Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, Milan, Italy.
Department of Biomedical, Surgical and Dental Sciences, University of Milano, Milan, Italy.
Eat Weight Disord. 2022 Oct;27(7):2905-2910. doi: 10.1007/s40519-022-01420-8. Epub 2022 Jun 9.
The visceral fat of patients affected by abdominal obesity is inflamed, and the main histopathologic feature is the high density of crown-like structures (CLS). Epicardial adipose tissue (EAT) is a visceral fat of paramount importance for its relationships with coronary vessels and myocardium. Its inflammation in patients with abdominal obesity could be of clinical relevance, but histopathological studies on CLS density in EAT are lacking. This study aimed to assess the histopathology of EAT biopsies obtained from patients undergoing open-heart surgery.
We collected EAT biopsies from 10 patients undergoing open-heart surgery for elective coronary artery bypass grafting (CABG) (n = 5) or valvular replacement (VR) (n = 5). Biopsies were treated for light microscopy and immunohistochemistry. We quantify the CLS density in each EAT sample.
Despite all patients having abdominal obesity, in EAT samples, no CLS were detected in the VR group; in contrast, CLS were detected in the CABG group (about 17 CLS/10 adipocytes vs. 0.0 CLS/10 adipocytes, CABG vs. VR group, respectively). An impressive density of CLS (100 times that of other patients) was found in one patient (LS) in the CABG group that had a relevant anamnestic aspect: relatively rapid increase of weight gain, especially in abdominal adipose tissue, coincident with myocardial infarction.
CLS density could be an important predictive tool for cardiovascular diseases. Furthermore, the LS case implies a role for timing in weight gain.
No level of evidence; this is a basic science study.
患有腹型肥胖的患者的内脏脂肪发炎，其主要组织病理学特征是高密 crown-like structures（CLS）。心外膜脂肪组织（EAT）是一种重要的内脏脂肪，与冠状动脉和心肌密切相关。腹型肥胖患者的 EAT 炎症可能具有临床相关性，但关于 EAT 中 CLS 密度的组织病理学研究尚缺乏。本研究旨在评估接受心脏直视手术的患者的 EAT 活检的组织病理学。
我们从 10 名因择期冠状动脉旁路移植术（CABG）（n=5）或瓣膜置换术（VR）（n=5）而行心脏直视手术的患者中收集 EAT 活检。对活检进行光镜和免疫组织化学检查。我们对每个 EAT 样本中的 CLS 密度进行量化。
尽管所有患者均有腹型肥胖，但在 VR 组的 EAT 样本中未检测到 CLS；相反，在 CABG 组中检测到 CLS（分别为 17 个 CLS/10 个脂肪细胞与 0.0 CLS/10 个脂肪细胞，CABG 与 VR 组）。在 CABG 组中，一名患者（LS）的 CLS 密度非常高（是其他患者的 100 倍），该患者具有相关的病史特征：体重迅速增加，尤其是腹部脂肪组织增加，与心肌梗死同时发生。
CLS 密度可能是心血管疾病的重要预测工具。此外，LS 病例意味着体重增加的时机可能具有重要作用。
无证据级别；这是一项基础科学研究。
