Tiberiu Nyulas, Mirabela Morariu, Nora Rat, Emese Marton, Victoria Ancuta Rus, Mihaela Ratiu, Theodora Benedek and Imre Benedek
Background: Epicardial adipose tissue (EAT) has been recently identified as a major player in the development of the atherosclerotic process. This study aimed to investigate the role of EAT as a marker associated with a higher vulnerability of atheromatous coronary plaques in patients with acute myocardial infarction (AMI) as compared to patients with stable angina.
Material and methods: This analysis enrolled a total of 89 patients, 47 with stable angina (SA) and 42 with AMI, who underwent echocardiographic investigations and epicardial fat measurement in 2D-parasternal long axis view. The study lot was divided as follows: Group 1 included patients with prior AMI, and Group 2 included patients with SA.
Results: There were no significant differences between the two groups regarding cardiovascular risk factors, excepting smoking status, which was recorded more frequently in Group 1 as compared to Group 2 (36.17% vs. 11.63%, p = 0.02). The mean epicardial fat diameter was 9.12 ± 2.28 mm (95% CI: 8.45–9.79 mm) in Group 1 and 6.30 ± 2.03 mm (95% CI: 5.675–6.93 mm) in Group 2, the difference being highly significant statistically (p <0.0001). The mean value of left ventricular ejection fraction was significantly lower in patients with AMI (Group 1 – 47.60% ± 7.96 vs. Group 2 – 51.23% ± 9.05, p = 0.04). EAT thickness values showed a weak but significant positive correlation with the level of total cholesterol (r = −0.22, p = 0.03) and with the value of end-systolic left ventricle diameter (r = 0.33, = 0.001).
Conclusions: The increased thickness of EAT was associated with other serum- or image-based biomarkers of disease severity, such as the left ventricular ejection fraction, end-systolic diameter of the left ventricle, and total cholesterol. Our results indicate that EAT is significantly higher in patients with acute coronary syndrome, proving that EAT could serve as a marker of vulnerability in cardiovascular diseases.
Victoria Ancuța Rus, Florina Ruța, Maria Sălcudean, Monica Tarcea, Costela Șerban, Călin Avram, Iustinian Simion and Theodora Benedek
Background: Adopting a healthy lifestyle, including a healthy diet, weight control, regular exercise, smoking cessation, and alcohol limitation, plays an important role in treating high blood pressure and cardiovascular and chronic diseases.
Aim: This study aimed to investigate adherence to the DASH diet in relation to the occurrence of high blood pressure and chronic disease risk factors, in a group of people from Tîrgu Mureș.
Material and methods: This was a cross-sectional study based on a food frequency and lifestyle questionnaire applied to a group of 2,010 people aged 15–92 years from Tîrgu Mureș.
Results: Individuals over the age of 45 had higher DASH scores (Q4, Q5) compared to subjects younger than 40 years (Q1 and Q2, p <0.001). An important percentage (19.3%) of subjects who preferred a meat-based diet (Q3) had significantly larger abdominal circumference (mean 92.2 ± 0.91 cm, p <0.001). An association between pure alcohol intake (mean 5.6 ± 0.43 g) and an unhealthy diet (Q1) was observed, compared to the average 1.7 ± 19 g of alcohol consumed by subjects with a healthy diet (Q5), alcohol consumption decreasing with an increasing DASH score (p <0.001).
Conclusion: This study shows that individuals diagnosed with at least one cardiovascular risk factor had a higher adherence to the DASH diet than individuals with no cardiovascular risk factors, most likely due to the fact that diagnosed individuals had changed their eating behavior and lifestyle from the time of diagnosis, with a positive impact on treatment outcomes and quality of life.
Tiberiu Nyulas, Emese Marton, Victoria Ancuta Rus, Nora Rat, Mihaela Ratiu, Theodora Benedek and Imre Benedek
Background: The independent role of each plaque feature in relation to plaque vulnerability is still the subject of ongoing research. This study aimed to compare the morphologic characteristics of vulnerable atheromatous coronary plaques with the ones of stable, non-vulnerable plaques, and in plaques with different locations in the coronary tree, in order to identify the most relevant imaging-based biomarkers associated with coronary plaque vulnerability.
Material and methods: This was a prospective observational, non-randomized study that included 50 patients with unstable angina who underwent computed tomography angiography for assessment of the entire coronary artery tree followed by complex morphologic analysis of all lesions, divided into two groups: group 1 – 25 patients with vulnerable plaque (VP) and group 2 – 25 age- and gender-matched patients with non-vulnerable plaque (NVP).
Results: Lesions with a stenosis degree >70% were significantly longer than those with a stenosis degree <70% (8.27 ± 2.74 mm vs. 5.56 ± 4.11 mm, p = 0.04). VP presented significantly higher values of plaque thickness (p = 0.0005), plaque burden (p = 0.0004), and higher total plaque volume (p = 0.0005) than NVP. The remodeling index was not significantly different between the groups (p = 0.6), but the eccentricity index was (0.24 ± 0.14 compared to 0.14 ± 0.17, p = 0.023). Linear regression analysis revealed a significant correlation between plaque burden and plaque components in VP (r = 0.76, p <0.0001 for necrotic core; r = 0.62, p = 0.0008 for fibro-fatty tissue; and r = 0.5, p = 0.01 for fibrotic tissue volume). Culprit plaques located in the right coronary artery presented significantly larger plaque burden volumes (91.17 ± 4.88 mm3 vs. 83.35 ± 8.47 mm3, p = 0.04), larger volumes of necrotic core (82.03 ± 47.85 mm3 vs. 45.84 ± 43.72 mm3, p = 0.02) and fibrofatty tissue (53.23 ± 31.92 mm3 vs. 23.76 ± 20.90 mm3, p = 0.02) than the ones situated in the left coronary artery.
Conclusions: VPs from the culprit lesions exhibit a different phenotype than non-vulnerable ones, and vulnerability features are present in a significantly larger extent in VPs from the right coronary artery as compared to those from the left coronary artery.