P12 Role of CT measured epicardial adipose tissue in moderate to severe aortic stenosis

Introduction Epicardial adipose tissue (EAT) exerts paracrine effects on the myocardium. More lipid-laden adipocytes, with lower attenuation on computed tomography (CT), are associated with greater pro-inflammatory activity. We aim to compare EAT in patients with aortic stenosis (AS) and healthy controls and explore correlations with cardiac remodelling. Methods Asymptomatic patients with AS and controls were prospectively recruited and underwent non-contrast cardiac CT, magnetic resonance imaging (MRI) and transthoracic echocardiography (TTE). Fully automated volumetric quantification of EAT with an attenuation of -190 to -30 Hounsfield units (HU) was performed. A cut off of -90HU determined higher and lower attenuation adipose tissue. Results 124 patients with AS (max. velocity 3.88±0.57m/s, aortic valve area index 0.57±0.15 cm2/m2) and 39 controls were included. Mean EAT attenuation was significantly lower in AS compared to controls (-75.94±5.47 vs -69.93±5.4 HU, p On univariate analysis, indexed total and low attenuation EAT volumes were associated with measures of diastolic dysfunction: longitudinal (r=-0.266, p=0.004 and r=-0.220, p=0.017) and circumferential peak early diastolic strain rate (r -0.245, p=0.008 and r=-0.203, p=0.029) on CMR and E/e’ (r=0.194, p=0.034 and r=0.192, p=0.036) on TTE, but not independent of age, BMI and AS severity. Conclusion Total and low attenuation indexed EAT volumes were higher in AS compared to controls and associated with diastolic dysfunction, but not independent of age, BMI and AS severity.</p

sj-docx-1-tae-10.1177_20420188231193231 – Supplemental material for Response to a low-energy meal replacement plan on glycometabolic profile and reverse cardiac remodelling in type 2 diabetes: a comparison between South Asians and White Europeans

Supplemental material, sj-docx-1-tae-10.1177_20420188231193231 for Response to a low-energy meal replacement plan on glycometabolic profile and reverse cardiac remodelling in type 2 diabetes: a comparison between South Asians and White Europeans by Lavanya Athithan, Gaurav S. Gulsin, Joseph Henson, Loai Althagafi, Emma Redman, Stavroula Argyridou, Kelly S. Parke, Jian Yeo, Thomas Yates, Kamlesh Khunti, Melanie J. Davies, Gerry P. McCann and Emer M. Brady in Therapeutic Advances in Endocrinology and Metabolism</p

Age at diagnosis of type 2 diabetes and cardiovascular risk factor profile: A pooled analysis.

The diagnosis of type 2 diabetes (T2D) in younger adults, an increasingly common public health issue, is associated with a higher risk of cardiovascular complications and mortality, which may be due to a more adverse cardiovascular risk profile in individuals diagnosed at a younger age.To investigate the association between age at diagnosis and the cardiovascular risk profile in adults with T2D.A pooled dataset was used, comprised of data from five previous studies of adults with T2D, including 1409 participants of whom 196 were diagnosed with T2D under the age of 40 years. Anthropometric and blood biomarker measurements included body weight, body mass index (BMI), waist circumference, body fat percentage, glycaemic control (HbA1c), lipid profile and blood pressure. Univariable and multivariable linear regression models, adjusted for diabetes duration, sex, ethnicity and smoking status, were used to investigate the association between age at diagnosis and each cardiovascular risk factor.A higher proportion of participants diagnosed with T2D under the age of 40 were female, current smokers and treated with glucose-lowering medications, compared to participants diagnosed later in life. Participants diagnosed with T2D under the age of 40 also had higher body weight, BMI, waist circumference and body fat percentage, in addition to a more adverse lipid profile, compared to participants diagnosed at an older age. Modelling results showed that each one year reduction in age at diagnosis was significantly associated with 0.67 kg higher body weight [95% confidence interval (CI): 0.52-0.82 kg], 0.18 kg/m2 higher BMI (95%CI: 0.10-0.25) and 0.32 cm higher waist circumference (95%CI: 0.14-0.49), after adjustment for duration of diabetes and other confounders. Younger age at diagnosis was also significantly associated with higher HbA1c, total cholesterol, low-density lipoprotein cholesterol and triglycerides.The diagnosis of T2D earlier in life is associated with a worse cardiovascular risk factor profile, compared to those diagnosed later in life.</p