Fatih ÖZTÜRK, Adem ATICI, Yunus Emre OKUDAN, Ali Yaşar KILINÇ, Mehmet YAMAN, Hakkı ŞİMŞEK, Koray DEMİR, Serkan AKDAĞ

Relatıonshıp Between Epıcardıal Adıpose Tıssue And Syntax Score In Patıents Wıth Acute Coronary Syndrome

Objective: The aim of this study was to evaluate the relationship between epicardial adipose tissue (EAT) thickness and SYNTAX score in patients with acute coronary syndrome (ACS).Methods: The study included 200 patients with ACS and 150 non-ACS. Systolic (EAT-S) and diastolic EAT (EAT-D) thickness was measured in each patient. EAT thickness and the relationship between EAT thickness and SYNTAX score were compared between the patient and control groups.Results: Age, body mass index, and presence of hypertension and diabetes mellitus (DM) established a significant difference while smoking status and presence of hyperlipidemia caused no significant difference between the patient and non-ACS. Both EAT-S and EAT-D thickness established a significant difference between the two groups (5.57±1.15 vs. 4.47± 0.60, p

Akut Koroner Sendrom Hastalarında Syntax Skoru İle Epikardiyal Yağ Doku Arasındaki İlişki

Amaç: Çalışmanın amacı akut koroner sendromlu (AKS) hastalarda epikardiyal yağ dokusu (EYD) kalınlığı ile Syntax Skoru arasındaki ilişkiyi değerlendirmektedir. Yöntemler: Çalışmaya AKS geçiren 200 ve AKS geçirmemiş olan 150 hasta dahil edilmiştir. Her hasta için sistolik(S-EYD) ve diyastolik(D-EYD) EYD kalınlığı ölçülmüştür. EYD kalınlığı ve EYD ile Syntax Skoru arasındaki ilişki hastalar ve kontrol grupları arasında karşılaştırılmıştır. Bulgular: Hastalar ve kontrol grubu karşılaştırıldığında yaş, vücut kitle indeksi, hipertansiyon ve diyabet varlığı anlamlı olarak farklı iken, tütün kullanımı ve hiperlipidemi varlığı açısından her iki grup arasında farklılık saptanmamıştır. Hem S-EYD hem de D-EYD kalınlığı her iki grup arasında farklı olarak bulunmuştur (5.57±1.15 vs. 4.47± 0.60, p

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1. Members WG, Thom T, Haase N, et al. Heart disease and stroke statistics—2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006; 113: e85-e151.

2. Isik T, Uyarel H, Ergelen M, et al. Primer anjiyoplastinin 75 yaş ve üstü hastalarda kısa ve uzun dönem sonuçları/Short and long term outcomes of primary angioplasty in patients aged 75 years and over. Dicle Tip Dergisi. 2011; 38: 189.

3. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002; 106: 3143-421.

4. Iacobellis G, Ribaudo MC, Assael F, et al. Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. The Journal of Clinical Endocrinology & Metabolism. 2003; 88: 5163-8.

5. Ahn S-G, Lim H-S, Joe D-Y, et al. Relationship of epicardial adipose tissue by echocardiography to coronary artery disease. Heart. 2008; 94: e7-e.

6. Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nature clinical practice Cardiovascular medicine. 2005; 2: 536-43.

7. Mazurek T, Zhang L, Zalewski A, et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation. 2003; 108: 2460-6.

8. Baker AR, Da Silva NF, Quinn DW, et al. Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovascular diabetology. 2006; 5: 1.

9. Chaldakov GN, Fiore M, Stankulov IS, et al. Neurotrophin presence in human coronary atherosclerosis and metabolic syndrome: a role for NGF and BDNF in cardiovascular disease? Progress in brain research. 2004; 146: 279-89.

10. Kremen J, Dolinkova M, Krajickova J, et al. Increased subcutaneous and epicardial adipose tissue production of proinflammatory cytokines in cardiac surgery patients: possible role in postoperative insulin resistance. The journal of clinical endocrinology & metabolism. 2006; 91: 4620-7.

11. Cheng K, Chu C, Lee K, et al. Adipocytokines and proinflammatory mediators from abdominal and epicardial adipose tissue in patients with coronary artery disease. International journal of obesity. 2008; 32: 268-74.

12. Fain J, Sacks H, Buehrer B, et al. Identification of omentin mRNA in human epicardial adipose tissue: comparison to omentin in subcutaneous, internal mammary artery periadventitial and visceral abdominal depots. International Journal of Obesity. 2008; 32: 810-5.

