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Gianluca Iacobellis - One of the best experts on this subject based on the ideXlab platform.

  • Epicardial Fat: A New Therapeutic Target in Psoriasis.
    Current pharmaceutical design, 2020
    Co-Authors: Preetha Kamath, Gabrielle Benesh, Paolo Romanelli, Gianluca Iacobellis
    Abstract:

    Psoriasis is a chronic inflammatory disease affecting over 8 million Americans. Importantly, patients with psoriasis are at an increased risk of developing atherosclerosis, coronary artery disease, and myocardial infarctions. Several studies have suggested that psoriasis may be an independent risk factor for cardiovascular disease given their shared inflammatory properties and pathogenic similarities. Epicardial Fat is also linked to cardiovascular disease and may be an independent risk factor for atherosclerosis. It has been proposed that measuring Epicardial Fat tissue may serve as a useful subclinical measure of cardiovascular disease in psoriasis patients. Echocardiography has been increasingly adopted as an accurate, minimally invasive, and cost-effective measure of determining the volume and thickness of Epicardial Fat. Using echocardiographic measures of Epicardial Fat thickness as a marker of cardiovascular disease and therapeutic target in psoriasis patients may provide clinicians with a means to better manage and hopefully prevent deleterious downstream effects.

  • Association between endothelial dysfunction, Epicardial Fat and subclinical atherosclerosis during menopause
    Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis, 2017
    Co-Authors: Julio O. Cabrera-rego, Daisy Navarro-despaigne, Liudmila Staroushik-morel, Karel Díaz-reyes, Marcos M. Lima-martínez, Gianluca Iacobellis
    Abstract:

    Abstract Background Menopausal transition is critical for the development of early, subclinical vascular damage. Multiple factors, such as atherosclerosis, increased Epicardial Fat, and endothelial dysfunction can play a role. Hence, the objective of this study was the comparison of Epicardial adipose tissue and carotid intima media thickness in order to establish the best predictor of carotid stiffness in middle-aged women with endothelial dysfunction. Methods A total of 43 healthy women aged 40–59 years old with endothelial dysfunction previously demonstrated by flow mediated dilation were recruited to have anthropometric, biochemical, hormonal and ultrasound determinations of carotid intima media thickness and Epicardial Fat thickness. Results Carotid arterial stiffness parameters (local pulse wave velocity [4.7 ± 0.7 vs 4.8 ± 0.5 vs 5.6 ± 0.5 m/s, respectively, p p β [4.4 ± 1.4 vs 5.0 ± 1.1 vs 6.4 ± 1.3, respectively, p p  = 0.007) showed a significant and proportional increase in the group of late post-menopausal women when compared to early post-menopausal and pre-menopausal groups, respectively. Among body Fat markers, Epicardial Fat was the strongest predictor of local pulse wave velocity, independent of age. Conclusions In menopausal women with endothelial dysfunction, menopausal transition is associated with increased carotid arterial stiffness and Epicardial Fat thickness, independent of age. Ultrasound measured Epicardial Fat was a better independent predictor of arterial stiffness than carotid intima media thickness in these women.

  • Epicardial Fat Thickness and Primary Aldosteronism.
    Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme, 2016
    Co-Authors: Gianluca Iacobellis, Laura Zinnamosca, Cristiano Marinelli, Luigi Petramala, Camilla Calvieri, Antonio Concistrè, Gino Iannucci, G. De Toma, Claudio Letizia
    Abstract:

    Primary aldosteronism (PA) is associated with increased cardiovascular risk and left ventricle (LV) changes. Given its peculiar biomolecular and anatomic properties, excessive Epicardial Fat, the heart-specific visceral Fat depot, can affect LV morphology. Whether Epicardial Fat can be associated with aldosterone and LV mass (LVM) in patients with PA is unknown. We performed ultrasound measurement of the Epicardial Fat thickness (EAT) in 79 consecutive newly diagnosed patients with PA, 59 affected by bilateral adrenal hyperplasia (IHA), 20 aldosterone-producing adenoma (APA), and 30 patients with essential hypertension (low renin hypertension) (EH). The 3 groups did not differ by age, sex distribution, body mass index (BMI), waist circumference (WC), or blood pressure values. EAT showed a trend of increase in both APA and IHA groups when compared to patients with EH (8.3±1.8 vs. 7.9±1.3 vs. 7.8±2 mm, respectively). EAT was significantly correlated with indexed LVM in the IHA group (r=0.35, p

