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Myocardial triglyceride content in patients with dilated cardiomyopathy
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Abstracts / Atherosclerosis 235 (2014) e27–e83
Methods: Aortic biopsies from patients undergoing elective aorta/aortic valve replacement surgery were analysed using histology (n¼49) and gene expression (n¼122). An additional 14 mammary artery biopsies were evaluated histologically. Patients with atherosclerosis, as defined by coronary angiography, were excluded. The presence of adipocytes was determined by visual inspection of vessel sections by two independent observers. Adipocyte-specific gene expression (adiponectin (ADIPOQ), leptin (LEP) and perilipin 1 (PLIN)) within the adventitia was determined by microarray and correlated with selected metabolic risk factors (BMI, waist-hip ratio, glucose, triacyglycerol). Results: Adipocyte morphology was seen within the aortic adventitia in 39% of the samples. In mammary artery, no adipocyte morphology was observed within the adventitia. The presence of adipocytes was confirmed by PLIN immunostaining. Expression levels of adipocyte-specific genes were significantly higher in aortic adventitia as compared to aortic media (ratio of adventitia to media: ADIPOQ 3.78, LEP 1.42, PLIN 1.92, all p<0.001). Waist-hip ratio correlated significantly with adventitial expression of LEP (r¼0.221, p¼0.021) and PLIN (r¼0.192, p¼0.045).
larger in patients with DCM compared to controls. In the whole study cohort, myocardial TG correlated positively (r ¼ 0.451, p¼0.012) whereas epicardial (r ¼ - 0.601, p<0.001) and pericardial fat (r ¼ - 0.391, p¼0.033) correlated inversely with LV ejection fraction. Conclusion: Myocardial TG content is decreased and epicardial and pericardial fat depots increased in non-diabetic subjects with DCM. Although recognized as a site of ectopic fat accumulation, myocardial TG seems to play a specific role as a myocardial energy source in congestive heart failure. 38 - Obesity and adipose tissue EAS-0201. OBESITY PARADOX STILL EXISTS AFTER PERCUTANEOUS CORONARY INTERVENTION INDEPENDENT OF METABOLIC STATUS S. Hana, P. Oha, K. Koha, K. Leea, S. Seoa, T. Ahna, E. Shina a
Cardiology, Gachon University Gil Medical Center, Incheon, Korea
Objectives: Previous studies have suggested an obesity paradox in patients with coronary artery disease. Because obese patients are also known to have multiple metabolic derangements, therefore, we aimed to investigate the impact of obesity and it's relation with metabolic parameters on clinical outcomes in patient undergoing percutaneous coronary intervention (PCI).
Ă
Immunostaining of perilipin 1 (brown coloration) indicating the presence of adipocytes within the adventita of human aorta (magnification: upper 5x, lower 20x) Conclusion: Adventitial adipocytes are present within human aorta, but not mammary artery. Since aortic adventitial gene expression of LEP and PLIN correlated significantly with waist-hip ratio, this might suggest that central obesity is associated with the appearance of adipocytes within the aorta, which could be involved in the development of atherosclerosis. 38 - Obesity and adipose tissue EAS-0060. MYOCARDIAL TRIGLYCERIDE CONTENT IN PATIENTS WITH DILATED CARDIOMYOPATHY M. Granér MD a, M. Pentikäinen MD a, K. Nyman MD b, R. Siren MD c, J. Lundbom MD b, A. Hakkarainen MD b, K. Lauerma MD b, N. Lundbom MD b, M.S. Nieminen MD b, M.R. Taskinen MD b a Heart and Lung Center Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland; b HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland; c Department of General Practice and Primary Health Care, Health Center of City of Helsinki, Helsinki, Finland
Objectives: Ectopic fat accumulation within and around the heart has been related to increased risk of heart disease. Limited data exist on cardiac adiposity in subjects with dilated cardiomyopathy (DCM). The aim of the study was to examine the components of cardiac steatosis and their relationship to left ventricular (LV) structure and function in non-diabetic DCM patients. Methods: Myocardial and hepatic TG contents were measured with 1.5 T magnetic resonance (MR) spectroscopy, and LV function, visceral adipose (VAT) and abdominal subcutaneous tissue (SAT), epicardial and pericardial fat by MR imaging in 10 non-diabetic men with DCM and in 20 controls. Results: In face of comparable intra-abdominal fat depots, myocardial TG [0.41 % (0.21-2.19) vs. 0.86 % (0.31-2.24), p¼0.002] was markedly lower and epicardial (895 mm2 110 vs. 664 mm2 180, p¼0.001) and pericardial fat [2173 mm2 (616-3673) vs. 1168 mm2 (266-2319), p¼0.028] depots were
Methods: A total of 714 consecutive patients who underwent PCI between May 2010 and April 2011 were enrolled and divided into three groups according to body mass index (BMI): normal weight (BMI < 23.0 kg/m2, n¼211), overweight (23.0 BMI < 27.5 kg/m2, n¼375), and obese groups (BMI 27.5 kg/m2, n¼128). Lipid profile, fasting glucose, insulin, HbA1c, and insulin sensitivity evaluated by quantitative insulin-sensitivity check index (QUICKI) were measured. Primary endpoint was 1-year major adverse cardiovascular events (MACEs), defined as the composite of allcause death, non-fatal myocardial infarction (MI), stroke, revascularization, or admission for heart failure. Results: The overweight or obese group had a higher incidence of hypertension, diabetes, and hyperlipidemia than the normal weight group. Left ventricular systolic dysfunction (ejection fraction < 40%) was more frequent in the normal group compared to the overweight or obese group (14.1% vs. 7.3% vs. 8.6%, p¼0.026, respectively). Fasting glucose, HbA1c, LDL-cholesterol did not differ significantly between groups. However, obese group had higher levels of fasting insulin than normal weight group (12.513.6mU/mL vs. 8.612.4mU/mL, p¼0.007). In addition, there was a significant difference of QUICKI between normal, overweight and obese groups (0.3450.048 vs. 0.3360.040 vs. 0.3210.038, p<0.05 for each groups, respectively). The cumulative incidence of MACEs at 1 year was 15.6% for the normal group, 5.9% for the overweight group, and 3.9% for the obese group (p<0.001). Conclusion: Overweight or obese patients had better clinical outcomes compared with normal weight patients after PCI although overweight or obese patients have more metabolic abnormality. 38 - Obesity and adipose tissue EAS-0137. CALORIC RESTRICTION BY DIET OR SLEEVE GASTRECTOMY HAS LITTLE EFFECT ON METAINFLAMMATION DESPITE IMPROVING INSULIN RESISTANCE K. Widynskia, B.A. Aulingera, K. Piotrowskia, J. Zugwursta, T. To Vieta, B. Gökea, U.C. Broedla, J. Schirraa, K.G. Parhofera a Medical Germany
Department
2,
Ludwig-Maximilians
Universität,
München,
Objectives: Obesity and type 2 diabetes (T2D) are associated with chronic low-grade inflammation of adipose tissues (metainflammation). Pro- and anti-inflammatory cytokines produced within these tissues are linked to insulin resistance and atherosclerosis. Although studies have shown decreased inflammation on a long-term basis, there is no data on the short-term effect of bariatric surgery in comparison to caloric restriction by diet.
Abstracts / Atherosclerosis 235 (2014) e27–e83
Methods: Aortic biopsies from patients undergoing elective aorta/aortic valve replacement surgery were analysed using histology (n¼49) and gene expression (n¼122). An additional 14 mammary artery biopsies were evaluated histologically. Patients with atherosclerosis, as defined by coronary angiography, were excluded. The presence of adipocytes was determined by visual inspection of vessel sections by two independent observers. Adipocyte-specific gene expression (adiponectin (ADIPOQ), leptin (LEP) and perilipin 1 (PLIN)) within the adventitia was determined by microarray and correlated with selected metabolic risk factors (BMI, waist-hip ratio, glucose, triacyglycerol). Results: Adipocyte morphology was seen within the aortic adventitia in 39% of the samples. In mammary artery, no adipocyte morphology was observed within the adventitia. The presence of adipocytes was confirmed by PLIN immunostaining. Expression levels of adipocyte-specific genes were significantly higher in aortic adventitia as compared to aortic media (ratio of adventitia to media: ADIPOQ 3.78, LEP 1.42, PLIN 1.92, all p<0.001). Waist-hip ratio correlated significantly with adventitial expression of LEP (r¼0.221, p¼0.021) and PLIN (r¼0.192, p¼0.045).
larger in patients with DCM compared to controls. In the whole study cohort, myocardial TG correlated positively (r ¼ 0.451, p¼0.012) whereas epicardial (r ¼ - 0.601, p<0.001) and pericardial fat (r ¼ - 0.391, p¼0.033) correlated inversely with LV ejection fraction. Conclusion: Myocardial TG content is decreased and epicardial and pericardial fat depots increased in non-diabetic subjects with DCM. Although recognized as a site of ectopic fat accumulation, myocardial TG seems to play a specific role as a myocardial energy source in congestive heart failure. 38 - Obesity and adipose tissue EAS-0201. OBESITY PARADOX STILL EXISTS AFTER PERCUTANEOUS CORONARY INTERVENTION INDEPENDENT OF METABOLIC STATUS S. Hana, P. Oha, K. Koha, K. Leea, S. Seoa, T. Ahna, E. Shina a
Cardiology, Gachon University Gil Medical Center, Incheon, Korea
Objectives: Previous studies have suggested an obesity paradox in patients with coronary artery disease. Because obese patients are also known to have multiple metabolic derangements, therefore, we aimed to investigate the impact of obesity and it's relation with metabolic parameters on clinical outcomes in patient undergoing percutaneous coronary intervention (PCI).
