Epicardial Fat Tissue and Coronary Artery Disease

Epikardijalno masno tkivo (EMT) ekstraabdominalno je visceralno masno tkivo smješteno između miokarda i visceralnog lista perikarda s kojima je embriološki, anatomski i funkcionalno povezano. Debljina epikardijalnoga masnog tkiva danas je prepoznata kao nezavisni rizični čimbenik koronarne bolesti srca (KBS), o čemu svjedoči sve veći broj kliničkih studija. Povećani volumen epikardijalnoga masnog tkiva povezan je s kroničnom upalom i povećanim lučenjem proupalnih citokina koji pogoduju i promoviraju proces aterogeneze. Standardiziranim postupkom ultrazvučnog mjerenja debljine epikardijalnoga masnog tkiva lateralnog zida desnog ventrikula može se s velikom sigurnošću predvidjeti postojanje KBS-a, a uz pomoć kompjutorizirane tomografije ili magnetske rezonancije predvidjeti i rizik od mogućega koronarnog događaja. Povezanost debljine i upale epikardijalnoga masnog tkiva s KBS-om nameće ideju o potencijalnim terapijskim intervencijama radi usporavanja procesa aterogeneze.Epicardial fat tissue is extraabdominal visceral fat tissue located between the myocardial muscle and the visceral pericard and connected to it embryonally and functionally. A large number of clinical studies support the claim that the epicardial adipose tissue thickness is an independent risk factor for coronary disease. The enlarged volume of the epicardial fat tissue is connected to chronical inflammation and strong production of anti inflammatory cytokines which entice the atherogenesis. Coronary disease can be predicted by standard measurement of the epicardial fat thickness of the right ventricle lateral wall. Thus it is possible to predict the risk of a coronary incident by conducting a CT or MR scan. The correlation between epicardial fat thickness and inflammation of the fat tissue suggests the possibility of potential therapeutical interventions with the aim to delay aterogenesis

The heart frequency and it\u27s variability in hypertensive patients considering A/B type of behaviour and eight basic emotions and levels of anger expression

U ovom radu istraživali smo autonomnu regulaciju rada srca putem frekvencije srca i njene varijabilnosti kod 100 bolesnika s esencijalnom hipertenzijom i usporedili sa 100 ispitanika zdrave kontrolne grupe. Bolesnici s esencijalnom hipertenzijom imali su značajno kraći prosječni RR interval, odnosno bržu frekvenciju srca nego kontrolna grupa. Prosječna varijabilnost frekvencije srca je statistički značajno niža u hipertenzivnoj, nego u zdravoj kontrolnoj grupi. Na frekvenciju srca i njenu varijabilnost ukupno značajno utječu, pri mirnom i dubokom disanju: sistolički tlak, dijastolički tlak, masa lijevog ventrikula, dijastolička disfunkcija lijevog ventrikula, veličina lijevog atrija, trajanje hipertenzije, visina kolesterola i triglicerida. Najznačajnija negativna povezanost nađena je između varijabilnosti frekvencije srca i trajanja hipertenzije. U hipertenzivnih bolesnika i u kontrolnoj skupini češći je “A tip” nego “B tip” ponašanja. U hipertenzivnoj grupi statistički je značajan ukupan utjecaj svih nezavisnih varijabli po Bortneru na varijabilnost frekvencije srca pri mirnom disanju. Frekvencija srca i njena varijabilnost povezane su sa osam temeljnih emocija kodu hipertenzivnih ispitanika i kontrolne skupine. U grupi hipertenzivnih bolesnika varijabilnost frekvencije srca značajno je pozitivno povezana s emocionalnom dimenzijom “Inkorporacija”, a negativno s emocionalnim dimenzijama “Zaštita”, “Odbacivanje” i “Reprodukcija”. Naši podaci pokazuju da bolesnici s dugotrajnom hipertenzijom imaju povišenu frekvenciju srca i reduciranu varijabilnost frekvencije srca, što su poznati čimbenici rizika za povišeni kardijalni mortalitet.The aim of this paper was to comparation between autonomic regulation of the heart rate and it\u27s variability within 100 essential hypertensive patients and 100 examinees in healthy control group. Essential hypertensive patients had significantly shorter average RR interval, that is, faster heart frequency then the control group. Average variability of the heart frequency was statisticaly considerably lower in hypertensive than in the healthy control group. Sistolic blood pressure, diastolic blood pressure, duration of hypertension, levels have considerate total influence on heart frequency and it\u27s variability during calm and during deep breathing. The most distinctive negative connection was found between variability of the heart frequency and duration of hypertension. The type A behaviour within hypertensive patients and the control group was more common then type B. In the hypertensive group, total influence of all independent Bortner\u27s variables on to variability of the heart frequency during calm breathing was statisticaly important. Within hypertensive patients and the control group, the heart frequency and it\u27s variability were connected with eight basic emotions. In the group of hypertensive patients variability of the heart frequency is significantly positively connected with emotional dimension "Incorporation", but negatively with emotional dimensions "Protection", "Rejection" and "Reproduction". Our data showes that patients with long-term hypertension have increased heart frequency and reduced variability of the heart frequency, which are well-known risk factors for increased cardial mortality

