Volume de Gordura Epicárdica está Associada com Disfunção Endotelial, mas Não com Calcificação Coronariana: From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Karina P.M.P. Martins; Sandhi M. Barreto; Daniel Bos; Jesiana Pedrosa; Douglas R.M. Azevedo; Larissa Fortunato Araújo; Murilo Foppa; Bruce B. Duncan; Antonio Luiz P. Ribeiro; Luisa C.C. Brant

doi:10.36660/abc.20210750

Volume de Gordura Epicárdica está Associada com Disfunção Endotelial, mas Não com Calcificação Coronariana: From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Translated title of the contribution: Epicardial Fat Volume Is Associated with Endothelial Dysfunction, but not with Coronary Calcification: From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Karina P.M.P. Martins, Sandhi M. Barreto, Daniel Bos, Jesiana Pedrosa, Douglas R.M. Azevedo, Larissa Fortunato Araújo, Murilo Foppa, Bruce B. Duncan, Antonio Luiz P. Ribeiro, Luisa C.C. Brant^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: The increase in epicardial fat volume (EFV) is related to coronary artery disease (CAD), independent of visceral or subcutaneous fat. The mechanism underlying this association is unclear. Coronary artery calcium (CAC) score and endothelial dysfunction are related to coronary events, but whether EFV is related to these markers needs further clarification. Objectives: To evaluate the association between automatically measured EFV, cardiovascular risk factors, CAC, and endothelial function. Methods: In 470 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) with measures of EFV, CAC score and endothelial function, we performed multivariable models to evaluate the relation between cardiovascular risk factors and EFV (response variable), and between EFV (explanatory variable) and endothelial function variables or CAC score. Two-sided p <0.05 was considered statistically significant. Results: Mean age was 55 ± 8 years, 52.3% of patients were men. Mean EFV was 111mL (IQ 86-144), and the prevalence of CAC score=0 was 55%. In the multivariable analyses, increased EFV was related to female sex, older age, waist circumference, and triglycerides (p<0.001 for all). Higher EFV was associated with worse endothelial function: as compared with the first quartile, the odds ratio for basal pulse amplitude were (q2=1.22, 95%CI 1.07-1.40; q3=1.50, 95%CI 1.30-1.74; q4=1.50, 95%CI 1.28-1.79) and for peripheral arterial tonometry ratio were (q2=0.87, 95%CI 0.81-0.95; q3=0.86, 95%CI 0.79-0.94; q4=0.80, 95%CI 0.73-0.89), but not with CAC score>0. Conclusion: Higher EFV was associated with impaired endothelial function, but not with CAC. The results suggest that EFV is related to the development of CAD through a pathway different from the CAC pathway, possibly through aggravation of endothelial dysfunction and microvascular disease.

Translated title of the contribution	Epicardial Fat Volume Is Associated with Endothelial Dysfunction, but not with Coronary Calcification: From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
Original language	Portuguese
Pages (from-to)	912-920
Number of pages	9
Journal	Arquivos Brasileiros de Cardiologia
Volume	119
Issue number	6
DOIs	https://doi.org/10.36660/abc.20210750
Publication status	Published - 2022

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Martins, K. P. M. P., Barreto, S. M., Bos, D., Pedrosa, J., Azevedo, D. R. M., Araújo, L. F., Foppa, M., Duncan, B. B., Ribeiro, A. L. P., & Brant, L. C. C. (2022). Volume de Gordura Epicárdica está Associada com Disfunção Endotelial, mas Não com Calcificação Coronariana: From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Arquivos Brasileiros de Cardiologia, 119(6), 912-920. https://doi.org/10.36660/abc.20210750

