¹Altai State Medical University, Barnaul, Russian Federation
²Research Institute for Complex Issues of Cardiovascular Diseases, Siberian Branch of the RAMS, Kemerovo, Russian Federation,
³Altai State Cardiological Dispensary, Barnaul, Russian Federation
*Corresponding author: Prof. Galina A. Chumakova, PhD, ScD, Department of Hospital and Policlinical Therapy, Altai State Medical University. 40, Lenin ave., Barnaul, 656038, Altai Krai, Russian Federation. E-mail:g.a.chumakova@mail.ru
Obesity is a global epidemic characteristic of the 21st century; therefore, studying the subclinical markers of coronary atherosclerosis in overweight patients is current and relevant. With weight increase, hypertrophy and hyperplasia of adipocytes occur not only in the abdominal area, but also in the ectopic local fat depots, including the epicardial ones. As the myocardium and coronary arteries are anatomically related, hormonally active epicardial fat seems to be a pathologic link between obesity and coronary heart disease (CHD). The objective of this research is to study the relationship between epicardial adiposity and abdominal obesity with metabolic risk factors and visceral fat adipokines. The influence of epicardial fat thickness (EFT) and waist circumference (WC) on the risk of development of significant coronary atherosclerosis in obese patients with CHD was studied (138 men, 55.47±9.07 years and BMI 35.2±5.2 kg/m2). The ROC analysis reveals that EFT is more informative in diagnosing significant stenoses (≥70 %): sensitivity of the given marker constituted 80.4 %, specificity – 67.6 % (cut-off value=6 mm). On comparison of the epicardial and abdominal adiposity as predictors of coronary atherosclerosis, EFT was found to be more significant than WC. In patients with CHD, the increase in EFT is associated with the more serious involvement of the coronary arteries, whereas the WC analysis did not establish similar regularities. Evaluation of EFT in obese patients can be used as a noninvasive marker indicative of the presence of subclinical stenoses of the coronary arteries.
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