Epicardial Adipose Tissue Removal Potentiates Outward Remodeling and Arrests Coronary Atherogenesis.

Abstract

BACKGROUND:

Pericoronary epicardial adipose tissue (cEAT) serves as a metabolic and paracrine organ that contributes to inflammation and is associated with macrovascular coronary artery disease (CAD) development. Although there is a strong correlation in humans between cEAT volume and CAD severity, there remains a paucity of experimental data demonstrating a causal link of cEAT to CAD. The current study tested the hypothesis that surgical resection of cEAT attenuates inflammation and CAD progression.

METHODS:

Female Ossabaw miniature swine (n = 12) were fed an atherogenic diet for 8 months and randomly allocated into sham (n = 5) or adipectomy (n = 7) groups. Both groups underwent a thoracotomy, opening of the pericardial sac, and placement of radioopaque clips to mark the proximal left anterior descending artery. Adipectomy swine underwent removal of 1 to 1.5 cm2 of cEAT from the proximal artery. After sham or adipectomy, CAD severity was assessed with intravascular ultrasonography. Swine recovered for an additional 3 months on an atherogenic diet, and CAD was assessed immediately before euthanasia. Artery sections were processed for histologic and immunohistochemical analysis.

RESULTS:

Severity of CAD as assessed by percent stenosis was reduced in the adipectomy cohort compared with shams; however, plaque size remained unaltered, whereas larger plaque sizes developed in sham-operated swine. Adipectomy resulted in an expanded arterial diameter, similar to the Glagov phenomenon of positive outward remodeling. No differences in inflammatory marker expression were observed.

CONCLUSIONS:

These data indicate that cEAT resection did not alter inflammatory marker expression, but arrested CAD progression through increased positive outward remodeling and arrest of atherogenesis.

• Authors: Mikaela L McKenney-Drake, Stacey D Rodenbeck, Rebecca S Bruning, Ayeeshik Kole, Kyle W Yancey, Mouhamad Alloosh, Harold S Sacks, Michael Sturek
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 103 Issue 5 Pg. 1622-1630 (May 2017) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 28223054 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers

Topics

• Adipose Tissue (surgery)
• Animals
• Biomarkers (metabolism)
• Coronary Artery Disease (diagnostic imaging, metabolism, therapy)
• Coronary Vessels (diagnostic imaging, pathology)
• Female
• Inflammation (metabolism, therapy)
• Plaque, Atherosclerotic (diagnostic imaging, pathology, therapy)
• Random Allocation
• Swine
• Swine, Miniature
• Ultrasonography, Interventional