13. Bettencourt N, Toschke AM, Leite D et al. Epicardial adipose tissue is an independent predictor of coronary atherosclerotic burden. International journal of cardiology. 2012; 158: 26- 32.

14. members ATF, Windecker S, Kolh P et al. 2014 ESC/EACTS guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). European heart journal. 2014; 35: 2541- 619.

15. Ender Ö, Görgülü Ş, Hale A, et al. GRACE and TIMI scores in predicting the extension of coronary artery disease in patients with non-ST elevation myocardial infarction. Dicle Tıp Dergisi. 2015; 42: 170-4.

16. Alan B, Hattapoglu S, Dusak A, Aktan A. Karotis intima-media kalinliginin koroner arter hastalik siddetini belirleyen Gensini skoru ile iliskisi/Relationship of intima-media thickness with Gensini score that determines the severity of coronary artery disease. Dicle Tip Dergisi. 2015; 42: 501.

17. Lusis AJ, Fogelman AM, Fonarow GC. Genetic basis of atherosclerosis: part I: new genes and pathways. Circulation. 2004; 110: 1868-73.

18. Diet M. Traditional Risk Factors, and the Rate of Cardiovascular Complications After Myocardial Infarction: Final Report of the Lyon Diet Heart Study. Circulation. 1999; 99: 779-85.

19. Sacks HS, Fain JN. Human epicardial adipose tissue: a review. American heart journal. 2007; 153: 907-17.

20. Djaberi R, Schuijf JD, van Werkhoven JM, et al. Relation of epicardial adipose tissue to coronary atherosclerosis. The American journal of cardiology. 2008; 102: 1602-7.

21. Alexopoulos N, McLean DS, Janik M, Arepalli CD, Stillman AE, Raggi P. Epicardial adipose tissue and coronary artery plaque characteristics. Atherosclerosis. 2010; 210: 150-4.

22. Iwasaki K, Urabe N, Kitagawa A, Nagao T. The association of epicardial fat volume with coronary characteristics and clinical outcome. The International Journal of Cardiovascular Imaging. 2018; 34: 301-9.

23. Subbotin VM. Neovascularization of coronary tunica intima (DIT) is the cause of coronary atherosclerosis. Lipoproteins invade coronary intima via neovascularization from adventitial vasa vasorum, but not from the arterial lumen: a hypothesis. Theoretical Biology and Medical Modelling. 2012;9:11.

24. Raggi P: Epicardial adipose tissue and progression of coronary artery calcium: cause and effect or simple association? In.: JACC: Cardiovascular Imaging; 2014.

25. Greenstein AS, Khavandi K, Withers SB, et al. Local inflammation and hypoxia abolish the protective anticontractile properties of perivascular fat in obese patients. Circulation. 2009; 119: 1661.

26. Kor A: Diyabetik periferik arter hastalığında netrin-1, asimetrik dimetilarjinin (ADNA), endotelin-1, total antioksidan kapasitesi ve total oksidatif stres (TAK, TOS) plazma düzeyleri arasındaki ilişkilerin araştırılması. Selçuk Üniversitesi Tıp Fakültesi; 2016.

27. Patel VB, Shah S, Verma S, Oudit GY. Epicardial adipose tissue as a metabolic transducer: role in heart failure and coronary artery disease. Heart failure reviews. 2017; 22:889-902.

28. Kannel WB. Lipids, diabetes, and coronary heart disease: insights from the Framingham Study. American heart journal. 1985; 110: 1100-7.

29. Grundy SM, Benjamin IJ, Burke GL, et al. Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation. 1999; 100: 1134-46.

30. Wang Z, Zhang Y, Liu W, Su B. Evaluation of epicardial adipose tissue in patients of type 2 diabetes mellitus by echocardiography and its correlation with intimal medial thickness of carotid artery. Experimental and Clinical Endocrinology & Diabetes. 2017; 125: 598-602.

31. Şengül C, Özveren O. Epicardial adipose tissue: a review of physiology, pathophysiology, and clinical applications. Anadolu Kardiyol Derg. 2013; 13: 261- 5.

32. Shemirani H, Meysam Khoshavi M. Correlation of echocardiographic epicardial fat thickness with severity of coronary artery disease-an observational study. Anatolian Journal of Cardiology/Anadolu Kardiyoloji Dergisi. 2012; 12.

33. Yorgun H, Canpolat U, Hazırolan T, et al. Increased epicardial fat tissue is a marker of metabolic syndrome in adult patients. International journal of cardiology. 2013; 165: 308-13.

34. Haffner SM, Lehto S, Rönnemaa T, Pyörälä K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. New England journal of medicine. 1998; 339: 229-34.