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The Relationship between Epicardial Adipose Tissue and Coronary Artery Calcification in Peritoneal Dialysis Patients
Kultigin Turkmen1, Orhan Ozbek, Hatice Kayikcioğlu
1Department of Nephrology, Selcuk University Meram School of Medicine, Meram, Turkey.
Insights
Epicardial adipose tissue (EAT) is significantly higher in peritoneal dialysis (PD) patients compared to healthy individuals. Increased EAT is associated with coronary artery calcification (CAC) in PD patients, suggesting a link to inflammation.
Area of Science:
- Cardiology
- Nephrology
- Radiology
Background:
- Cardiovascular disease (CVD) is a major concern in end-stage renal disease (ESRD) patients, with risk factors including atherosclerosis and coronary artery calcification (CAC).
- Epicardial adipose tissue (EAT), the heart's visceral fat depot, has been linked to coronary artery disease (CAD) in various populations.
- The relationship between EAT and CAC in peritoneal dialysis (PD) patients remains under-investigated.
Purpose of the Study:
- To investigate the association between epicardial adipose tissue (EAT) and coronary artery calcification (CAC) in patients undergoing peritoneal dialysis (PD).
Main Methods:
- A study involving 45 PD patients and 25 healthy controls, measuring EAT and CAC scores (CACS) using multidetector computed tomography (MDCT).
- Patients were stratified into subgroups based on CACS to compare EAT levels.
Main Results:
- PD patients exhibited significantly higher EAT compared to healthy controls (p = 0.02).
- Patients with higher CACS (>10) had significantly greater EAT than those with lower CACS (≤10) and healthy controls.
- Both age and EAT were correlated with a CACS of 10 or higher.
Conclusions:
- A significant relationship exists between EAT and the anatomic assessment of coronary artery lesions (via MDCT) in PD patients.
- This association may be driven by heightened inflammation and proinflammatory cytokines characteristic of uremic conditions.
Abstract:
BACKGROUND: Atherosclerosis, endothelial dysfunction, coronary artery calcification (CAC), and left ventricular hypertrophy are the most commonly encountered risk factors in the pathogenesis of cardiovascular disease in end-stage renal disease patients. Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between coronary artery disease and EAT has been shown in healthy subjects and patients with a high risk of coronary artery disease. In the present study, we aimed to investigate the relationship between EAT and CAC in peritoneal dialysis (PD) patients. Patients and Methods: Forty-five PD patients (18 females, 27 males, with a mean age of 50.6 ± 15 years) and 25 healthy subjects (12 females, 13 males, with a mean age of 52.4 ± 10.7 years) were enrolled in the study. EAT and CAC score (CACS) measurements were performed by a multidetector computed tomography scanner. RESULTS: EAT of the PD patients was significantly higher than that of the healthy subjects (p = 0.02). When patients were divided into two subgroups (group 1: CACS ≤10, n = 20; group 2: CACS >10, n = 25), EAT was also significantly higher in group 2 patients than in group 1 patients and healthy subjects. Age and EAT were also found to be correlated with CACS ≥10. CONCLUSION: There is a relationship between the anatomic assessment of coronary artery lesions by multidetector computed tomography and EAT in PD patients. This relationship might be attributed to increased inflammation and proinflammatory cytokines in uremic patients.
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