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Christopher J Odonnell - One of the best experts on this subject based on the ideXlab platform.
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prevalence distribution and risk factor correlates of high pericardial and Intrathoracic fat depots in the framingham heart study
Circulation-cardiovascular Imaging, 2010Co-Authors: George Thanassoulis, Amir A Mahabadi, Ramachandran S. Vasan, Udo Hoffmann, Joseph M Massaro, Christopher J OdonnellAbstract:Background— Pericardial and Intrathoracic fat depots may represent novel risk factors for obesity-related cardiovascular disease. We sought to determine the prevalence, distribution, and risk factor correlates of high pericardial and Intrathoracic fat deposits. Methods and Results— Participants from the Framingham Heart Study (n=3312; mean age, 52 years; 48% women) underwent multidetector CT imaging in 2002 to 2005; high pericardial and high Intrathoracic fat were defined on the basis of the sex-specific 90th percentile for these fat depots in a healthy reference sample. For men and women, the prevalence of high pericardial fat was 29.3% and 26.3%, respectively, and high Intrathoracic fat was 31.4% and 35.3%, respectively. Overall, 22.1% of the sample was discordant for pericardial and Intrathoracic fat depots: 8.3% had high pericardial but normal Intrathoracic fat and 13.8% had high Intrathoracic but normal pericardial fat. Higher body mass index, higher waist circumference, and increased prevalence of metabolic syndrome were more prevalent in participants with high Intrathoracic fat depots than with high pericardial fat ( P <0.05 for all comparisons). High abdominal visceral adipose tissue was more frequent in participants with high Intrathoracic adipose tissue compared with those with high pericardial fat ( P <0.001). Intrathoracic fat but not waist circumference was more highly correlated with visceral adipose tissue ( r =0.76 and 0.78 in men and women, respectively; P <0.0001) than with subcutaneous adipose tissue (SAT) ( r =0.46 and 0.54 in men and women, respectively; P <0.0001). Conclusions— Although prevalence of pericardial fat and Intrathoracic fat were comparable at 30%, Intrathoracic fat correlated more closely with metabolic risk and visceral fat. Intrathoracic fat may be a potential marker of metabolic risk and visceral fat on thoracic imaging.
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association of pericardial fat Intrathoracic fat and visceral abdominal fat with cardiovascular disease burden the framingham heart study
European Heart Journal, 2008Co-Authors: Amir A Mahabadi, Daniel Levy, Guido A Rosito, Philip A Wolf, Joseph M Massaro, Joanne M. Murabito, Christopher J OdonnellAbstract:Aims The aim of this study was to assess whether pericardial fat, Intrathoracic fat, and visceral abdominal adipose tissue (VAT) are associated with the prevalence of cardiovascular disease (CVD). Methods and results Participants from the Framingham Heart Study Offspring cohort underwent abdominal and chest multidetector computed tomography to quantify volumes of pericardial fat, Intrathoracic fat, and VAT. Relations between each fat depot and CVD were assessed using logistic regression. The analysis of 1267 participants (mean age 60 years, 53.8% women, 9.7% with prevalent CVD) demonstrated that pericardial fat [odds ratio (OR) 1.32, 95% confidence interval (CI) 1.11–1.57; P = 0.002] and VAT (OR 1.35, 95% CI 1.11–1.57; P = 0.003), but not Intrathoracic fat (OR 1.14, 95% CI 0.93–1.39; P = 0.22), were significantly associated with prevalent CVD in age–sex-adjusted models and after adjustment for body mass index and waist circumference. After multivariable adjustment, associations were attenuated ( P > 0.14). Only pericardial fat was associated with prevalent myocardial infarction after adjusting for conventional measures of adiposity (OR 1.37, 95% CI 1.03–1.82; P = 0.03). Conclusion Pericardial fat and VAT, but not Intrathoracic fat, are associated with CVD independent of traditional measures of obesity but not after further adjustment for traditional risk factor. Taken together with our prior work, these findings may support the hypothesis that pericardial fat contributes to coronary atherosclerosis.
