The role of intraabdominal adipose tissue in patients with comorbid cardiac pathology with overweight and obesity

Abstract

Goal. To estimate the value of the intra-abdominal fat depot and study its relationship with the parameters of heart remodeling and morphometric indices of the liver in comorbid cardiac patients.
Material and methods. We examined 112 male patients with coronary artery disease (CAD) and arterial hypertension (HA) aged 61.2 ± 1.7 years. Depending on body mass index (IMB), patients divided into three subgroups: the first – 29 people with IMB of up to 24.9 kg/m2, the second – 43 people with IMB of 25 kg/m2 to 29.9 kg/m2 (overweight), the third – 40 people with IMB > 30 kg/m2 (obesity I–II degree). Anthropometric and metabolic parameters were studied and the thickness of intraabdominal fat (TIA) was determined using an ultrasound apparatus. Based on Echo – and Dopler echocardiography (EchoCG), linear and volume parameters of the left ventricle and atrium were evaluated. For the diagnosis of nonalcoholic fatty liver disease-NAFLD (at the stage of steatosis), an ultrasound of the hepatobiliary system was performed with an assessment of the morphometric and qualitative parameters of the liver.
Results. The highest value of intra-abdominal fat was determined in patients with overweight and obesity (groups 2 and 3). Positive correlations of TIА with the main metabolic parameters (lipid and carbohydrate spectrum, adiposopathy index) were established. The results of the study revealed a correlation between TIA – myocardial mass index in groups 2 and 3 of patients, final diastolic volume, the volume of the left atrium (p < 0.001). The relationship between the scores of ultrasound of the liver and TIA in obese patients was established (r2 = 0.59; p < 0.001 and r3 = 0.59; p < 0.001), as well as the presence of a direct correlation between TIA and an increase in the size of the right and left lobes the liver. Based on factor analysis, a direct relationship between NAFLD (at the stage of steatosis) and the main metabolic factors, structural restructuring of the heart, and also with the size of TIA was confirmed.
Conclusion. In patients with coronary artery disease and arterial hypertension with overweight and obesity (with an initially equivalent comorbid status), intraabdominal fat appears in as an additional ectopic visceral marker and demonstrates direct associations with the parameters of carbohydrate, fat metabolism, remodeling parameters of the heart and liver