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Archives of cardiovascular diseases
Volume 112, n° 10
pages 594-603 (octobre 2019)
Doi : 10.1016/j.acvd.2019.06.005
Received : 19 Mars 2019 ;  accepted : 12 June 2019
Clinical research

Epicardial adipose tissue volume is associated with left ventricular remodelling in calcific aortic valve stenosis
Le volume de graisse épicardique est associé au remodelage ventriculaire gauche au cours du rétrécissement aortique calcifié

Dimitri Arangalage a, b, c, Tiffany Mathieu a, c, Virginia Nguyen a, b, c, Claire Cimadevilla d, Caroline Kerneis a, Xavier Duval c, e, Sarah Tubiana f, Fabien Hyafil b, g, Phalla Ou b, c, h, Christophe Tribouilloy i, Alec Vahanian a, b, c, David Messika-Zeitoun j,
a Department of Cardiology, Bichat Hospital, 75018 Paris, France 
b Université de Paris, UMRS1148, INSERM, 75018 Paris, France 
c Université de Paris, 75006 Paris, France 
d Department of Cardiac Surgery, Bichat Hospital, 75018 Paris, France 
e Centre d’Investigation Clinique, Bichat Hospital, 75018 Paris, France 
f Centre de Ressources Biologiques, Bichat Hospital, 75018 Paris, France 
g Department of Nuclear Medicine, Bichat Hospital, 75018 Paris, France 
h Department of Radiology, Bichat Hospital, 75018 Paris, France 
i Department of Cardiology, Amiens University Hospital, 80054 Amiens, France 
j University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada 

Corresponding author at: University of Ottawa Heart Institute, 40, Ruskin Street, Ottawa, ON K1Y 4W7, Canada.University of Ottawa Heart Institute40, Ruskin StreetOttawaON K1Y 4W7Canada

The severity of left ventricular (LV) remodelling is only partially related to the severity of aortic valve stenosis; additional factors, including diabetes, insulin resistance, obesity and metabolic syndrome, may play important roles. Epicardial adipose tissue (EAT), now considered as a metabolically active organ, is also linked to these factors.


To analyse the association between EAT volume measured using computed tomography and LV remodelling in a prospective cohort of patients with aortic stenosis.


Consecutive asymptomatic patients with at least mild degenerative aortic stenosis enrolled in a prospective cohort that aimed to assess the determinants of aortic stenosis occurrence and progression constituted our population.


We enrolled 143 patients (78±5 years; 65% men). Mean LV mass and EAT volume were 219±64g and 134±56mL, respectively. LV hypertrophy was diagnosed in 86 patients (60%), and concentric hypertrophy (32%) was the main remodelling pattern. EAT was associated with body mass index (P <0.001) and body surface area (P <0.001), but not with age (P =0.33) or aortic stenosis severity (all P >0.10). EAT was correlated with LV mass (r =0.41; P <0.0001), and after adjustment for age, sex, body mass index/body surface area, hypertension, waist circumference, low-density lipoprotein cholesterol and aortic stenosis severity, EAT was independently associated with LV mass (P =0.01/P =0.02). Similar results were found when EAT and LV mass index (adjusted for body surface area) were considered instead of absolute values (P =0.04).


In this prospective cohort of patients with aortic stenosis, EAT volume was independently associated with LV mass. Further studies are warranted to elucidate the underlying mechanisms of this link.

The full text of this article is available in PDF format.

L’amplitude du remodelage ventriculaire gauche (VG) n’est que partiellement associée à la sévérité du rétrécissement aortique calcifié (RAC). Des facteurs additionnels comme le diabète, l’obésité et le syndrome métabolique pourraient également influencer ce remodelage. La graisse épicardique (GE) est un organe métaboliquement actif, également associée à ces facteurs.


Notre objectif était d’analyser l’association entre volume de GE mesuré par scanner et remodelage VG.


Notre population d’étude était constituée de patients consécutifs asymptomatiques, ayant un RAC au moins modéré, inclus dans une cohorte prospective visant à évaluer les déterminants de l’apparition et de la progression du RAC.


Parmi les 143 patients (78±5 ans ; 65 % d’hommes) inclus, la masse VG et le volume de GE étaient respectivement de 219±64g et 134±56mL. Une hypertrophie VG a été diagnostiquée chez 86 patients (60 %). L’hypertrophie concentrique (32 %) était le principal type de remodelage observé. La GE était associée à l’indice de masse corporelle (IMC) (p <0,001) et à la surface corporelle (BSA) (p <0,001), mais ni à l’âge (p =0,33) ni à la sévérité du RAC (p >0,10). La GE était corrélée à la masse VG (r =0,41 ; p <0,0001) et après ajustement sur l’âge, le sexe, le rapport IMC/BSA, l’hypertension artérielle, le périmètre abdominal, le taux de LDL-cholestérol et la sévérité du RAC, la GE était indépendamment associée à la masse VG (p =0,01/p =0,02).


Dans cette cohorte prospective de patients souffrant de RAC, le volume de GE était indépendamment associé à la masse VG. Des études complémentaires sont nécessaires pour élucider les mécanismes physiopathologiques sous-jacents.

The full text of this article is available in PDF format.

Keywords : Aortic valve stenosis, Adipose tissue, Left ventricular remodelling

Mots clés : Rétrécissement aortique calcifié, Graisse épicardique, Remodelage ventriculaire gauche

Abbreviations : BMI, BSA, CT, EAT, LDL, LV, LVMI, RWT

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