title: [Evaluation of cardiovascular remodeling and epicardial fat thickness in patients with chronic heart failure and metabolic syndrome].
abstract: OBJECTIVE
  To estimate cardiac chamber sizes and epicardial fat (EF) thickness in patients with chronic heart failure (CHF) and metabolic syndrome (MS).
  
  
  METHODS
  The investigation enrolled 77 patients with CHF. The diagnosis of the latter was made on the basis of clinical symptoms and verified measuring N-terminal pro-brain natriuretic peptide levels in all the patients. A study group (SG) included 39 patients with CHF and MS. A control group comprised 38 CHF patients without MS. Clinical and biochemical blood tests and electrocardiography were performed in all the patients. Cardiac chamber sizes, myocardial wall thickness, and EF were estimated from echocardiographic findings. Fatty liver index (FLI) and nonalcoholic fatty liver disease (NAFLD) fibrosis score (NFS) were calculated in all the patients.
  
  
  RESULTS
  All the patients had clinical signs and symptoms of CHF. There were 25 (32%) men among the 77 patients. The mean age was 63.9±10.3 years. The patients with CHF and MS showed pronounced myocardial remodeling, which was manifested as significantly higher increases in the sizes of cardiac chambers and in the thickness of their walls and as larger EF thickness (EFT) and larger myocardial mass. In SG, EFT was 3.39±1.82 mm (p=0.00001). This group exhibited correlations between EFT and FLI (r=0.52; p=0.004), glycated hemoglobin levels (r=0.41; p=0.016), E peak (r=-0.25; p=0.005), E/A ratio (r=0.25; p=0.041), left ventricular (LV) end-systolic size (r=0.25; p=0.035), LV myocardial mass (r=0.29; p=0.038), NFS (r=0.29; p=0.002), and body mass index (r=0.29; p=0.003).
  
  
  CONCLUSIONS
  The found correlations between EFT and the clinical and metabolic parameters of CHD and cardiovascular diseases allow EFT to be regarded as a new marker of risk for MS and cardiovascular diseases.
authors.affiliation: National Research Center for Preventive Medicine, Moscow, Russia.
authors.forename: O M
authors.initials: OM
authors.lastname: Drapkina
authors.affiliation: I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
authors.forename: E V
authors.initials: EV
authors.lastname: Zyatenkova
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004452:Echocardiography / Q000379:methods; D005080:Exercise Test / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D010446:Peptide Fragments / Q000378:metabolism; D010496:Pericardium / Q000473:pathology*; D013223:Statistics as Topic; D066253:Vascular Remodeling; D020257:Ventricular Remodeling
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain