An increase in epicardial adipose tissue is strongly associated with carotid-intima media thickness and atherosclerotic plaque, but LDL only with the plaque.

OBJECTIVE: Carotid intima-media thickness (CIMT) is reliable marker of subclinical atherosclerosis and cardiovascular events. Until today, there was no study that investigated whether epicardial adipose tissue (EAT), which is a surrogate for lipid depot in a special visceral tissue or circulating lipids, is more important for CIMT and atherosclerotic plaque. METHODS: Our study, having cross-sectional and prospective observational design, included 252 patients who were admitted to our outpatient clinic. EAT identified as an echo-free space under the pericardial layer on 2-dimensional echocardiography, was measured perpendicularly in front of the right ventricular free wall at end-systole. RESULTS: EAT significantly correlated with CIMT (r=0.623, p<0.001). CIMT was significantly increased with rising EAT thickness (0.72±0.15 mm, 0.85±0.16 mm, and 0.95±0.12 mm in patients with EAT <5 mm, 5-7, and >7 mm, p<0.001, respectively). Multiple linear regression analysis revealed that age (Beta: 0.406, p<0.001), male gender (Beta: 0.244, p<0.001), and EAT (Beta: 0.450, p<0.001) as independent correlates of CIMT. Otherwise, in logistic regression analysis, only EAT (OR, 1.386; 95% CI, 1.203-1.597, p<0.001) and LDL cholesterol (OR, 1.013; 95% CI, 1.002-1.013, p=0.02) were independent predictors for presence of carotid plaque. CONCLUSION: Our study showed that EAT has a relationship with both CIMT and the presence of carotid plaque, but LDL is independently related to the plaque. This finding suggests that EAT thickness may be a risk factor and biomarker, playing an important role beginning from early stages of atherosclerosis, unlike LDL cholesterol, which appear to have a role in later stages of atherosclerosis.

[Cardiac pacemakers designed for magnetic resonance environment]. / Manyetik rezonans ortami için gelistirilmis kalp pilleri.

Electromagnetic fields associated with magnetic resonance imaging (MRI) can cause serious functional disturbances in patients with cardiac pacemakers. Thus, an implanted pacemaker is generally considered a contraindication for an MRI scan. Studies have shown that MRI indication may emerge in about 17% of patients within one year of pacemaker implantation, and up to 75% of these patients may require MRI during the lifetime of their device. Introduction of pacemaker systems designed specifically for the MRI environment is an important development, providing pacemaker patients with access to this important diagnostic modality. In this article, the current status of MR conditional pacemakers is discussed, together with clinical applications.