Relationship Between Perivascular Adipose Tissue and Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis.

We conducted a systematic review and meta-analysis aimed at estimating the association between perivascular adipose tissue (PVAT) and some of the cardiovascular risk factors. A systematic search was conducted from January 1980 up to and including 2022 to identify studies that examined the relationship between PVAT and cardiovascular risk factors as obesity and its indices, hypertension, lipids, and glucose intolerance/diabetes. The Medline and Embase databases were searched using the PubMed and Scopus. Data were extracted from 23 studies that fit the criteria. To conduct meta-analysis, we used an approximation of equating the method of correlating assessment because different authors used either Pearson or Spearman correlation. Interrelations of PVAT and body mass index were analyzed in eight studies. Most studies revealed reliable direct correlation; the results of the meta-analysis also showed a significant (P = 0.37, P < 0.01, n = 12,346) correlation. PVAT and waist circumference were analyzed in six studies. Meta-analysis on the selected sample (n = 10,947) showed a significant (r = 0.45, P < 0.01) correlation. Relationship between PVAT and hypertension was revealed in three studies. Direct correlations were found in all studies. Meta-analysis showed the reliability of the correlation dependence (r = 0.21, P < 0.01, n = 3996). PVAT and blood glucose was evaluated in three studies (n = 3689). In each study a reliable (P < 0.05) direct correlation was obtained. Meta-analysis showed a significant correlation of weak strength (r = 0.24, P < 0.01). We demonstrated significant positive correlations of PVAT with the levels of total cholesterol (r = 0.05, P < 0.01), low-density lipoprotein cholesterol (r = 0.13, P < 0.01), and triglycerides (r = 0.29, P < 0.01), and a negative relationship with high-density lipoprotein cholesterol (r = -0.18, P < 0.01) in this meta-analysis. Despite some limitations, the findings of this systematic review and meta-analysis confirmed that PVAT significantly correlates with studied cardiovascular risk factors. Because PVAT presents a great interest in terms of cardiovascular remodeling and cardiovascular disease, its assessment in patients with and without cardiovascular pathology needs further research.

Pararenal Fat and Renal Dysfunction in Patients without Significant Cardiovascular Disease.

INTRODUCTION: Accumulation of fat tissue around the kidneys is considered to be a risk factor for chronic kidney disease (CKD). The objective of the study was to investigate the association of pararenal fat tissue (PRFT) and renal dysfunction in patients without clinically significant cardiovascular diseases (CVDs). METHODS: The study included 320 patients without CVDs (mean age 63.8 ± 13.9 years). All patients underwent anthropometric measurements, standard biochemical blood tests, including a lipid panel and uric acid concentration. Glomerular filtration rate (GFR) was calculated using the CKD-EPI formula. All patients underwent computed tomography of the abdomen with measurement of the PRFT thickness. The research results were processed using StatSoftStatistica 10.0 software. RESULTS: The average PRFT thickness was 1.45 cm [0.9; 2.0]. It was significantly higher in obese individuals when compared with patients with normal body weight (1.9 cm [1.3; 2.6] vs. 1.0 cm [0.6; 1.7]) and overweight people (1.9 cm [1.3; 2.6] vs. 1.1 cm [0.8; 1.6]) (p < 0.001). GFR was significantly higher in subjects with normal body weight when compared with obese patients (72 mL/min/1.73 m2 [59; 83] vs. 61 mL/min/1.73 m2 [51; 70]) and overweight patients (72 mL/min/1.73 m2 [59; 83] vs. 61 mL/min/1.73 m2 [54; 72]) (p < 0.001). PRFT thickness was significantly higher in patients with stage 3 CKD when compared with those with stage 1 CKD (2.2 cm [1.6; 3.3] vs. 0.9 cm [0.9; 1.0]) and with stage 2 CKD (2.2 cm [1.6; 3.3] vs. 1.3 cm [0.9; 1.8]) (p < 0.001). A significant correlation was found between PRFT thickness and body mass index (r = 0.49, p < 0.05), waist circumference (r = 0.55, p < 0.05), GFR (r = -0.47, p < 0.05), and uric acid level (r = 0.46, p < 0.05). Multiple linear regression analysis revealed a significant relationship between GFR and age (ß ± SE -0.43 ± 0.15, p = 0.01), PRFT thickness (ß ± SE -0.38 ± 0.14, p = 0.01) and with the level of low-density lipoprotein cholesterol (ß ± SE -0.32 ± 0.12, p = 0.01). Logistic regression analysis showed that the risk of renal dysfunction development was associated with PRFT thickness (OR = 6.198; 95% CI: 1.958-19.617; p < 0.05). ROC analysis determined the threshold values of PRFT thickness (>1.68 cm, AUC = 0.875), above which the development of renal dysfunction can be predicted (sensitivity 63.2%, specificity 93.4%). CONCLUSION: The results of our study indicate the relationship between PRFT and visceral obesity and renal dysfunction in patients without clinically significant CVDs.

Relationship of Pericardial Fat Tissue With Cardiovascular Risk Factors in Patients Without Cardiovascular Diseases.