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pericardial fat visceral abdominal fat cardiovascular disease risk factors and vascular calcification in a community based sample the framingham heart study
Circulation, 2008Co-Authors: Guido A Rosito, Amir A Mahabadi, Frederick L. Ruberg, Ramachandran S. Vasan, Udo Hoffmann, Joseph M Massaro, Christopher J OdonnellAbstract:Background— Pericardial fat may be an important mediator of metabolic risk. Correlations with cardiovascular disease risk factors and vascular calcification in a community-based sample are lacking. We sought to examine associations between pericardial fat, metabolic risk factors, and vascular calcification. Methods and Results— Participants free of cardiovascular disease from the Framingham Heart Study (n=1155, mean age 63 years, 54.8% women) who were part of a multidetector computed tomography study underwent quantification of Intrathoracic fat, pericardial fat, visceral abdominal fat (VAT), coronary artery calcification, and aortic artery calcification. Intrathoracic and pericardial fat volumes were examined in relation to body mass index, waist circumference, VAT, metabolic risk factors, coronary artery calcification, and abdominal aortic calcification. Intrathoracic and pericardial fat were directly correlated with body mass index (r=0.41 to 0.51, P<0.001), waist circumference (r=0.43 to 0.53, P<0.001...
Joseph M Massaro - One of the best experts on this subject based on the ideXlab platform.
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prevalence distribution and risk factor correlates of high pericardial and Intrathoracic fat depots in the framingham heart study
Circulation-cardiovascular Imaging, 2010Co-Authors: George Thanassoulis, Amir A Mahabadi, Ramachandran S. Vasan, Udo Hoffmann, Joseph M Massaro, Christopher J OdonnellAbstract:Background— Pericardial and Intrathoracic fat depots may represent novel risk factors for obesity-related cardiovascular disease. We sought to determine the prevalence, distribution, and risk factor correlates of high pericardial and Intrathoracic fat deposits. Methods and Results— Participants from the Framingham Heart Study (n=3312; mean age, 52 years; 48% women) underwent multidetector CT imaging in 2002 to 2005; high pericardial and high Intrathoracic fat were defined on the basis of the sex-specific 90th percentile for these fat depots in a healthy reference sample. For men and women, the prevalence of high pericardial fat was 29.3% and 26.3%, respectively, and high Intrathoracic fat was 31.4% and 35.3%, respectively. Overall, 22.1% of the sample was discordant for pericardial and Intrathoracic fat depots: 8.3% had high pericardial but normal Intrathoracic fat and 13.8% had high Intrathoracic but normal pericardial fat. Higher body mass index, higher waist circumference, and increased prevalence of metabolic syndrome were more prevalent in participants with high Intrathoracic fat depots than with high pericardial fat ( P <0.05 for all comparisons). High abdominal visceral adipose tissue was more frequent in participants with high Intrathoracic adipose tissue compared with those with high pericardial fat ( P <0.001). Intrathoracic fat but not waist circumference was more highly correlated with visceral adipose tissue ( r =0.76 and 0.78 in men and women, respectively; P <0.0001) than with subcutaneous adipose tissue (SAT) ( r =0.46 and 0.54 in men and women, respectively; P <0.0001). Conclusions— Although prevalence of pericardial fat and Intrathoracic fat were comparable at 30%, Intrathoracic fat correlated more closely with metabolic risk and visceral fat. Intrathoracic fat may be a potential marker of metabolic risk and visceral fat on thoracic imaging.
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pericardial fat volume correlates with inflammatory markers the framingham heart study
Obesity, 2010Co-Authors: Thomas M Tadros, James B Meigs, Guido A Rosito, John F Keaney, Izabella Lipinska, Ramachandran S. Vasan, Udo Hoffmann, Martin G Larson, Joseph M Massaro, Sekar KathiresanAbstract:The objective of this study was to determine whether systemic inflammatory and oxidative stress marker concentrations correlate with pericardial and Intrathoracic fat volumes. Participants of the Framingham Offspring Study (n = 1,175, 53% women, mean age 59 ± 9 years) had pericardial and Intrathoracic fat volumes assessed by multidetector computed tomography (MDCT) scans, and provided fasting blood and urine samples to measure concentrations of 14 inflammatory markers: C-reactive protein (CRP), interleukin-6, monocyte chemoattractant protein-1 (MCP-1), CD40 ligand, fibrinogen, intracellular adhesion molecule-1, lipoprotein-associated phospholipase A2 activity and mass, myeloperoxidase, osteoprotegerin, P-selectin, tumor necrosis factor-α, tumor necrosis factor receptor-2, and urinary isoprostanes. Multivariable linear regression models were used to determine the association of log-transformed inflammatory marker concentrations with fat volumes, using fat volume as the dependent variable. Due to smaller sample sizes, models were rerun after adding urinary isoprostanes (n = 961) and tumor necrosis factor-α (n = 813) to the marker panel. Upon backward elimination, four of the biomarkers correlated positively with each fat depot: CRP (P < 0.0001 for each fat depot), interleukin-6 (P < 0.05 for each fat depot), MCP-1 (P < 0.01 for each fat depot), and urinary isoprostanes (P < 0.01 for pericardial fat; P < 0.001 for Intrathoracic fat). Even after adjusting for BMI, waist circumference (WC), and abdominal visceral fat, CRP (P = 0.0001) and urinary isoprostanes (P = 0.02) demonstrated significant positive associations with Intrathoracic fat, but not with pericardial fat. Multiple markers of inflammation and oxidative stress correlated with pericardial and Intrathoracic fat volumes, extending the known association between regional adiposity and inflammation and oxidative stress.