The Heart Frequency and Its Variability in Hypertensive Patients Considering A/B Type of Behaviour and Eight Basic Emotions and Levels of Anger Expression

The aim of this paper was to comparation between autonomic regulation of the heart rate and it’s variability within 100 essential hypertensive patients and 100 examinees in healthy control group. Essential hypertensive patients had significantly shorter average RR interval, that is, faster heart frequency then the control group. Average variability of the heart frequency was statisticaly considerably lower in hypertensive than in the healthy control group. Sistolic blood pressure, diastolic blood pressure, duration of hypertension, levels have considerate total influence on heart frequency and it’s variability during calm and during deep breathing. The most distinctive negative connection was found between variability of the heart frequency and duration of hypertension. The type A behaviour within hypertensive patients and the control group was more common then type B. In the hypertensive group, total influence of all independent Bortner’s variables on to variability of the heart frequency during calm breathing was statisticaly important. Within hypertensive patients and the control group, the heart frequency and it’s variability were connected with eight basic emotions. In the group of hypertensive patients variability of the heart frequency is significantly positively connected with emotional dimension »Incorporation«, but negatively with emotional dimensions »Protection«, »Rejection« and »Reproduction«. Our data showes that patients with long-term hypertension have increased heart frequency and reduced variability of the heart frequency, which are well-known risk factors for increased cardial mortality

Clinical Characteristics of Patients with Spondyloarthritides and HLA-B27 Positive Antigen

The aim of this study was to present our experiences in diagnosing spondyloarthritides (SpA), and to list the most common clinical features of HLA-B 27 positive patients.The study included 65 HLA-B 27 positive patients with confirmed diagnosis of ankylosing spondylitis(AS) and psoriatic arthritis (PsA) who were analyzed between 2009 and 2010 in Clinic of Internal Medicine in Osijek. The diagnosis of seronegative spondyloarthritides was based on the ASAS (Assessment in AS Working Group) classification criteria for axial and then supplemented with ASAS criteria for peripheral SpA and was confirmed by radiological techniques. For diagnosing the ankylosing spondylitis (AS), there have been applied the modified New York criteria. Radiological criteria for definite sacroiliitis according to the modified New York criteria is bilateral sacroiliitis, grade 2–4 (2) or unilateral sacroiliitis, grade 3–4. For diagnosing the psoriatic arthritis (PsA), there were used CASPAR diagnostic criteria. Other features of SpA are defined within the existing classification criteria. HLA-B27 antigen was determined by direct immune-fluorescence technique using flow cytometer. The average age of patients was 50.34 years, of whom 27 female (41.53%), 38 male (58.46%). Duration of illness was 15.79 years on average.With 75.38% of patients, there had been determined the diagnosis of AS; 24.62% of patients had the diagnosis of PsA. The most common clinical characteristics that patients had were: inflammatory back pain (pain Inflammation along the lumbosacral spine), peripheral arthritis, intermittent pain in the gluteus, sacroiliitis, enthesitis, uveitis, dactilitis

Epicardial Fat Tissue and Coronary Artery Disease

Epikardijalno masno tkivo (EMT) ekstraabdominalno je visceralno masno tkivo smješteno između miokarda i visceralnog lista perikarda s kojima je embriološki, anatomski i funkcionalno povezano. Debljina epikardijalnoga masnog tkiva danas je prepoznata kao nezavisni rizični čimbenik koronarne bolesti srca (KBS), o čemu svjedoči sve veći broj kliničkih studija. Povećani volumen epikardijalnoga masnog tkiva povezan je s kroničnom upalom i povećanim lučenjem proupalnih citokina koji pogoduju i promoviraju proces aterogeneze. Standardiziranim postupkom ultrazvučnog mjerenja debljine epikardijalnoga masnog tkiva lateralnog zida desnog ventrikula može se s velikom sigurnošću predvidjeti postojanje KBS-a, a uz pomoć kompjutorizirane tomografije ili magnetske rezonancije predvidjeti i rizik od mogućega koronarnog događaja. Povezanost debljine i upale epikardijalnoga masnog tkiva s KBS-om nameće ideju o potencijalnim terapijskim intervencijama radi usporavanja procesa aterogeneze.Epicardial fat tissue is extraabdominal visceral fat tissue located between the myocardial muscle and the visceral pericard and connected to it embryonally and functionally. A large number of clinical studies support the claim that the epicardial adipose tissue thickness is an independent risk factor for coronary disease. The enlarged volume of the epicardial fat tissue is connected to chronical inflammation and strong production of anti inflammatory cytokines which entice the atherogenesis. Coronary disease can be predicted by standard measurement of the epicardial fat thickness of the right ventricle lateral wall. Thus it is possible to predict the risk of a coronary incident by conducting a CT or MR scan. The correlation between epicardial fat thickness and inflammation of the fat tissue suggests the possibility of potential therapeutical interventions with the aim to delay aterogenesis

