Correlation Between Epicardial Fat Thickness and Cardiovascular Risk in Hemodialysis Patients

Ashraf Abd El-Khalik Barakat; Fatma Mohammed Nasr; Amna Ahmed Metwaly; Manar Abd El-Rouf Raafat Ameen

doi:doi:10.11648/j.ajim.20150303.12

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Correlation Between Epicardial Fat Thickness and Cardiovascular Risk in Hemodialysis Patients

Ashraf Abd El-Khalik Barakat, Fatma Mohammed Nasr, Amna Ahmed Metwaly, Manar Abd El-Rouf Raafat Ameen

Published in American Journal of Internal Medicine (Volume 3, Issue 3)

Received: 6 March 2015 Accepted: 19 March 2015 Published: 26 March 2015

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Abstract

Background: Cardiovascular diseases are common in hemodialysis (HD) patients and cardiovascular mortality is responsible for 50% of overall deaths in these patients. Epicardial fat thickness (EpFT) may be an effective marker for the prediction of cardiovascular diseases in hemodialysis patients. The thickness of EpF can be measured by echocardiography that can accurately estimate the actual amount of EpF. The aim of the current study is to assess the association between EpFT and carotid intima-media thickness (CIMT), left ventricular systolic and diastolic function and left ventricular mass index in patients with chronic kidney disease (CKD) undergoing hemodialysis to clarify the relationships between EpF and cardiovascular disease risk in these patients. Materials and Methods: Forty adult uremic patients from dialysis unit and twenty (age and sex matched) healthy control subjects were included in this study. Clinical evaluation, routine laboratory investigations, echocardiographic study including measurement of EpFT and carotid Duplex to estimate CIMT were done to all subjects. Results: we found highly significant increase in serum C-reactive protein and significant increase in serum phosphorus and triglyceride with significant decrease in serum calcium and high-density lipoprotein cholesterol in hemodialysis patients compared to the controls. Also, there were significant increases in left ventricular mass index, left atrium diameter, carotid intima-media thickness, epicardial fat thickness, peak velocity of the late filling wave due to atrial contraction (A wave) and deceleration time of E wave in hemodialysis patients compared to the controls. There were also highly significant decrease in E/A ratio in hemodialysis patients compared to healthy control subjects. EpFT measured by echocardiography in hemodialysis patients was positively correlated with body mass index, CRP, left atrium diameter, left ventricular mass index, deceleration time and CIMT and negatively correlated with high-density lipoprotein cholesterol and E/A ratio. Conclusion: Hemodialysis patients can be evaluated routinely by echocardiography for early detection of cardiovascular structural and functional changes which are common in these patients and epicardial fat thickness is an effective marker for the prediction of cardiovascular risk in hemodialysis patients.

Published in	American Journal of Internal Medicine (Volume 3, Issue 3)
DOI	10.11648/j.ajim.20150303.12
Page(s)	86-94
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Hemodialysis Patients, Cardiovascular Diseases, Carotid Intima-Media Thickness, Epicardial Fat Thickness

References

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Ashraf Abd El-Khalik Barakat, Fatma Mohammed Nasr, Amna Ahmed Metwaly, Manar Abd El-Rouf Raafat Ameen. (2015). Correlation Between Epicardial Fat Thickness and Cardiovascular Risk in Hemodialysis Patients. American Journal of Internal Medicine, 3(3), 86-94. https://doi.org/10.11648/j.ajim.20150303.12

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Ashraf Abd El-Khalik Barakat; Fatma Mohammed Nasr; Amna Ahmed Metwaly; Manar Abd El-Rouf Raafat Ameen. Correlation Between Epicardial Fat Thickness and Cardiovascular Risk in Hemodialysis Patients. Am. J. Intern. Med. 2015, 3(3), 86-94. doi: 10.11648/j.ajim.20150303.12

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Ashraf Abd El-Khalik Barakat, Fatma Mohammed Nasr, Amna Ahmed Metwaly, Manar Abd El-Rouf Raafat Ameen. Correlation Between Epicardial Fat Thickness and Cardiovascular Risk in Hemodialysis Patients. Am J Intern Med. 2015;3(3):86-94. doi: 10.11648/j.ajim.20150303.12