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association of pericardial fat Intrathoracic fat and visceral abdominal fat with cardiovascular disease burden the framingham heart study
European Heart Journal, 2008Co-Authors: Amir A Mahabadi, Daniel Levy, Guido A Rosito, Philip A Wolf, Joseph M Massaro, Joanne M. Murabito, Christopher J OdonnellAbstract:Aims The aim of this study was to assess whether pericardial fat, Intrathoracic fat, and visceral abdominal adipose tissue (VAT) are associated with the prevalence of cardiovascular disease (CVD). Methods and results Participants from the Framingham Heart Study Offspring cohort underwent abdominal and chest multidetector computed tomography to quantify volumes of pericardial fat, Intrathoracic fat, and VAT. Relations between each fat depot and CVD were assessed using logistic regression. The analysis of 1267 participants (mean age 60 years, 53.8% women, 9.7% with prevalent CVD) demonstrated that pericardial fat [odds ratio (OR) 1.32, 95% confidence interval (CI) 1.11–1.57; P = 0.002] and VAT (OR 1.35, 95% CI 1.11–1.57; P = 0.003), but not Intrathoracic fat (OR 1.14, 95% CI 0.93–1.39; P = 0.22), were significantly associated with prevalent CVD in age–sex-adjusted models and after adjustment for body mass index and waist circumference. After multivariable adjustment, associations were attenuated ( P > 0.14). Only pericardial fat was associated with prevalent myocardial infarction after adjusting for conventional measures of adiposity (OR 1.37, 95% CI 1.03–1.82; P = 0.03). Conclusion Pericardial fat and VAT, but not Intrathoracic fat, are associated with CVD independent of traditional measures of obesity but not after further adjustment for traditional risk factor. Taken together with our prior work, these findings may support the hypothesis that pericardial fat contributes to coronary atherosclerosis.
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pericardial fat visceral abdominal fat cardiovascular disease risk factors and vascular calcification in a community based sample the framingham heart study
Circulation, 2008Co-Authors: Guido A Rosito, Amir A Mahabadi, Frederick L. Ruberg, Ramachandran S. Vasan, Udo Hoffmann, Joseph M Massaro, Christopher J OdonnellAbstract:Background— Pericardial fat may be an important mediator of metabolic risk. Correlations with cardiovascular disease risk factors and vascular calcification in a community-based sample are lacking. We sought to examine associations between pericardial fat, metabolic risk factors, and vascular calcification. Methods and Results— Participants free of cardiovascular disease from the Framingham Heart Study (n=1155, mean age 63 years, 54.8% women) who were part of a multidetector computed tomography study underwent quantification of Intrathoracic fat, pericardial fat, visceral abdominal fat (VAT), coronary artery calcification, and aortic artery calcification. Intrathoracic and pericardial fat volumes were examined in relation to body mass index, waist circumference, VAT, metabolic risk factors, coronary artery calcification, and abdominal aortic calcification. Intrathoracic and pericardial fat were directly correlated with body mass index (r=0.41 to 0.51, P<0.001), waist circumference (r=0.43 to 0.53, P<0.001...
Unal Sakinci - One of the best experts on this subject based on the ideXlab platform.
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Intrathoracic humeral head fracture-dislocation: is removal of the humeral head necessary?
The Annals of Thoracic Surgery, 2007Co-Authors: Bulent Kocer, Gultekin Gulbahar, Cem Nuri Aktekin, Nesimi Günal, Barış Birinci, Koray Dural, Unal SakinciAbstract:Intrathoracic fracture dislocation of the humeral head due to a blunt trauma is very rare. It may be accompanied by local and systemic injuries associated with high-energy trauma. Because a limited number of cases were reported, appropriate treatment modality remains unclear. A case of Intrathoracic humeral head fracture-dislocation caused by a high-speed motor vehicle accident is presented herewith, along with the treatment methods used within the scope of the current literature.
