Relation of Quantity of Subepicardial Adipose Tissue to Infarct Size in Patients With ST-Elevation Myocardial Infarction

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art_BIERE_Relation_of_Quantity_of_Subepicardial_Adipose_Tissue_to_2017.PDF (729.51 KB)
Citações na Scopus
12
Tipo de produção
article
Data de publicação
2017
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
Autores
BIERE, Loic
BEHAGHEL, Vianney
MATEUS, Victor
GRANI, Christoph
OUERGHI, Kais
GRALL, Sylvain
WILLOTEAUX, Serge
PRUNIER, Fabrice
KWONG, Raymond
Citação
AMERICAN JOURNAL OF CARDIOLOGY, v.119, n.12, p.1972-1978, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
According to the so-called obesity paradox, obesity might present a protective role in patients with myocardial infarction. We aimed to assess the influence of the epicardial adipose tissue (EAT) volume on cardiac healing and remodeling in patients with acute ST-elevation myocardial infarction. We prospectively included 193 consecutive patients presenting a first STEMI without known coronary artery disease. Cardiac magnetic resonance imaging was performed at baseline and after a 3-month follow-up. EAT volume was computed, and the population was divided into quartiles: the highest quartile of EAT defining the high EAT group (h-EAT). h-EAT was associated with increased body mass index, higher rate of history of hypertension, and smaller infarct size at initial CMR assessment (18.3 +/- 11.9% vs 23 +/- 13.7% of total left ventricular [LV] mass, p = 0.041). Moreover, microvascular obstruction was less frequent in the h-EAT group (36.2% vs 59.3%, p = 0.006). There were no differences in LV ejection fraction (LVEF), LV volumes, systolic wall stress, coronary artery burden, and clinical events during the index hospitalization between the EAT groups at baseline and at follow-up. Linear regression analysis showed h-EAT to be associated with smaller infarct size at baseline (beta coefficient = -3.25 [95% CI -5.89 to -0.61], p = 0.016). h-EAT also modified positively the effect of infarct size on LV remodeling, as assessed by the change in LVEF (p = 0.046). In conclusion, h-EAT was paradoxically related to smaller infarct size and acted as an effect modifier in the relation between the extent of infarct size and LVEF changes. Patients with higher extent of EAT presented better cardiac healing.
Palavras-chave
URI
https://observatorio.fm.usp.br/handle/OPI/21535
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Coleções
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - ODS/03