  • Epicardial Fat: a new cardiovascular therapeutic target.
    Current opinion in pharmacology, 2016
    Co-Authors: Gianluca Iacobellis
    Abstract:

    Epicardial Fat is the visceral Fat depot of the heart. Given its rapid metabolism, organ Fat specificity and simple objective measurability, Epicardial Fat can serve as target for pharmaceutical agents targeting the adipose tissue. Epicardial Fat has shown to significantly respond to thiazolidinediones, glucagon like peptide 1 receptor agonists, dipeptidyl peptidase-4 inhibitors and statins. Epicardial Fat may represent a measurable risk factor and modifiable therapeutic target. Targeted pharmaceutical interventions may allow the Epicardial Fat to resume its physiological role. A drug-induced browning effect on Epicardial Fat suggests the development of pharmacological strategies to increase energy consumption. The potential of modulating the Epicardial Fat transcriptome with targeted pharmacological agents can open new avenues in the pharmacotherapy of cardio-metabolic diseases.

  • Epicardial Fat Thickness as a Biomarker in Cardiovascular Disease
    2016
    Co-Authors: Gianluca Iacobellis
    Abstract:

    Epicardial adipose tissue is the visceral Fat depot of the heart with unique anatomical and functional properties. Epicardial Fat can be considered a novel biomarker of cardiovascular disease. Its thickness can be visualized and measured using standard two-dimensional echocardiography with several advantages, including its low cost, easy accessibility, and good reproducibility. Echocardiographic Epicardial Fat thickness reflects the intra-abdominal visceral Fat and intramyocardial Fat accumulation. Epicardial Fat thickness is related to traditional G. Iacobellis (*) Division of Diabetes, Endocrinology and Metabolism, Miller School of Medicine, University of Miami, Miami, FL, USA e-mail: giacobellis@med.miami.edu # Springer Science+Business Media Dordrecht 2015 V.B. Patel, V.R. Preedy (eds.), Biomarkers in Cardiovascular Disease, DOI 10.1007/978-94-007-7741-5_13-1 1 and novel cardiovascular risk factors. Epicardial Fat thickness correlates and predicts the risk of metabolic syndrome. Epicardial Fat has been associated with the presence and severity of coronary artery disease, independent of traditional cardiometabolic risk factor and coronary calcification. Given its rapid metabolism and its simple objective measurability, Epicardial Fat can serve as target for pharmaceutical agents targeting the adipose tissue.

Satoshi Terae - One of the best experts on this subject based on the ideXlab platform.

  • Single-slice Epicardial Fat area measurement: do we need to measure the total Epicardial Fat volume?
    Japanese journal of radiology, 2011
    Co-Authors: Noriko Oyama, Daisuke Goto, Yoichi M. Ito, Naoki Ishimori, Rie Mimura, Tomoo Furumoto, Fumi Kato, Hiroyuki Tsutsui, Nagara Tamaki, Satoshi Terae
    Abstract:

    Purpose The aim of this study was to assess a method for measuring Epicardial Fat volume (EFV) by means of a single-slice area measurement. We investigated the relation between a single-slice Fat area measurement and total EFV.