Amir A Mahabadi - One of the best experts on this subject based on the ideXlab platform.
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prevalence distribution and risk factor correlates of high pericardial and Intrathoracic fat depots in the framingham heart study
Circulation-cardiovascular Imaging, 2010Co-Authors: George Thanassoulis, Amir A Mahabadi, Ramachandran S. Vasan, Udo Hoffmann, Joseph M Massaro, Christopher J OdonnellAbstract:Background— Pericardial and Intrathoracic fat depots may represent novel risk factors for obesity-related cardiovascular disease. We sought to determine the prevalence, distribution, and risk factor correlates of high pericardial and Intrathoracic fat deposits. Methods and Results— Participants from the Framingham Heart Study (n=3312; mean age, 52 years; 48% women) underwent multidetector CT imaging in 2002 to 2005; high pericardial and high Intrathoracic fat were defined on the basis of the sex-specific 90th percentile for these fat depots in a healthy reference sample. For men and women, the prevalence of high pericardial fat was 29.3% and 26.3%, respectively, and high Intrathoracic fat was 31.4% and 35.3%, respectively. Overall, 22.1% of the sample was discordant for pericardial and Intrathoracic fat depots: 8.3% had high pericardial but normal Intrathoracic fat and 13.8% had high Intrathoracic but normal pericardial fat. Higher body mass index, higher waist circumference, and increased prevalence of metabolic syndrome were more prevalent in participants with high Intrathoracic fat depots than with high pericardial fat ( P <0.05 for all comparisons). High abdominal visceral adipose tissue was more frequent in participants with high Intrathoracic adipose tissue compared with those with high pericardial fat ( P <0.001). Intrathoracic fat but not waist circumference was more highly correlated with visceral adipose tissue ( r =0.76 and 0.78 in men and women, respectively; P <0.0001) than with subcutaneous adipose tissue (SAT) ( r =0.46 and 0.54 in men and women, respectively; P <0.0001). Conclusions— Although prevalence of pericardial fat and Intrathoracic fat were comparable at 30%, Intrathoracic fat correlated more closely with metabolic risk and visceral fat. Intrathoracic fat may be a potential marker of metabolic risk and visceral fat on thoracic imaging.
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association of pericardial fat Intrathoracic fat and visceral abdominal fat with cardiovascular disease burden the framingham heart study
European Heart Journal, 2008Co-Authors: Amir A Mahabadi, Daniel Levy, Guido A Rosito, Philip A Wolf, Joseph M Massaro, Joanne M. Murabito, Christopher J OdonnellAbstract:Aims The aim of this study was to assess whether pericardial fat, Intrathoracic fat, and visceral abdominal adipose tissue (VAT) are associated with the prevalence of cardiovascular disease (CVD). Methods and results Participants from the Framingham Heart Study Offspring cohort underwent abdominal and chest multidetector computed tomography to quantify volumes of pericardial fat, Intrathoracic fat, and VAT. Relations between each fat depot and CVD were assessed using logistic regression. The analysis of 1267 participants (mean age 60 years, 53.8% women, 9.7% with prevalent CVD) demonstrated that pericardial fat [odds ratio (OR) 1.32, 95% confidence interval (CI) 1.11–1.57; P = 0.002] and VAT (OR 1.35, 95% CI 1.11–1.57; P = 0.003), but not Intrathoracic fat (OR 1.14, 95% CI 0.93–1.39; P = 0.22), were significantly associated with prevalent CVD in age–sex-adjusted models and after adjustment for body mass index and waist circumference. After multivariable adjustment, associations were attenuated ( P > 0.14). Only pericardial fat was associated with prevalent myocardial infarction after adjusting for conventional measures of adiposity (OR 1.37, 95% CI 1.03–1.82; P = 0.03). Conclusion Pericardial fat and VAT, but not Intrathoracic fat, are associated with CVD independent of traditional measures of obesity but not after further adjustment for traditional risk factor. Taken together with our prior work, these findings may support the hypothesis that pericardial fat contributes to coronary atherosclerosis.