@article{c8bf62c64b4e41b3822dffa2a5c09b5a,

title = "Volume de Gordura Epic{\'a}rdica est{\'a} Associada com Disfun{\c c}{\~a}o Endotelial, mas N{\~a}o com Calcifica{\c c}{\~a}o Coronariana: From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)",

abstract = "Background: The increase in epicardial fat volume (EFV) is related to coronary artery disease (CAD), independent of visceral or subcutaneous fat. The mechanism underlying this association is unclear. Coronary artery calcium (CAC) score and endothelial dysfunction are related to coronary events, but whether EFV is related to these markers needs further clarification. Objectives: To evaluate the association between automatically measured EFV, cardiovascular risk factors, CAC, and endothelial function. Methods: In 470 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) with measures of EFV, CAC score and endothelial function, we performed multivariable models to evaluate the relation between cardiovascular risk factors and EFV (response variable), and between EFV (explanatory variable) and endothelial function variables or CAC score. Two-sided p <0.05 was considered statistically significant. Results: Mean age was 55 ± 8 years, 52.3% of patients were men. Mean EFV was 111mL (IQ 86-144), and the prevalence of CAC score=0 was 55%. In the multivariable analyses, increased EFV was related to female sex, older age, waist circumference, and triglycerides (p<0.001 for all). Higher EFV was associated with worse endothelial function: as compared with the first quartile, the odds ratio for basal pulse amplitude were (q2=1.22, 95%CI 1.07-1.40; q3=1.50, 95%CI 1.30-1.74; q4=1.50, 95%CI 1.28-1.79) and for peripheral arterial tonometry ratio were (q2=0.87, 95%CI 0.81-0.95; q3=0.86, 95%CI 0.79-0.94; q4=0.80, 95%CI 0.73-0.89), but not with CAC score>0. Conclusion: Higher EFV was associated with impaired endothelial function, but not with CAC. The results suggest that EFV is related to the development of CAD through a pathway different from the CAC pathway, possibly through aggravation of endothelial dysfunction and microvascular disease.",

author = "Martins, {Karina P.M.P.} and Barreto, {Sandhi M.} and Daniel Bos and Jesiana Pedrosa and Azevedo, {Douglas R.M.} and Ara{\'u}jo, {Larissa Fortunato} and Murilo Foppa and Duncan, {Bruce B.} and Ribeiro, {Antonio Luiz P.} and Brant, {Luisa C.C.}",

year = "2022",

doi = "10.36660/abc.20210750",

language = "Portuguese",

volume = "119",

pages = "912--920",

journal = "Arquivos Brasileiros de Cardiologia",

issn = "0066-782X",

publisher = "Arquivos Brasileiros de Cardiologia",

number = "6",

}

Martins, KPMP, Barreto, SM, Bos, D, Pedrosa, J, Azevedo, DRM, Araújo, LF, Foppa, M, Duncan, BB, Ribeiro, ALP & Brant, LCC 2022, 'Volume de Gordura Epicárdica está Associada com Disfunção Endotelial, mas Não com Calcificação Coronariana: From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)', Arquivos Brasileiros de Cardiologia, vol. 119, no. 6, pp. 912-920. https://doi.org/10.36660/abc.20210750

Volume de Gordura Epicárdica está Associada com Disfunção Endotelial, mas Não com Calcificação Coronariana: From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). / Martins, Karina P.M.P.; Barreto, Sandhi M.; Bos, Daniel et al.
In: Arquivos Brasileiros de Cardiologia, Vol. 119, No. 6, 2022, p. 912-920.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Volume de Gordura Epicárdica está Associada com Disfunção Endotelial, mas Não com Calcificação Coronariana

T2 - From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

AU - Martins, Karina P.M.P.

AU - Barreto, Sandhi M.

AU - Bos, Daniel

AU - Pedrosa, Jesiana

AU - Azevedo, Douglas R.M.

AU - Araújo, Larissa Fortunato

AU - Foppa, Murilo

AU - Duncan, Bruce B.

AU - Ribeiro, Antonio Luiz P.

AU - Brant, Luisa C.C.

