Related Experiment Video
Updated: Jul 4, 2025
Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Assessing the Relationship between Indexed Epicardial Adipose Tissue Thickness, Oxidative Stress in Adipocytes, and
Laurentiu Braescu1,2, Adrian Sturza3,4, Oana Maria Aburel3,4
1Department VI Cardiology-Cardiovascular Surgery Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy, E. Murgu Sq. No. 2, 300041 Timișoara, Romania.
Insights
Indexed epicardial adipose tissue thickness (EATTi) is a reliable indicator of coronary artery disease (CAD) complexity in open-heart surgery patients. Higher EATTi values correlate with more intricate CAD, aiding pre-operative assessment and surgical decision-making.
Area of Science:
- Cardiovascular Medicine
- Medical Imaging
- Biomarkers in Disease
Background:
- Epicardial adipose tissue (EAT) plays a role in cardiovascular health.
- Epicardial adipose tissue thickness (EATTi) is being investigated as a potential marker in coronary artery disease (CAD).
- Understanding EATTi's association with CAD complexity is crucial for surgical patient management.
Purpose of the Study:
- To investigate the relationship between indexed epicardial adipose tissue thickness (EATTi) and oxidative stress in epicardial adipose tissue (EAT).
- To determine if EATTi can serve as an additional marker for predicting CAD complexity in open-heart surgery patients.
- To assess the clinical utility of EATTi in pre-operative assessment for cardiac surgery.
Main Methods:
- A cross-sectional study involving 25 open-heart surgery patients.
- Measurement of indexed epicardial adipose tissue thickness (EATTi).
- Assessment of oxidative stress in EAT using spectrophotometric assay.
- Categorization of patients into groups based on valvular heart disease, CAD, and diabetes mellitus (DM).
- Evaluation of CAD complexity using the SYNTAX score.
Main Results:
- EATTi was significantly elevated in patients with both CAD and DM compared to those with CAD alone or only valvular disease.
- Patients with higher SYNTAX scores (indicating more complex CAD) exhibited significantly higher EATTi.
- An EATTi threshold of 4.15 mm/m² demonstrated high sensitivity (80%) and specificity (86%) for predicting complex CAD (SYNTAX score >22).
- Excellent intra- and interobserver reproducibility was observed for EATTi measurements.
Conclusions:
- Indexed epicardial adipose tissue thickness (EATTi) is significantly associated with the complexity of coronary artery disease (CAD) in patients undergoing open-heart surgery.
- EATTi serves as a reliable indicator of intricate CAD forms, correlating with higher SYNTAX scores.
- EATTi holds clinical relevance as a potential prognostic marker in the pre-operative assessment of cardiac surgical patients.
Abstract:
Background and Objectives: This cross-sectional study conducted at the Timișoara Institute of Cardiovascular Diseases, Romania, and the Centre for Translational Research and Systems Medicine from "Victor Babeș" University of Medicine and Pharmacy of Timișoara, Romania, investigated the relationship between indexed epicardial adipose tissue thickness (EATTi) and oxidative stress in epicardial adipose tissue (EAT) adipocytes in the context of coronary artery disease (CAD) among open-heart surgery patients. The objective was to elucidate the contribution of EATTi as an additional marker for complexity prediction in patients with CAD, potentially influencing clinical decision-making in surgical settings. Materials and Methods: The study included 25 patients undergoing cardiac surgery, with a mean age of 65.16 years and a body mass index of 27.61 kg/m2. Oxidative stress in EAT was assessed using the ferrous iron xylenol orange oxidation spectrophotometric assay. The patients were divided into three groups: those with valvular heart disease without CAD, patients with CAD without diabetes mellitus (DM), and patients with both CAD and DM. The CAD complexity was evaluated using the SYNTAX score. Results: The EATTi showed statistically significant elevations in the patients with both CAD and DM (mean 5.27 ± 0.67 mm/m2) compared to the CAD without DM group (mean 3.78 ± 1.05 mm/m2, p = 0.024) and the valvular disease without CAD group (mean 2.67 ± 0.83 mm/m2, p = 0.001). Patients with SYNTAX scores over 32 had significantly higher EATTi (5.27 ± 0.66 mm/m2) compared to those with lower scores. An EATTi greater than 4.15 mm/m2 predicted more complex CAD (SYNTAX score >22) with 80% sensitivity and 86% specificity. The intra- and interobserver reproducibility for the EATTi measurement were excellent (intra-class correlation coefficient 0.911, inter-class correlation coefficient 0.895). Conclusions: EATTi is significantly associated with CAD complexity in patients undergoing open-heart surgery. It serves as a reliable indicator of more intricate CAD forms, as reflected by higher SYNTAX scores. These findings highlight the clinical relevance of EATTi in pre-operative assessment, suggesting its potential utility as a prognostic marker in cardiac surgical patients.
