Prognostic Significance of Cardiac Fat Deposits in Patients with Coronary Heart Disease

Abstract

INTRODUCTION: Obesity is one of the leading risk factors for the development of cardiovascular diseases. At present, of the greatest scientific interest are local deposits of adipose tissue as a possible morphological substrate for the development of this group of diseases. Along with the traditional risk factors, one more risk factor for a poor prognosis of cardiovascular disease can be a change in the thickness of the epicardial fat (EF) and of the interatrial septum (IAS) in case of its lipomatosis.

AIM: To study the significance of EF and of IAS thickness as markers of cardiovascular risk in coronary heart disease.

MATERIALS AND METHODS: The study involved 116 individuals with coronary heart disease (55 men (47%) and 61 women (53%), mean age — 68 [61; 72] years). Thickness of EF and IAS was evaluated by the method of echocardiography. The frequency of poor outcomes was evaluated using Kaplan–Meier method, ROC-curve analysis. The differences were considered statistically significant at p < 0.05.

RESULTS: In the group of patients with unstable angina, the threshold value of IAS thickness was 0.7 cm (p < 0.001), and of EF thickness — 0.8 cm (÷2 = 10.89, p = 0.001), in the group of patients with myocardial infarction — 0.7 cm (p < 0.001) and 0.8 cm (p < 0.001), respectively. In the group of patient with unstable angina, IAS thickness > 0.7 cm (÷2 = 10.3, p = 0.0013) and EF thickness > 0.8 cm (÷2 = 10.89, p = 0.001) demonstrate a poor prognosis in comparison with the parameters below the threshold values. In the group of patients with myocardial infarction, IAS thickness > 0.7 cm (÷2 = 8.4, p = 0.005) and EF > 0.8 cm (÷2 = 9.66, p = 0.0019) demonstrate poor prognosis in comparison with the parameters below the threshold values.

CONCLUSION: In unstable angina and myocardial infarction, the value of IAS thickness > 0.7 cm (p = 0.0013 and p = 0.005, respectively) and of EF thickness > 0.8 cm (p = 0.001 and p = 0.0019, respectively) present a poor prognosis compared to lower values. It is recommended that EF and IAS thickness be determined in echocardiography as an additional marker for a poor prognosis in coronary heart disease.

Keywords

ischemic heart disease / obesity / epicardial fat / lipomatosis of atrial septum

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Uryasyev O.M., Solov’yeva A.V., Cheskidov A.V., Filimonova A.A., Nikiforova E.А.