  • Single-slice Epicardial Fat area measurement: do we need to measure the total Epicardial Fat volume?
    Japanese Journal of Radiology, 2011
    Co-Authors: Noriko Oyama, Daisuke Goto, Yoichi M. Ito, Naoki Ishimori, Rie Mimura, Tomoo Furumoto, Fumi Kato, Hiroyuki Tsutsui, Nagara Tamaki, Satoshi Terae
    Abstract:

    Purpose The aim of this study was to assess a method for measuring Epicardial Fat volume (EFV) by means of a single-slice area measurement. We investigated the relation between a single-slice Fat area measurement and total EFV. Methods and methods A series of 72 consecutive patients (ages 65 ± 11 years; 36 men) who had undergone cardiac computed tomography (CT) on a 64-slice multidetector scanner with prospective electrocardiographic triggering were retrospectively reviewed. Pixels in the pericardium with a density range from −230 to −30 Hounsfield units were considered Fat, giving the per-slice Epicardial Fat area (EFA). The EFV was estimated by the summation of EFAs multiplied by the slice thickness. We investigated the relation between total EFV and each EFA. Results EFAs measured at several anatomical landmarks—right pulmonary artery, origins of the left main coronary artery, right coronary artery, coronary sinus—all correlated with the EFV ( r = 0.77–0.92). The EFA at the LMCA level was highly reproducible and showed an excellent correlation with the EFV ( r = 0.92). Conclusion The EFA is significantly correlated with the EFV. The EFA is a simple, quick method for representing the time-consuming EFV, which has been used as a predictive indicator of cardiovascular diseases.

Giuseppe Barbaro - One of the best experts on this subject based on the ideXlab platform.

  • Epicardial Fat thickness and nonalcoholic Fatty liver disease in obese subjects
    Obesity, 2014
    Co-Authors: Gianluca Iacobellis, Giorgio Barbarini, C Letizia, Giuseppe Barbaro
    Abstract:

    Objective Ectopic Fat accumulation within the heart and the liver are linked to an increased cardiovascular risk. Ultrasound-measured cardiac and liver steatosis are easily accessible markers of intra-organ ectopic Fat accumulation. The hypothesis that echocardiographic Epicardial Fat thickness is independently associated with nonalcoholic Fatty liver disease (NAFLD) in obese subjects is tested. Design and Methods Sixty-two obese (BMI > 30 kg m−2) subjects with ultrasonographic evidence of NAFLD and 62 control obese subjects without history or signs of NAFLD underwent echocardiographic Epicardial Fat thickness measurement. Results Epicardial Fat thickness was significantly higher (P < 0.01) in obese subjects with NAFLD when compared to those without NAFLD. Epicardial Fat thickness was significantly higher (9.7 ± 0.2 vs. 8 ± 0.7 mm, P < 0.01) in subjects with severe (ultrasound score 3) than those with moderate (score 2) liver steatosis. Among waist circumference and BMI, Epicardial Fat thickness resulted in the best independent correlate of liver steatosis (R2 = 0.77, P < 0.001). Conclusions Our study suggests that Epicardial Fat is a good predictor of liver steatosis in obese subjects. Echocardiographic Epicardial Fat predicts ultrasound-measured Fatty liver better than BMI or waist circumferences does. Patients with severe Fatty liver infiltration presented with the highest amount of cardiac Fat accumulation.

  • Epicardial Fat thickness and nonalcoholic Fatty liver disease in obese subjects
    Obesity (Silver Spring Md.), 2013
    Co-Authors: Gianluca Iacobellis, Giorgio Barbarini, C Letizia, Giuseppe Barbaro
    Abstract:

    Objective Ectopic Fat accumulation within the heart and the liver are linked to an increased cardiovascular risk. Ultrasound-measured cardiac and liver steatosis are easily accessible markers of intra-organ ectopic Fat accumulation. The hypothesis that echocardiographic Epicardial Fat thickness is independently associated with nonalcoholic Fatty liver disease (NAFLD) in obese subjects is tested. Design and Methods Sixty-two obese (BMI > 30 kg m−2) subjects with ultrasonographic evidence of NAFLD and 62 control obese subjects without history or signs of NAFLD underwent echocardiographic Epicardial Fat thickness measurement. Results Epicardial Fat thickness was significantly higher (P 