Ă
Immunostaining of perilipin 1 (brown coloration) indicating the presence of adipocytes within the adventita of human aorta (magnification: upper 5x, lower 20x) Conclusion: Adventitial adipocytes are present within human aorta, but not mammary artery. Since aortic adventitial gene expression of LEP and PLIN correlated significantly with waist-hip ratio, this might suggest that central obesity is associated with the appearance of adipocytes within the aorta, which could be involved in the development of atherosclerosis. 38 - Obesity and adipose tissue EAS-0060. MYOCARDIAL TRIGLYCERIDE CONTENT IN PATIENTS WITH DILATED CARDIOMYOPATHY M. Granér MD a, M. Pentikäinen MD a, K. Nyman MD b, R. Siren MD c, J. Lundbom MD b, A. Hakkarainen MD b, K. Lauerma MD b, N. Lundbom MD b, M.S. Nieminen MD b, M.R. Taskinen MD b a Heart and Lung Center Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland; b HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland; c Department of General Practice and Primary Health Care, Health Center of City of Helsinki, Helsinki, Finland
Objectives: Ectopic fat accumulation within and around the heart has been related to increased risk of heart disease. Limited data exist on cardiac adiposity in subjects with dilated cardiomyopathy (DCM). The aim of the study was to examine the components of cardiac steatosis and their relationship to left ventricular (LV) structure and function in non-diabetic DCM patients. Methods: Myocardial and hepatic TG contents were measured with 1.5 T magnetic resonance (MR) spectroscopy, and LV function, visceral adipose (VAT) and abdominal subcutaneous tissue (SAT), epicardial and pericardial fat by MR imaging in 10 non-diabetic men with DCM and in 20 controls. Results: In face of comparable intra-abdominal fat depots, myocardial TG [0.41 % (0.21-2.19) vs. 0.86 % (0.31-2.24), p¼0.002] was markedly lower and epicardial (895 mm2 110 vs. 664 mm2 180, p¼0.001) and pericardial fat [2173 mm2 (616-3673) vs. 1168 mm2 (266-2319), p¼0.028] depots were
Methods: A total of 714 consecutive patients who underwent PCI between May 2010 and April 2011 were enrolled and divided into three groups according to body mass index (BMI): normal weight (BMI < 23.0 kg/m2, n¼211), overweight (23.0 BMI < 27.5 kg/m2, n¼375), and obese groups (BMI 27.5 kg/m2, n¼128). Lipid profile, fasting glucose, insulin, HbA1c, and insulin sensitivity evaluated by quantitative insulin-sensitivity check index (QUICKI) were measured. Primary endpoint was 1-year major adverse cardiovascular events (MACEs), defined as the composite of allcause death, non-fatal myocardial infarction (MI), stroke, revascularization, or admission for heart failure. Results: The overweight or obese group had a higher incidence of hypertension, diabetes, and hyperlipidemia than the normal weight group. Left ventricular systolic dysfunction (ejection fraction < 40%) was more frequent in the normal group compared to the overweight or obese group (14.1% vs. 7.3% vs. 8.6%, p¼0.026, respectively). Fasting glucose, HbA1c, LDL-cholesterol did not differ significantly between groups. However, obese group had higher levels of fasting insulin than normal weight group (12.513.6mU/mL vs. 8.612.4mU/mL, p¼0.007). In addition, there was a significant difference of QUICKI between normal, overweight and obese groups (0.3450.048 vs. 0.3360.040 vs. 0.3210.038, p<0.05 for each groups, respectively). The cumulative incidence of MACEs at 1 year was 15.6% for the normal group, 5.9% for the overweight group, and 3.9% for the obese group (p<0.001). Conclusion: Overweight or obese patients had better clinical outcomes compared with normal weight patients after PCI although overweight or obese patients have more metabolic abnormality. 38 - Obesity and adipose tissue EAS-0137. CALORIC RESTRICTION BY DIET OR SLEEVE GASTRECTOMY HAS LITTLE EFFECT ON METAINFLAMMATION DESPITE IMPROVING INSULIN RESISTANCE K. Widynskia, B.A. Aulingera, K. Piotrowskia, J. Zugwursta, T. To Vieta, B. Gökea, U.C. Broedla, J. Schirraa, K.G. Parhofera a Medical Germany
Department
2,
Ludwig-Maximilians
Universität,
München,
Objectives: Obesity and type 2 diabetes (T2D) are associated with chronic low-grade inflammation of adipose tissues (metainflammation). Pro- and anti-inflammatory cytokines produced within these tissues are linked to insulin resistance and atherosclerosis. Although studies have shown decreased inflammation on a long-term basis, there is no data on the short-term effect of bariatric surgery in comparison to caloric restriction by diet.