Clinical Trial Details
— Status: Not yet recruiting
Administrative data
| NCT number |
NCT04111198 |
| Other study ID # |
Epicardial fat tissue |
| Secondary ID |
|
| Status |
Not yet recruiting |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
December 1, 2019 |
| Est. completion date |
March 1, 2023 |
Study information
| Verified date |
September 2019 |
| Source |
Assiut University |
| Contact |
Hatem Abd Elrhman Helmy, Professor |
| Phone |
01005212162 |
| Email |
hatem19652007[@]yahoo.com |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial Summary
correlation between EFT volume measured by Cardiac MRI and the angiographic severity of
coronary artery disease (Syntax Score) in diabetic vs non diabetic CAD population and detect
if there is a cut off value for each group that could predict higher risk.
Description:
Epicardial fat tissue (EFT) is is most commonly defined as adipose tissue surrounding the
heart, located between the myocardium and the visceral layer of pericardium Once considered
only as a mere storage compartment, the adipose tissue is now recognized for its extensive
metabolic and endocrine function, EFT is a storage fat that covers 80% of the heart's
surface, representing 20% of the organ total weight, EFT is considered to be a part of
visceral adipose tissue. This fat is a major source of biomolecules and compartmentalized
production of cytokines and hormones, acting as a localized gland.
Moreover, EFT and the underlying myocardium share the same microcirculation, suggesting a
close and strong interaction between these two structures, it regulates heart and blood
vessel physiologically, via paracrine and vasocrine mechanisms. It has also been reported
that EFT acts as important energy reservoir for cardiomyocytes, which depend on fatty acids
oxidations as energy source especially during periods of high demand.
Although EFT is needed for heart muscle function, in recent decades it has been published
that increased thickness greatly enhances the risk of developing CVD and metabolic syndrome,
becoming a new pharmacological target for primary and secondary prevention strategies.
Therefore, the measurement of epicardial fat deposition is important. In terms of modulation,
the use of statins could function as a possible treatment to help decrease the volume of EFT
beside stabilization of atherosclerotic plaques.
Detection and quantification of EFT require a variety of useful imaging techniques, including
2-dimensional (2D) echocardiography, non-contrast computed tomography (CT) and magnetic
resonance imaging (MRI) . Since fat tissue generates a strong MRI signal, both thickness and
volume of epicardial fat can be easily measured with this modality.
Clinical research found that it was related to coronary artery disease, where it was found to
be independently and linearly associated with CAD and its severity, atrial fibrillation as
well as myocardial dysfunction.
It is known that abnormally accumulated visceral fat is a risk factor for insulin resistance,
which can reduce insulin sensitivity, increase the expression and secretion of
proinflammatory cytokines in adipose tissue and promote the development of DM and
cardiovascular diseases. Since EFT is a part of the visceral fat, it carries that risk.
Regarding relation to CAD in DM, there have been conflicting data.
Maniam et al reported that EFT was higher in non-diabetics with CVD, but not in T2DM with or
without CVD. This suggests EFT may play a greater role in CVD in non-diabetics than those
with T2DM.
However, in the past few years, several other studies have reported that EFT is abnormally
increased in DM patients. However, small sample sizes and potential confounders (such as
differences in EFT measurements and DM typing) were thought to affect the strength of
previous evidence.
A metanalysis conducted suggests that the amount of EFT is significantly higher in DM
patients than in non-DM patients.
Another study addressing mainly type 1 DM found that Long-term survivors of T1DM have a
higher prevalence of coronary atherosclerosis compared to controls but EFT volume was not
associated with coronary atherosclerosis in T1DM patients.