  • Epicardial Fat thickness and left ventricular mass in subjects with adrenal incidentaloma
    Endocrine, 2013
    Co-Authors: Gianluca Iacobellis, Atil Y Kargi, Laura Zinnamosca, Luciano Colangelo, Cristiano Marinelli, Giuseppe Barbaro, Antonio Ciardi, Luigi Petramala, Valentina Serra, Giorgio De Toma
    Abstract:

    Emerging evidences indicate that patients diagnosed with adrenal incidentaloma may present with cardiovascular complications. Epicardial Fat is known to play a role in left ventricle (LV) changes. Whether Epicardial Fat can be associated with LV mass (LVM) in patients with incidentaloma is unknown. We test the hypothesis that echocardiographic Epicardial Fat thickness is independently related to LVM in a well-studied group of subjects with adrenal incidentaloma. 46 consecutive patients (age 59 ± 9 years) with imaging diagnosis of adrenal incidentaloma and 30 healthy controls underwent echocardiogram for Epicardial Fat thickness and LVM measurement. Non-functional incidentaloma was confirmed in 40 subjects, whereas 6 patients were actually diagnosed with mild Cushing’s syndrome. Epicardial Fat thickness was significantly higher in patients with incidentaloma and mild Cushing’s syndrome when compared to controls, (p < 0.01 for both). LVMh2.7 was higher in subjects with adrenal incidentaloma than in controls and higher in subjects with mild Cushing’s syndrome than in those with adrenal incidentaloma (p < 0.05 and p < 0.01). Multiple regression analysis showed that Epicardial Fat thickness was the best correlate (R 2 = 0.36, β 2.8, p < 0.01) of LVM in overall study patients. We showed for the first time that (1) Epicardial Fat thickness and LVM are higher in subjects with adrenal incidentaloma and (2) Epicardial Fat thickness independently correlates with LVM. Echocardiographic Epicardial Fat may serve as non-invasive marker of visceral Fat and earlier cardiac abnormalities in patients with adrenal incidentaloma.

  • relationship of Epicardial Fat thickness and fasting glucose
    International Journal of Cardiology, 2008
    Co-Authors: Gianluca Iacobellis, Giuseppe Barbaro, Hertzel C Gerstein
    Abstract:

    In this study we sought to evaluate whether increase in echocardiographic Epicardial Fat thickness, index of cardiac and visceral adiposity, is associated with impaired fasting glucose (IFG). Epicardial Fat thickness and fasting plasma glucose (FPG) were measured in 115 consecutive non-diabetic Caucasian subjects [65 men, 50 women, median age of 42 years (range 30-64 years), median body mass index (BMI) of 27 kg/m(2) (range 22-33 kg/m(2)), who underwent routine transthoracic echocardiogram. Study subjects were designated as having normal fasting glucose (NFG) with FPG<100 mg/dl; and IFG with FPG (100 and <126 mg/dl). Epicardial Fat thickness was significantly higher in IFG than NFG subjects (8+/-3 vs 6+/-2 mm; 7.1+/-4 vs 5.8+/-3 mm, p<0.001 for both and respectively in men and women. Epicardial Fat thickness was significantly correlated with FPG (r=0.60, p<0.001). Our data indicate for the first time that higher Epicardial Fat thickness is associated with IFG in non-diabetic men and women. Echocardiographic Epicardial Fat measurement may be an additional tool for diabetes-related cardiac risk stratification.

  • Relationship of Epicardial Fat thickness and fasting glucose.
    International journal of cardiology, 2008
    Co-Authors: Gianluca Iacobellis, Giuseppe Barbaro, Hertzel C Gerstein
    Abstract:

    In this study we sought to evaluate whether increase in echocardiographic Epicardial Fat thickness, index of cardiac and visceral adiposity, is associated with impaired fasting glucose (IFG). Epicardial Fat thickness and fasting plasma glucose (FPG) were measured in 115 consecutive non-diabetic Caucasian subjects [65 men, 50 women, median age of 42 years (range 30-64 years), median body mass index (BMI) of 27 kg/m(2) (range 22-33 kg/m(2)), who underwent routine transthoracic echocardiogram. Study subjects were designated as having normal fasting glucose (NFG) with FPG

Noriko Oyama - One of the best experts on this subject based on the ideXlab platform.

