Evidence map›Paper›PMID 34172829›Full record

ArticleInternational journal of obesity (2005)2021

Epicardial adipose tissue differentiates in patients with and without coronary microvascular dysfunction.

Ihab Mahmoud, Iryna Dykun, Luisa Kärner, Stefanie Hendricks, Matthias Totzeck, Fadi Al-Rashid, Tienush Rassaf, Amir A Mahabadi

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of obesity (2005), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 32 citations in OpenAlex.

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  4. Epicardial adipose tissue in coronary microvascular disease.American heart journal plus : cardiology research and practice · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Ihab MahmoudWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Clinic Essen, Essen, Germany.
Iryna DykunWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Clinic Essen, Essen, Germany.
Luisa KärnerWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Clinic Essen, Essen, Germany.
Stefanie HendricksWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Clinic Essen, Essen, Germany.
Matthias TotzeckWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Clinic Essen, Essen, Germany.
Fadi Al-RashidWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Clinic Essen, Essen, Germany.
Tienush RassafWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Clinic Essen, Essen, Germany.
Amir A MahabadiWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Clinic Essen, Essen, Germany. amir-abbas.mahabadi@uk-essen.de.ORCID http://orcid.org/0000-0003-2336-7991
West German Heart and Vascular Center Essen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesCoronary microvascular dysfunction (CMD) is a common disorder, leading to symptoms similar to obstructive coronary artery disease and bears important prognostic implications. Local inflammation is suggested to promote development of CMD. Epicardial adipose tissue (EAT) is a local visceral fat depot surrounding the heart and the coronary arteries, modifying the inflammatory environment of the heart. We compared EAT in patients with and without CMD.

methodsWe retrospectively included consecutive patients undergoing diagnostic coronary angiography as well as transthoracic echocardiography between March and October 2016. EAT thickness was defined as space between the epicardial wall of the myocardium and the visceral layer of the pericardium and EAT index was calculated as EAT thickness/body surface area. Logistic regression analysis was used to determine the association of EAT index with the presence of CMD.

resultsOverall, 399 patients (mean age 60.2 ± 14.0 years, 46% male) were included. EAT thickness was significantly higher in patients with CMD compared to patients without CMD (EAT thickness 4.4 ± 1.8 vs. 4.9 ± 2.4 mm, p = 0,048 for patients without and with CMD, respectively). In univariate regression analysis, EAT index was associated with a 30% higher frequency of CMD (odds ratio [95% confidence interval]: 1.30 [1.001-1.69], p = 0.049). Effect sizes remained stable upon adjustment for body mass index (BMI, 1.30 [1.003-1.70], p = 0.048), but were attenuated when ancillary adjusting for age and gender (1.17 [0.90-1.54, p = 0.25). The effect was more pronounced in patients >65 years of age and independent of BMI and sex (1.85 [1.14-3.00], p = 0.013).

conclusionEAT thickness is independently associated with CMD and can differentiate between patients with and without CMD especially in older age groups. Our results support the hypothesis that modulation of local inflammation by epicardial fat is involved in the development of CMD.

Indexed as

Adipose TissueAgedEchocardiographyFemaleHumansMaleMicrocirculationMiddle AgedOdds RatioPericardiumRetrospective StudiesRisk Factors

Identifiers

PMID34172829
PMCPMC8380538
OpenAlexW3173370523

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.