial fat.
Identifiants
pubmed: 35986769
doi: 10.1007/s00330-022-09029-2
pii: 10.1007/s00330-022-09029-2
pmc: PMC9755093
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
330-338Informations de copyright
© 2022. The Author(s).
Références
Circ Res. 2009 Feb 27;104(4):541-9
pubmed: 19122178
Cardiovasc Diabetol. 2018 Jan 4;17(1):6
pubmed: 29301516
Cardiovasc Diagn Ther. 2012 Jun;2(2):85-93
pubmed: 24282702
Cardiovasc Res. 2021 Nov 22;117(13):2624-2638
pubmed: 34343276
Expert Opin Pharmacother. 2020 Aug;21(11):1367-1376
pubmed: 32401066
Circ Heart Fail. 2018 Sep;11(9):e004050
pubmed: 30354362
N Engl J Med. 2003 Aug 28;349(9):829-30
pubmed: 12944567
Transpl Int. 2021 Oct;34(10):1886-1894
pubmed: 34268796
Circulation. 2008 Feb 5;117(5):605-13
pubmed: 18212276
Diabetes Metab Syndr Obes. 2019 Dec 05;12:2559-2566
pubmed: 31824184
Eur Radiol. 2020 Aug;30(8):4317-4326
pubmed: 32179995
Int J Cardiol. 2012 Jun 28;158(1):26-32
pubmed: 21255849
J Cardiovasc Comput Tomogr. 2019 Sep - Oct;13(5):288-296
pubmed: 30952610
J Heart Lung Transplant. 2010 Jul;29(7):717-27
pubmed: 20620917
Eur Heart J Cardiovasc Imaging. 2018 May 1;19(5):490-497
pubmed: 29236951
Med Phys. 2013 Sep;40(9):091910
pubmed: 24007161
Atherosclerosis. 2011 Oct;218(2):363-8
pubmed: 21835407
J Heart Lung Transplant. 2010 Aug;29(8):914-56
pubmed: 20643330
Eur Radiol. 2022 Mar;32(3):1843-1852
pubmed: 34523009
Transplantation. 2020 Jan;104(1):e38-e39
pubmed: 31478991
Eur Radiol. 2019 Jul;29(7):3638-3646
pubmed: 30859284
Mediators Inflamm. 2020 Jun 4;2020:1348913
pubmed: 32565719
Obes Rev. 2015 May;16(5):406-15
pubmed: 25753297
Cardiovasc Diabetol. 2015 Sep 30;14:130
pubmed: 26419433
Allergy Asthma Clin Immunol. 2013 Aug 15;9(1):30
pubmed: 23947590
Transplantation. 2010 May 15;89(9):1141-8
pubmed: 20386145
J Am Coll Cardiol. 2013 Apr 2;61(13):1388-95
pubmed: 23433560
JACC Cardiovasc Imaging. 2017 Nov;10(11):1405-1407
pubmed: 28216004
J Endocr Soc. 2020 Mar 13;4(4):bvz042
pubmed: 32190806
J Cardiovasc Comput Tomogr. 2014 Sep-Oct;8(5):342-58
pubmed: 25301040
Transplantation. 2019 Mar;103(3):502-511
pubmed: 30211824
Eur J Heart Fail. 2018 Nov;20(11):1559-1566
pubmed: 30070041
J Heart Lung Transplant. 2019 Oct;38(10):1056-1066
pubmed: 31548031
Eur Heart J Cardiovasc Imaging. 2015 Nov;16(11):1264-9
pubmed: 25908795
Semin Immunol. 2012 Apr;24(2):122-30
pubmed: 21937238
J Heart Lung Transplant. 2021 Jun;40(6):426-429
pubmed: 33745782