  • Single-slice Epicardial Fat area measurement: do we need to measure the total Epicardial Fat volume?
    Japanese journal of radiology, 2011
    Co-Authors: Noriko Oyama, Daisuke Goto, Yoichi M. Ito, Naoki Ishimori, Rie Mimura, Tomoo Furumoto, Fumi Kato, Hiroyuki Tsutsui, Nagara Tamaki, Satoshi Terae
    Abstract:

    Purpose The aim of this study was to assess a method for measuring Epicardial Fat volume (EFV) by means of a single-slice area measurement. We investigated the relation between a single-slice Fat area measurement and total EFV.

  • Single-slice Epicardial Fat area measurement: do we need to measure the total Epicardial Fat volume?
    Japanese Journal of Radiology, 2011
    Co-Authors: Noriko Oyama, Daisuke Goto, Yoichi M. Ito, Naoki Ishimori, Rie Mimura, Tomoo Furumoto, Fumi Kato, Hiroyuki Tsutsui, Nagara Tamaki, Satoshi Terae
    Abstract:

    Purpose The aim of this study was to assess a method for measuring Epicardial Fat volume (EFV) by means of a single-slice area measurement. We investigated the relation between a single-slice Fat area measurement and total EFV. Methods and methods A series of 72 consecutive patients (ages 65 ± 11 years; 36 men) who had undergone cardiac computed tomography (CT) on a 64-slice multidetector scanner with prospective electrocardiographic triggering were retrospectively reviewed. Pixels in the pericardium with a density range from −230 to −30 Hounsfield units were considered Fat, giving the per-slice Epicardial Fat area (EFA). The EFV was estimated by the summation of EFAs multiplied by the slice thickness. We investigated the relation between total EFV and each EFA. Results EFAs measured at several anatomical landmarks—right pulmonary artery, origins of the left main coronary artery, right coronary artery, coronary sinus—all correlated with the EFV ( r = 0.77–0.92). The EFA at the LMCA level was highly reproducible and showed an excellent correlation with the EFV ( r = 0.92). Conclusion The EFA is significantly correlated with the EFV. The EFA is a simple, quick method for representing the time-consuming EFV, which has been used as a predictive indicator of cardiovascular diseases.

Howard J. Willens - One of the best experts on this subject based on the ideXlab platform.

  • Epicardial Fat in atrial fibrillation and heart failure.
    Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme, 2014
    Co-Authors: Gianluca Iacobellis, M. C. Zaki, D. Garcia, Howard J. Willens
    Abstract:

    Obesity is a well-known risk factor for atrial fibrillation (AF) and heart failure (HF). Epicardial Fat, the true visceral Fat depot of the heart, has been associated with changes in both cardiac function and morphology. In this study, we evaluated whether ultrasound-measured Epicardial Fat thickness is related to AF and HF. A cross-sectional study was performed in 84 consecutive subjects with clinical and ECG-documented history of permanent (AF) or paroxysmal AF (PAF) who underwent echocardiographic Epicardial Fat thickness measurement. Sixty-four subjects had AF and 20 showed PAF. AF subjects had higher prevalence of heart failure (HF), defined by ejection fraction (EF)

  • Echocardiographic Epicardial Fat: A Review of Research and Clinical Applications
    Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2009
    Co-Authors: Gianluca Iacobellis, Howard J. Willens
    Abstract:

    Epicardial Fat plays a role in cardiovascular diseases. Because of its anatomic and functional proximity to the myocardium and its intense metabolic activity, some interactions between the heart and its visceral Fat depot have been suggested. Epicardial Fat can be visualized and measured using standard two-dimensional echocardiography. Standard parasternal long-axis and short-axis views permit the most accurate measurement of Epicardial Fat thickness overlying the right ventricle. Epicardial Fat thickness is generally identified as the echo-free space between the outer wall of the myocardium and the visceral layer of pericardium and is measured perpendicularly on the free wall of the right ventricle at end-systole. Echocardiographic Epicardial Fat thickness ranges from a minimum of 1 mm to a maximum of almost 23 mm. Echocardiographic Epicardial Fat thickness clearly reflects visceral adiposity rather than general obesity. It correlates with metabolic syndrome, insulin resistance, coronary artery disease, and subclinical atherosclerosis, and therefore it might serve as a simple tool for cardiometabolic risk prediction. Substantial changes in echocardiographic Epicardial Fat thickness during weight-loss strategies may also suggest its use as a marker of therapeutic effect. Echocardiographic Epicardial Fat measurement in both clinical and research scenarios has several advantages, including its low cost, easy accessibility, rapid applicability, and good reproducibility. However, more evidence is necessary to evaluate whether echocardiographic Epicardial Fat thickness may become a routine way of assessing cardiovascular risk in a clinical setting.

  • Threshold Values of High-risk Echocardiographic Epicardial Fat Thickness
    Obesity (Silver Spring Md.), 2008
    Co-Authors: Gianluca Iacobellis, Giuseppe Barbaro, Howard J. Willens, Arya M. Sharma
    Abstract:

    Objective: Echocardiographic Epicardial adipose tissue is a new index of cardiac and visceral adiposity with great potential as a diagnostic tool and therapeutic target. In this study, we sought to provide threshold values of echocardiographic Epicardial Fat thickness associated with metabolic and anthropometric risk factors. Methods and Procedures: Epicardial Fat thickness was measured in 246 consecutive white subjects (120 women, 126 men, median age 46 years (30–65), median BMI 32 kg/m2 (22–52), median waist circumference 100.5 cm (85–140)), who underwent routine transthoracic echocardiogram for standard clinical indications. Metabolic syndrome (MetS), Insulin resistance, BMI, and waist circumference categories were identified and Epicardial Fat was calculated. Results: Among 246 subjects, 58% had MetS. These subjects showed median values of Epicardial Fat thickness of 9.5 and 7.5 mm (in men and women, respectively), significantly higher than those found in subjects without MetS (no MetS) (P < 0.001). Receiver operating characteristics (ROC) analysis showed that Epicardial Fat thickness of 9.5 and 7.5 mm maximize the sensitivity and specificity to predict MetS, in men and women, respectively. In separate analyses, median Epicardial Fat thickness values of 9.5 and 7.5 mm were cutoff points associated with high abdominal Fat in men and women, respectively. When insulin sensitivity was considered separately, Epicardial Fat thickness of 9.5 mm was associated with insulin resistance. Discussion: Median values of 9.5 and 7.5 mm should be considered the threshold values for high-risk echocardiographic Epicardial Fat thickness in white men and women, respectively. Echocardiographic Epicardial Fat measurement may be of help for cardiometabolic risk stratification and therapeutic interventions targeting the Fat.

  • Effects of weight loss after bariatric surgery on Epicardial Fat measured using echocardiography.
    The American journal of cardiology, 2007
    Co-Authors: Howard J. Willens, Patricia Byers, Julio A. Chirinos, Eugenio Labrador, Joshua M. Hare, Eduardo De Marchena
    Abstract:

    Epicardial Fat assessed using echocardiography is associated with abdominal visceral adipose tissue and cardiovascular risk factors. Because of its location, Epicardial Fat may directly affect the coronary vasculature and myocardium through local secretion of bioactive molecules. This study examines the effects of weight loss after bariatric surgery on Epicardial adipose tissue in patients with severe obesity. Clinical data and echocardiograms of 23 patients with severe obesity who had echocardiograms recorded before and 8.3 ± 3.7 months after undergoing bariatric surgery were retrospectively reviewed. Epicardial Fat thickness was measured as the hypoechoic space anterior to the right ventricle in both the parasternal long- and short-axis views, and an average was obtained. At baseline, patients had increased Epicardial Fat compared with normal-weight controls matched for age, gender, and ethnicity (5.3 ± 2.4 vs 3.0 ± 1.1 mm, p