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@article{10.11648/j.ajim.20150303.12,
  author = {Ashraf Abd El-Khalik Barakat and Fatma Mohammed Nasr and Amna Ahmed Metwaly and Manar Abd El-Rouf Raafat Ameen},
  title = {Correlation Between Epicardial Fat Thickness and Cardiovascular Risk in Hemodialysis Patients},
  journal = {American Journal of Internal Medicine},
  volume = {3},
  number = {3},
  pages = {86-94},
  doi = {10.11648/j.ajim.20150303.12},
  url = {https://doi.org/10.11648/j.ajim.20150303.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20150303.12},
  abstract = {Background: Cardiovascular diseases are common in hemodialysis (HD) patients and cardiovascular mortality is responsible for 50% of overall deaths in these patients. Epicardial fat thickness (EpFT) may be an effective marker for the prediction of cardiovascular diseases in hemodialysis patients. The thickness of EpF can be measured by echocardiography that can accurately estimate the actual amount of EpF. The aim of the current study is to assess the association between EpFT and carotid intima-media thickness (CIMT), left ventricular systolic and diastolic function and left ventricular mass index in patients with chronic kidney disease (CKD) undergoing hemodialysis to clarify the relationships between EpF and cardiovascular disease risk in these patients. Materials and Methods: Forty adult uremic patients from dialysis unit and twenty (age and sex matched) healthy control subjects were included in this study. Clinical evaluation, routine laboratory investigations, echocardiographic study including measurement of EpFT and carotid Duplex to estimate CIMT were done to all subjects. Results: we found highly significant increase in serum C-reactive protein and significant increase in serum phosphorus and triglyceride with significant decrease in serum calcium and high-density lipoprotein cholesterol in hemodialysis patients compared to the controls. Also, there were significant increases in left ventricular mass index, left atrium diameter, carotid intima-media thickness, epicardial fat thickness, peak velocity of the late filling wave due to atrial contraction (A wave) and deceleration time of E wave in hemodialysis patients compared to the controls. There were also highly significant decrease in E/A ratio in hemodialysis patients compared to healthy control subjects. EpFT measured by echocardiography in hemodialysis patients was positively correlated with body mass index, CRP, left atrium diameter, left ventricular mass index, deceleration time and CIMT and negatively correlated with high-density lipoprotein cholesterol and E/A ratio. Conclusion: Hemodialysis patients can be evaluated routinely by echocardiography for early detection of cardiovascular structural and functional changes which are common in these patients and epicardial fat thickness is an effective marker for the prediction of cardiovascular risk in hemodialysis patients.},
 year = {2015}
}

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TY  - JOUR
T1  - Correlation Between Epicardial Fat Thickness and Cardiovascular Risk in Hemodialysis Patients
AU  - Ashraf Abd El-Khalik Barakat
AU  - Fatma Mohammed Nasr
AU  - Amna Ahmed Metwaly
AU  - Manar Abd El-Rouf Raafat Ameen
Y1  - 2015/03/26
PY  - 2015
N1  - https://doi.org/10.11648/j.ajim.20150303.12
DO  - 10.11648/j.ajim.20150303.12
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 86
EP  - 94
PB  - Science Publishing Group
SN  - 2330-4324
UR  - https://doi.org/10.11648/j.ajim.20150303.12
AB  - Background: Cardiovascular diseases are common in hemodialysis (HD) patients and cardiovascular mortality is responsible for 50% of overall deaths in these patients. Epicardial fat thickness (EpFT) may be an effective marker for the prediction of cardiovascular diseases in hemodialysis patients. The thickness of EpF can be measured by echocardiography that can accurately estimate the actual amount of EpF. The aim of the current study is to assess the association between EpFT and carotid intima-media thickness (CIMT), left ventricular systolic and diastolic function and left ventricular mass index in patients with chronic kidney disease (CKD) undergoing hemodialysis to clarify the relationships between EpF and cardiovascular disease risk in these patients. Materials and Methods: Forty adult uremic patients from dialysis unit and twenty (age and sex matched) healthy control subjects were included in this study. Clinical evaluation, routine laboratory investigations, echocardiographic study including measurement of EpFT and carotid Duplex to estimate CIMT were done to all subjects. Results: we found highly significant increase in serum C-reactive protein and significant increase in serum phosphorus and triglyceride with significant decrease in serum calcium and high-density lipoprotein cholesterol in hemodialysis patients compared to the controls. Also, there were significant increases in left ventricular mass index, left atrium diameter, carotid intima-media thickness, epicardial fat thickness, peak velocity of the late filling wave due to atrial contraction (A wave) and deceleration time of E wave in hemodialysis patients compared to the controls. There were also highly significant decrease in E/A ratio in hemodialysis patients compared to healthy control subjects. EpFT measured by echocardiography in hemodialysis patients was positively correlated with body mass index, CRP, left atrium diameter, left ventricular mass index, deceleration time and CIMT and negatively correlated with high-density lipoprotein cholesterol and E/A ratio. Conclusion: Hemodialysis patients can be evaluated routinely by echocardiography for early detection of cardiovascular structural and functional changes which are common in these patients and epicardial fat thickness is an effective marker for the prediction of cardiovascular risk in hemodialysis patients.
VL  - 3
IS  - 3
ER  -

