Rubio GAF, Guerrero GC, Narváez RJL, Narváez ONG, Benítez MDR

Language: Spanish
References: 13
Page: 407-412
PDF size: 191.87 Kb.

ABSTRACT

Objective: To determine if there is an association between a non-dipper pattern and epicardial fat thickness in hypertensive patients.
Materials and Methods: A study was done including patients with hypertension, all of them underwent 24-hour ambulatory blood pressure monitoring with Cardioline Walk200b equipment; epicardial fat thickness was also measured with Aloka Alpha 6 equipment, with a 3.5 MHz transducer.
Results: Thirty patients were included; 15 showed a dipper pattern and 15 a nondipper pattern. There was not significant difference in the daytime hypertensive load of blood pressure between subjects with epicardial fat thickness › 5 mm and ‹ 5 mm (p = 0.18); however, subjects with epicardial fat thickness › 5 mm had a significantly higher nocturnal hypertensive load than subjects with epicardial fat thickness ‹ 5 mm https://doi.org/10.24245/mim.v40iAgosto.9874 (p = 0.033). The risk of presenting a nondipper pattern in subjects with epicardial fat thickness › 5 mm was 24.00 (p = 0.0017).
Conclusions: An epicardial fat thickness 5 mm significantly increases the risk of presenting a nondipper pattern in hypertensive subjects, due to an increase in nocturnal hypertensive load. This suggests a relevant role of epicardial fat on the mechanisms that lead to arterial hypertension and its complications.

REFERENCES

1. Benítez-Maldonado DR, Narváez-Rivera JL, Guerrero GC,et al. Diferencias en el grosor de la grasa epicárdica enpacientes con hipertensión, normotensión e hipertensiónlimítrofe. Arch Med Fam 2018; 20 (3): 113-117.

2. Iacobellis G. Local and systemic effects of the multifacetedepicardial adipose tissue depot. Nat Rev Endocrinol 2015;11: 363-371. doi: 10.1038/nrendo.2015.58

3. Rubio-Guerra AF, Guerrero García C. Papel de la grasaepicárdica en la patología cardiovascular. En: Rodríguez-García J, García-Peña R. Temas Selectos de MedicinaInterna. México: Colegio de Medicina Interna de México.Alfil 2019: 237-246.

4. Mookadam F, Goel R, Alharthi MS, Jiamsripong P, Cha S.Epicardial fat and its association with cardiovascular risk:a cross-sectional observational study. Heart Views 2010;11: 103-8. doi: 10.4103/1995-705X.76801

5. Hermida RC, Ayala DE, Mojón A, Smolensky MH, et al.Cardiovascular disease risk stratification by the Framighamscore is markedly improved by ambulatory compared withoffice blood pressure. Rev Esp Cardiol (Engl Ed) 2021; 74:953-961. https://doi.org/10.1016/j.rec.2020.08.004

6. Talalaj M, Bogolowska A, Wasowski M, et al. The influenceof body composition and fat distribution on circadian bloodpressure rhythm and nocturnal mean arterial pressure dippingin patients with obesity. PLoS One 2023; 18: e0281151.https://doi.org/10.1371/journal.pone.0281151

7. Iacobellis G, Willens HJ. Echocardiographic epicardialfat: a review of research and clinical applications. J AmSoc Echocardiogr 2009; 22: 1311-1319. doi: 10.1016/j.echo.2009.10.013

8. Rubio-Guerra AF, Narváez-Rivera JL. Hipertensión arterialen el paciente obeso. Arch Med Fam 2017; 19: 69-80.

9. Roush GC, Fagard RH, Salles GF, et al. Prognostic impactfrom clinic, daytime, and nighttime systolic bloodpressure in 9 cohorts on 13844 patients with hypertension.J Hypertens 2014; 32: 2332-2340. doi: 10.1097/HJH.0000000000000355

10. Boggia J, Li Y, Thijs L, Hansen TW, et al. Prognostic accuracyof day versus night ambulatory blood pressure: a cohortstudy. Lancet 2007; 370: 1219-1229. doi: 10.1016/S0140-6736(07)61538-4

11. Rubio-Guerra AF, Guerrero-García C, Meneses-Acero I,Maceda-Serrano A, et al. Epicardial fat thickness, but notintraabdominal fat, correlates with intima-media thicknessin patients with metabolic syndrome: Epicardial fatand intima-media thickness. Obes Res Clin Pract 2019; 13:602-603. doi: 10.1016/j.orcp.2019.10.004

12. Rubio-Guerra AF, Cabrera-Miranda LJ, Vargas-Robles H,Maceda-Serrano A, et al. Correlation between levels ofcirculating adipokines and adiponectin/resistin indexwith carotid intima-media thickness in hypertensive type2 diabetic patients. Cardiology 2013; 125 (3): 150-3. doi:10.1159/000348651

13. Homsi R, Thomas D, Gieseke J, Meier-Schroers M, et als.Epicardial fat volume and aortic stiffness in healthy individuals:A quantitative cardiac magnetic resonance study.Rofo 2016; 188: 853-8. doi: 10.1055/s-0042-110098