Epicardial Fat Tissue and Coronary Artery Disease

Epikardijalno masno tkivo (EMT) ekstraabdominalno je visceralno masno tkivo smješteno između miokarda i visceralnog lista perikarda s kojima je embriološki, anatomski i funkcionalno povezano. Debljina epikardijalnoga masnog tkiva danas je prepoznata kao nezavisni rizični čimbenik koronarne bolesti srca (KBS), o čemu svjedoči sve veći broj kliničkih studija. Povećani volumen epikardijalnoga masnog tkiva povezan je s kroničnom upalom i povećanim lučenjem proupalnih citokina koji pogoduju i promoviraju proces aterogeneze. Standardiziranim postupkom ultrazvučnog mjerenja debljine epikardijalnoga masnog tkiva lateralnog zida desnog ventrikula može se s velikom sigurnošću predvidjeti postojanje KBS-a, a uz pomoć kompjutorizirane tomografije ili magnetske rezonancije predvidjeti i rizik od mogućega koronarnog događaja. Povezanost debljine i upale epikardijalnoga masnog tkiva s KBS-om nameće ideju o potencijalnim terapijskim intervencijama radi usporavanja procesa aterogeneze.Epicardial fat tissue is extraabdominal visceral fat tissue located between the myocardial muscle and the visceral pericard and connected to it embryonally and functionally. A large number of clinical studies support the claim that the epicardial adipose tissue thickness is an independent risk factor for coronary disease. The enlarged volume of the epicardial fat tissue is connected to chronical inflammation and strong production of anti inflammatory cytokines which entice the atherogenesis. Coronary disease can be predicted by standard measurement of the epicardial fat thickness of the right ventricle lateral wall. Thus it is possible to predict the risk of a coronary incident by conducting a CT or MR scan. The correlation between epicardial fat thickness and inflammation of the fat tissue suggests the possibility of potential therapeutical interventions with the aim to delay aterogenesis

Epicardial Adipose Tissue Is Nonlinearly Related to Anthropometric Measures and Subcutaneous Adipose Tissue

Introduction. Adipose tissue is the largest endocrine organ, composed of subcutaneous (SAT) and visceral adipose tissue (VAT), the latter being highly associated with coronary artery disease (CAD). Expansion of epicardial adipose tissue (EAT) is linked to CAD. One way of assessing the CAD risk is with low-cost anthropometric measures, although they are inaccurate and cannot discriminate between VAT and SAT. The aim of this study is to evaluate (1) the relationship between EAT thickness, SAT thickness and anthropometric measures in a cohort of patients assessed at the cardiology unit and (2) determine predictive power of anthropometric measures and EAT and SAT thickness in establishment of CAD. Methods. Anthropometric measures were obtained from 53 CAD and 42 non-CAD patients. Vascular and structural statuses were obtained with coronarography and echocardiography, as well as measurements of the EAT and SAT thickness. Results. Anthropometric measures showed moderate positive correlation with EAT and SAT thickness. Anthropometric measures and SAT follow nonlinear S curve relationship with EAT. Strong nonlinear power curve relationship was observed between EAT and SAT thinner than 10 mm. Anthropometric measures and EAT and SAT were poor predictors of CAD. Conclusion. Anthropometric measures and SAT have nonlinear relationship with EAT. EAT thickness and anthropometric measures have similar CAD predictive value

Epicardial Adipose Tissue Is Nonlinearly Related to Anthropometric Measures and Subcutaneous Adipose Tissue

Introduction. Adipose tissue is the largest endocrine organ, composed of subcutaneous (SAT) and visceral adipose tissue (VAT), the latter being highly associated with coronary artery disease (CAD). Expansion of epicardial adipose tissue (EAT) is linked to CAD. One way of assessing the CAD risk is with low-cost anthropometric measures, although they are inaccurate and cannot discriminate between VAT and SAT. The aim of this study is to evaluate (1) the relationship between EAT thickness, SAT thickness and anthropometric measures in a cohort of patients assessed at the cardiology unit and (2) determine predictive power of anthropometric measures and EAT and SAT thickness in establishment of CAD. Methods. Anthropometric measures were obtained from 53 CAD and 42 non-CAD patients. Vascular and structural statuses were obtained with coronarography and echocardiography, as well as measurements of the EAT and SAT thickness. Results. Anthropometric measures showed moderate positive correlation with EAT and SAT thickness. Anthropometric measures and SAT follow nonlinear S curve relationship with EAT. Strong nonlinear power curve relationship was observed between EAT and SAT thinner than 10 mm. Anthropometric measures and EAT and SAT were poor predictors of CAD. Conclusion. Anthropometric measures and SAT have nonlinear relationship with EAT. EAT thickness and anthropometric measures have similar CAD predictive value