PY - 2022

Y1 - 2022

N2 - Background: The increase in epicardial fat volume (EFV) is related to coronary artery disease (CAD), independent of visceral or subcutaneous fat. The mechanism underlying this association is unclear. Coronary artery calcium (CAC) score and endothelial dysfunction are related to coronary events, but whether EFV is related to these markers needs further clarification. Objectives: To evaluate the association between automatically measured EFV, cardiovascular risk factors, CAC, and endothelial function. Methods: In 470 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) with measures of EFV, CAC score and endothelial function, we performed multivariable models to evaluate the relation between cardiovascular risk factors and EFV (response variable), and between EFV (explanatory variable) and endothelial function variables or CAC score. Two-sided p <0.05 was considered statistically significant. Results: Mean age was 55 ± 8 years, 52.3% of patients were men. Mean EFV was 111mL (IQ 86-144), and the prevalence of CAC score=0 was 55%. In the multivariable analyses, increased EFV was related to female sex, older age, waist circumference, and triglycerides (p<0.001 for all). Higher EFV was associated with worse endothelial function: as compared with the first quartile, the odds ratio for basal pulse amplitude were (q2=1.22, 95%CI 1.07-1.40; q3=1.50, 95%CI 1.30-1.74; q4=1.50, 95%CI 1.28-1.79) and for peripheral arterial tonometry ratio were (q2=0.87, 95%CI 0.81-0.95; q3=0.86, 95%CI 0.79-0.94; q4=0.80, 95%CI 0.73-0.89), but not with CAC score>0. Conclusion: Higher EFV was associated with impaired endothelial function, but not with CAC. The results suggest that EFV is related to the development of CAD through a pathway different from the CAC pathway, possibly through aggravation of endothelial dysfunction and microvascular disease.

AB - Background: The increase in epicardial fat volume (EFV) is related to coronary artery disease (CAD), independent of visceral or subcutaneous fat. The mechanism underlying this association is unclear. Coronary artery calcium (CAC) score and endothelial dysfunction are related to coronary events, but whether EFV is related to these markers needs further clarification. Objectives: To evaluate the association between automatically measured EFV, cardiovascular risk factors, CAC, and endothelial function. Methods: In 470 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) with measures of EFV, CAC score and endothelial function, we performed multivariable models to evaluate the relation between cardiovascular risk factors and EFV (response variable), and between EFV (explanatory variable) and endothelial function variables or CAC score. Two-sided p <0.05 was considered statistically significant. Results: Mean age was 55 ± 8 years, 52.3% of patients were men. Mean EFV was 111mL (IQ 86-144), and the prevalence of CAC score=0 was 55%. In the multivariable analyses, increased EFV was related to female sex, older age, waist circumference, and triglycerides (p<0.001 for all). Higher EFV was associated with worse endothelial function: as compared with the first quartile, the odds ratio for basal pulse amplitude were (q2=1.22, 95%CI 1.07-1.40; q3=1.50, 95%CI 1.30-1.74; q4=1.50, 95%CI 1.28-1.79) and for peripheral arterial tonometry ratio were (q2=0.87, 95%CI 0.81-0.95; q3=0.86, 95%CI 0.79-0.94; q4=0.80, 95%CI 0.73-0.89), but not with CAC score>0. Conclusion: Higher EFV was associated with impaired endothelial function, but not with CAC. The results suggest that EFV is related to the development of CAD through a pathway different from the CAC pathway, possibly through aggravation of endothelial dysfunction and microvascular disease.

UR - http://www.scopus.com/inward/record.url?scp=85143702727&partnerID=8YFLogxK

U2 - 10.36660/abc.20210750

DO - 10.36660/abc.20210750

M3 - Article

C2 - 36228276

AN - SCOPUS:85143702727

SN - 0066-782X

VL - 119

SP - 912

EP - 920

JO - Arquivos Brasileiros de Cardiologia

JF - Arquivos Brasileiros de Cardiologia

IS - 6

ER -

Volume de Gordura Epicárdica está Associada com Disfunção Endotelial, mas Não com Calcificação Coronariana: From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

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