Background: Obesity and related cardiovascular diseases (CVDs) are important public health problems. The role of visceral ectopic fat remains contested. We studied the relationship between pericardial fat tissue (PFT) volume and CVD risk factors. Methods: We examined 320 patients (average age 63.8 ± 19.9 years) without manifested CVD. Anthropometric indicators were measured, and body mass index (BMI) was calculated. The total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglycerides were assessed. Cardiovascular (CV) risk was calculated using the SCORE system. All patients underwent chest computed tomography with detection of PFT volume using specialized semiautomatic software. Results: Among study participants with normal body mass, the PFT volume was 1.95 cm3 [2.1; 3.9], while it was 3.0 cm3 [2.0; 3.7] in overweight patients and 3.6 cm3 [2.7; 4.7] in obese patients (P < 0.001). Patients with hypertension (HTN) also had significantly higher PFT volumes compared with individuals without HTN: 3.1 cm3 [2.3; 4.15] versus 1.8 cm3 [1.0; 2.5] (P < 0.001). Patients with higher CV risk had significantly higher PFT volume, categorized as follows: 1.6 cm3 [1.0; 2.4], low risk; 2.24 cm3 [2.0; 3.1], moderate risk; 3.1 cm3 [2.4; 3.7], high risk; and 3.9 cm3 [3.0; 5.1], very high risk, respectively (P < 0.001). Results of multiple regression demonstrated that waist circumference and HDL-C were significantly associated with PFT volume. Another model revealed a significant association of BMI and PFT volume with the level of CV risk. Conclusions: This study demonstrates the association of PFT volume with the major diagnostic criteria of obesity, HTN, lipid disorders, and CV risk measured by the SCORE system.

Relation between Tobacco Smoking/Electronic Smoking and Albuminuria/Vascular Stiffness in Young People without Cardiovascular Diseases.

INTRODUCTION/OBJECTIVE: Tobacco smoking is a well-known risk factor for cardiovascular and renal diseases. In recent years, alternative types of smoking, including vaping, have been becoming popular. The contribution of vape to vascular and renal injury is not known. We studied the relation between smoking of traditional/electronic cigarettes and arterial stiffness and albuminuria, which is also a vascular dysfunction marker. METHODS: We examined 270 young volunteers without significant clinical cardiovascular diseases (mean age: 21.2 ± 2.3 years). Twenty-seven percent of the subjects in the study group were smokers; 69.9% of them smoked traditional cigarettes and 30.1% smoked electronic cigarettes. The urine albumin level was assessed by a dipstick test, and the augmentation index was determined by photoplethysmography. A linear correlation test and multiple regression analysis were applied. RESULTS: The study groups did not differ in basic characteristics. The smokers demonstrated generally higher blood pressure levels and were overweight. Most of the smokers were male. In the groups of smokers, albuminuria was more frequent, especially among vapers (94 vs. 79% in tobacco smokers and 29% in nonsmokers). AU values (median [quartile 25; quartile 75]) were significantly higher in vapers (160 mg/L [150; 207.5]) vs. tobacco smokers (115 mg/L [60; 200]) and vs. nonsmokers (20 mg/L [10; 50]) (р < 0.05). Photoplethysmographic results showed relevant higher augmentation indices among tobacco smokers (-4, [-6.6; -1.9]) and vapers (-5.05 [-13.4; -3.3]) compared to nonsmokers (-16.2 [-23.9; -7]) (р < 0.05). Results of multiple regression analysis demonstrate that smoking of both traditional and electronic cigarettes is related to an increase in the albuminuria level and the augmentation index. CONCLUSIONS: Smoking of both traditional and electronic cigarettes is related to albuminuria and an increase in the augmentation index, which is a noninvasive marker for arterial stiffness.

Trimetazidine Modified Release in the Treatment of Stable Angina : TRIUMPH StudyTRImetazidine MR in Patients with Stable Angina: Unique Metabolic PatH.

OBJECTIVE: To assess the clinical efficacy, safety and effects on quality of life of trimetazidine modified release (MR) in patients with stable angina. METHODS: This large, open-label, uncontrolled study was conducted in 906 patients with stable angina in the Russian Federation. Patients were treated for 8 weeks with trimetazidine MR (35mg tablet, twice a day) in addition to their conventional therapy. RESULTS: Overall 846 patients (516 men and 330 women) aged 58.7 +/- 9 years completed the study. During the 8-week treatment period the number of angina attacks per week decreased continuously and significantly from 11.2 +/- 0.4 to 3.6 +/- 0.2 (p < 0.0001). Concurrently, the number of short-acting nitrate tablets taken per week decreased from 11.9 +/- 0.8 to 3.4 +/- 0.2 (p < 0.0001). Patients' quality of life, assessed on the Seattle Angina Questionnaire, showed a significant improvement (p < 0.0001) for all five items evaluated: physical limitation increased from 50.7 +/- 0.7 to 61.0 +/- 0.6, angina stability improved from 57.6 +/- 0.9 to 92.5 +/- 0.7, angina frequency extended from 33.3 +/- 0.7 to 55.6 +/- 0.8, treatment satisfaction increased from 62.3 +/- 0.7 to 77.4 +/- 0.5, and disease perception improved from 36.7 +/- 0.6 to 55.5 +/- 0.7. Adverse events were reported in 2.4% of patients (22/906) during the 8 weeks of treatment. No serious adverse events were reported. CONCLUSION: The results of this study suggest an improvement in clinical efficacy and in quality of life and a good tolerance of trimetazidine MR administered at a dose of 35mg twice a day for 8 weeks in patients with stable angina.