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Ashraf Abd El-Khalik Barakat

Intensive Care Department, Theodor Bilharz Research Institute, Cairo, Egypt
Fatma Mohammed Nasr

Intensive Care Department, Theodor Bilharz Research Institute, Cairo, Egypt
Amna Ahmed Metwaly

Intensive Care Department, Theodor Bilharz Research Institute, Cairo, Egypt
Manar Abd El-Rouf Raafat Ameen

Nephrology Department, Theodor Bilharz Research Institute, Cairo, Egypt

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Ashraf Abd El-Khalik Barakat, Fatma Mohammed Nasr, Amna Ahmed Metwaly, Manar Abd El-Rouf Raafat Ameen. (2015). Correlation Between Epicardial Fat Thickness and Cardiovascular Risk in Hemodialysis Patients. American Journal of Internal Medicine, 3(3), 86-94. https://doi.org/10.11648/j.ajim.20150303.12

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Ashraf Abd El-Khalik Barakat; Fatma Mohammed Nasr; Amna Ahmed Metwaly; Manar Abd El-Rouf Raafat Ameen. Correlation Between Epicardial Fat Thickness and Cardiovascular Risk in Hemodialysis Patients. Am. J. Intern. Med. 2015, 3(3), 86-94. doi: 10.11648/j.ajim.20150303.12

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AMA Style

Ashraf Abd El-Khalik Barakat, Fatma Mohammed Nasr, Amna Ahmed Metwaly, Manar Abd El-Rouf Raafat Ameen. Correlation Between Epicardial Fat Thickness and Cardiovascular Risk in Hemodialysis Patients. Am J Intern Med. 2015;3(3):86-94. doi: 10.11648/j.ajim.20150303.12