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pericardial fat visceral abdominal fat cardiovascular disease risk factors and vascular calcification in a community based sample the framingham heart study
Circulation, 2008Co-Authors: Guido A Rosito, Amir A Mahabadi, Frederick L. Ruberg, Ramachandran S. Vasan, Udo Hoffmann, Joseph M Massaro, Christopher J OdonnellAbstract:Background— Pericardial fat may be an important mediator of metabolic risk. Correlations with cardiovascular disease risk factors and vascular calcification in a community-based sample are lacking. We sought to examine associations between pericardial fat, metabolic risk factors, and vascular calcification. Methods and Results— Participants free of cardiovascular disease from the Framingham Heart Study (n=1155, mean age 63 years, 54.8% women) who were part of a multidetector computed tomography study underwent quantification of Intrathoracic fat, pericardial fat, visceral abdominal fat (VAT), coronary artery calcification, and aortic artery calcification. Intrathoracic and pericardial fat volumes were examined in relation to body mass index, waist circumference, VAT, metabolic risk factors, coronary artery calcification, and abdominal aortic calcification. Intrathoracic and pericardial fat were directly correlated with body mass index (r=0.41 to 0.51, P<0.001), waist circumference (r=0.43 to 0.53, P<0.001...
J Wedemeyer - One of the best experts on this subject based on the ideXlab platform.
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endoscopic closure of esophageal Intrathoracic leaks stent versus endoscopic vacuum assisted closure a retrospective analysis
Endoscopy, 2013Co-Authors: M Brangewitz, Torsten Voigtlander, Fabian A Helfritz, Tim O Lankisch, Michael Winkler, J Klempnauer, Michael P Manns, Andrea Schneider, J WedemeyerAbstract:Background and study aim: Placement of covered self-expanding metal or plastic stents (SEMS or SEPS) is an established method for managing Intrathoracic leaks. Recently, endoscopic vacuum-assisted closure (EVAC) has been described as a new effective treatment option. Our aim was to compare stent placement with EVAC for nonsurgical closure of Intrathoracic anastomotic leaks. Patients and methods: In a retrospective analysis we were able to identify 39 patients who were treated with SEMS or SEPS and 32 patients who were treated with EVAC for Intrathoracic leakage. In addition to successful fistula closure, we analyzed hospital mortality, number of endoscopic interventions, incidence of stenoses, and duration of hospitalization. Results: In a multivariate analysis, successful wound closure was independently associated with EVAC therapy (hazard ratio 2.997, 95 % confidence interval [95 %CI] 1.568 – 5.729; P = 0.001). The overall closure rate was significantly higher in the EVAC group (84.4 %) compared with the SEMS/SEPS group (53.8 %). No difference was found for hospitalization and hospital mortality. We found significantly more strictures in the stent group (28.2 % vs. 9.4 % with EVAC, P Conclusions: EVAC is an effective endoscopic treatment option for Intrathoracic leaks and showed higher effectiveness than stent placement in our cohort.
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management of major postsurgical gastroesophageal Intrathoracic leaks with an endoscopic vacuum assisted closure system
Gastrointestinal Endoscopy, 2010Co-Authors: J Wedemeyer, M Brangewitz, Michael Winkler, J Klempnauer, Michael P Manns, S Kubicka, Steffan Jackobs, Michael Neipp, Andrea SchneiderAbstract:Background Endoscopic treatment options for postsurgical Intrathoracic leaks include injection of fibrin glue, clip application, and stent placement. Endoscopic vacuum-assisted closure (E-VAC) may be an effective treatment option. Objective To demonstrate that E-VAC is an effective endoscopic treatment option for closure of major Intrathoracic postsurgical leaks. Design and Setting A prospective, single-center study at an academic medical center. Patients Eight consecutive patients with major Intrathoracic postsurgical leaks. Interventions Endoscopic placement of transnasal draining tubes, armed with a size-adjusted sponge at their distal end, in the necrotic anastomotic cavities, followed by continuous suction. Sponge and drainage were changed twice weekly. Patients were followed-up for 193 ± 137 days. Main Outcome Measurement Successful leak closure. Results Successful closure of leaks was achieved in 7 of 8 patients (88%) after a mean of 23 ± 8 days. A median of 7 endoscopic interventions was necessary. No major treatment-associated short-term or long-term (follow-up, 193 ± 137 days) complications were noted. Limitations Small sample size, single-center study, and lack of randomization. Conclusion E-VAC is an effective endoscopic treatment modality for major postsurgical Intrathoracic leaks. (This study is registered at Clinicaltrials.gov, identifier NCT00876551.)