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Certain fat found around the heart associated with higher risk of heart disease in postmenopausal women


A higher quantity of a sure sort of fat that surrounds the heart is considerably associated with a higher risk of heart disease in women after menopause and women with decrease ranges of estrogen at midlife, in line with new analysis led by the University of Pittsburgh Graduate School of Public Health.


The findings reveal a beforehand unknown, menopause-specific indicator of heart disease risk, pointing to potential methods to scale back that risk and a goal for future research on the impression of hormone replacement therapy in enhancing cardiovascular health. The outcomes are revealed on-line in the Journal of the American Heart Association.


“For the first time, we’ve pinpointed the type of heart fat, linked it to a risk factor for heart disease and shown that menopausal status and estrogen levels are critical modifying factors of its associated risk in women,” stated lead writer Samar R. El Khoudary, Ph.D., M.P.H., assistant professor in Pitt Public Health’s Department of Epidemiology.


There are two varieties of fat surrounding the heart:


  • Epicardial fat, the fat that immediately covers the heart tissue (the myocardium) and is situated between the outdoors of the heart and the pericardium (the membrane that encases the heart). It is the power supply for the heart.

  • Paracardial fat, which is outdoors the pericardium, anterior to the epicardial fat. There are not any recognized heart-protective features of this fat.


El Khoudary and her group evaluated medical knowledge, together with blood samples and heart CT scans, on 478 women from Pittsburgh and Chicago enrolled in the Study of Women’s Health Across the Nation (SWAN). The women have been in various levels of menopause, averaged 51 years previous and weren’t on hormone alternative remedy.


In a earlier research, the staff confirmed that a larger quantity of paracardial fat, however not epicardial fat, after menopause is defined by a decline in the intercourse hormone estradiol – the most potent estrogen – in midlife women. The higher quantity of epicardial fat was tied to different risk elements, comparable to obesity.


In the new research, the researchers constructed on these findings to find that not solely is a larger paracardial fat quantity particular to menopause, however – in postmenopausal women and women with decrease ranges of estradiol – it is also associated with a higher risk of coronary artery calcification, an early signal of heart disease that’s measured with a heart CT scan.


In the women studied, a rise in paracardial fat quantity from the 25th percentile to the 75th percentile (comparable to 60 % improve) was associated with a 160 % higher risk of coronary artery calcification and a 45 % improve in the extent of coronary artery calcification in postmenopausal women in contrast with pre- or early-menopausal women.


“Clearly, epicardial and paracardial fat are distinct types of heart fat that are found to be greater in postmenopausal women for different reasons with different effects on heart disease risk – and thus should be evaluated separately when searching for ways to help women avoid heart disease,” stated El Khoudary.


A current evaluation of earlier analysis found that heart fat volumes might be decreased efficiently with weight-reduction plan and bariatric surgical procedure. Given the uncertainty about the cardio-protective results of hormone alternative remedy, in addition to the lack of analysis on the influence of such remedy on heart fat volumes, El Khoudary is planning a research to guage hormone alternative remedy on heart fat accumulation, paying specific consideration to the varieties of heart fat.


Additional authors on this research are senior writer Karen A. Matthews, Ph.D., of Pitt; and co-authors Kelly J. Shields, Ph.D., of Allegheny Health Network; Imke Janssen, Ph.D., and Lynda H. Powell, Ph.D., each of Rush University Medical Center; Matthew Budoff, M.D., of the Los Angeles Biomedical Research Institute; and Susan A. Everson-Rose, Ph.D., of the University of Minnesota Medical School.


This analysis was supported by National Institutes of Health grants U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495, HL065581 and HL065591; and American Heart Association grant 12CRP11900031.


Article: Postmenopausal Women With Greater Paracardial Fat Have More Coronary Artery Calcification Than Premenopausal Women: The Study of Women’s Health Across the Nation (SWAN) Cardiovascular Fat Ancillary Study, Samar R. El Khoudary, Kelly J. Shields, Imke Janssen, Matthew J. Budoff, Susan A. Everson‐Rose, Lynda H. Powell, Karen A. Matthews, Journal of the American Heart Association, doi: 10.1161/JAHA.116.004545, revealed 29 January 2017.


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