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@article{10.11648/j.ajim.20150303.12,
  author = {Ashraf Abd El-Khalik Barakat and Fatma Mohammed Nasr and Amna Ahmed Metwaly and Manar Abd El-Rouf Raafat Ameen},
  title = {Correlation Between Epicardial Fat Thickness and Cardiovascular Risk in Hemodialysis Patients},
  journal = {American Journal of Internal Medicine},
  volume = {3},
  number = {3},
  pages = {86-94},
  doi = {10.11648/j.ajim.20150303.12},
  url = {https://doi.org/10.11648/j.ajim.20150303.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20150303.12},
  abstract = {Background: Cardiovascular diseases are common in hemodialysis (HD) patients and cardiovascular mortality is responsible for 50% of overall deaths in these patients. Epicardial fat thickness (EpFT) may be an effective marker for the prediction of cardiovascular diseases in hemodialysis patients. The thickness of EpF can be measured by echocardiography that can accurately estimate the actual amount of EpF. The aim of the current study is to assess the association between EpFT and carotid intima-media thickness (CIMT), left ventricular systolic and diastolic function and left ventricular mass index in patients with chronic kidney disease (CKD) undergoing hemodialysis to clarify the relationships between EpF and cardiovascular disease risk in these patients. Materials and Methods: Forty adult uremic patients from dialysis unit and twenty (age and sex matched) healthy control subjects were included in this study. Clinical evaluation, routine laboratory investigations, echocardiographic study including measurement of EpFT and carotid Duplex to estimate CIMT were done to all subjects. Results: we found highly significant increase in serum C-reactive protein and significant increase in serum phosphorus and triglyceride with significant decrease in serum calcium and high-density lipoprotein cholesterol in hemodialysis patients compared to the controls. Also, there were significant increases in left ventricular mass index, left atrium diameter, carotid intima-media thickness, epicardial fat thickness, peak velocity of the late filling wave due to atrial contraction (A wave) and deceleration time of E wave in hemodialysis patients compared to the controls. There were also highly significant decrease in E/A ratio in hemodialysis patients compared to healthy control subjects. EpFT measured by echocardiography in hemodialysis patients was positively correlated with body mass index, CRP, left atrium diameter, left ventricular mass index, deceleration time and CIMT and negatively correlated with high-density lipoprotein cholesterol and E/A ratio. Conclusion: Hemodialysis patients can be evaluated routinely by echocardiography for early detection of cardiovascular structural and functional changes which are common in these patients and epicardial fat thickness is an effective marker for the prediction of cardiovascular risk in hemodialysis patients.},
 year = {2015}
}

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TY  - JOUR
T1  - Correlation Between Epicardial Fat Thickness and Cardiovascular Risk in Hemodialysis Patients
AU  - Ashraf Abd El-Khalik Barakat
AU  - Fatma Mohammed Nasr
AU  - Amna Ahmed Metwaly
AU  - Manar Abd El-Rouf Raafat Ameen
Y1  - 2015/03/26
PY  - 2015
N1  - https://doi.org/10.11648/j.ajim.20150303.12
DO  - 10.11648/j.ajim.20150303.12
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 86
EP  - 94
PB  - Science Publishing Group
SN  - 2330-4324
UR  - https://doi.org/10.11648/j.ajim.20150303.12
AB  - Background: Cardiovascular diseases are common in hemodialysis (HD) patients and cardiovascular mortality is responsible for 50% of overall deaths in these patients. Epicardial fat thickness (EpFT) may be an effective marker for the prediction of cardiovascular diseases in hemodialysis patients. The thickness of EpF can be measured by echocardiography that can accurately estimate the actual amount of EpF. The aim of the current study is to assess the association between EpFT and carotid intima-media thickness (CIMT), left ventricular systolic and diastolic function and left ventricular mass index in patients with chronic kidney disease (CKD) undergoing hemodialysis to clarify the relationships between EpF and cardiovascular disease risk in these patients. Materials and Methods: Forty adult uremic patients from dialysis unit and twenty (age and sex matched) healthy control subjects were included in this study. Clinical evaluation, routine laboratory investigations, echocardiographic study including measurement of EpFT and carotid Duplex to estimate CIMT were done to all subjects. Results: we found highly significant increase in serum C-reactive protein and significant increase in serum phosphorus and triglyceride with significant decrease in serum calcium and high-density lipoprotein cholesterol in hemodialysis patients compared to the controls. Also, there were significant increases in left ventricular mass index, left atrium diameter, carotid intima-media thickness, epicardial fat thickness, peak velocity of the late filling wave due to atrial contraction (A wave) and deceleration time of E wave in hemodialysis patients compared to the controls. There were also highly significant decrease in E/A ratio in hemodialysis patients compared to healthy control subjects. EpFT measured by echocardiography in hemodialysis patients was positively correlated with body mass index, CRP, left atrium diameter, left ventricular mass index, deceleration time and CIMT and negatively correlated with high-density lipoprotein cholesterol and E/A ratio. Conclusion: Hemodialysis patients can be evaluated routinely by echocardiography for early detection of cardiovascular structural and functional changes which are common in these patients and epicardial fat thickness is an effective marker for the prediction of cardiovascular risk in hemodialysis patients.
VL  - 3
IS  - 3
ER  -

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