Relationship between the volume of perivascular adipose tissue and the vascular wall lesion

Aim. To study the relationship between the volume of perivascular adipose tissue (PVAT) and the vascular wall lesion.

Material and methods. The study included 318 patients without cardiovascular disease (mean age, 63,5±13,7 years). Hypertension was detected in 268 (84,3%) patients. All patients underwent assessment of anthropometric characteristics, lipid profile, arterial wall stiffness with the estimation of cardio-ankle vascular index, intima-media thickness, brachial artery endothelial vasomotor function. Chest computed tomography was performed with the estimation of the volumes of PVAT and pericardial adipose tissue (PAT).

Results. The volume of PVAT, on average, was 0,3 [0,2; 0,4] cm3 . The VAT volume was significantly higher in obese individuals when compared with patients with normal body weight: 0,4 [0,3; 0,5] vs 0,25 [0,2; 0,4] cm3 (p=0,0007). The VAT volume was higher in individuals with an increased CAVI level when compared with patients with normal CAVI values: 0,4 [0,3; 0,5] vs 0,3 [0,25; 0,3] (p=0,02). A significant correlation was found between the VAT volume and body mass index (r=0,27, p<0,005), waist circumference (r=0,41, p<0,005), CAVI (r=0,49, p<0,05), impaired endothelium-dependent brachial artery vasodilation (r=0,38, p<0,05). When performing multiple linear regression, a significant relationship of CAVI was found with age (β±SE, 0,51±0,15; p=0,002) and volume of PVAT (β±SE, 0,41±0,13; p=0,005).

Conclusion. The results indicate the relationship of PVAT with visceral obesity and vascular wall stiffness parameters.

1. Nilsson PM, Lurbe E, Laurent S. The early life origins of vascular ageing and cardiovascular risk: the EVA syndrome (review). J Hypertens. 2008;26:1049-57. doi:10.1097/HJH.0b013e3282f82c3e.

2. Laurent S, Boutouyrie P. Arterial Stiffness and Hypertension in the Elderly. Front Cardiovasc Med. 2020;7:544302. doi:10.3389/fcvm.2020.544302.

3. Nilsson PM, Olsen MH, Laurent S. Early Vascular Aging (EVA): New Directions in Cardiovascular Protection. Amsterdam: ElsevierInc. 2015. 363р. ISBN: 9780128013878.

4. Nilsson PM, Boutouyrie P, Cunha P, et al. Early vascular ageing in translation: from laboratory investigations to clinical applications in cardiovascular prevention. J Hypertens. 2013;31(8):1517-26. doi:10.1097/HJH.0b013e328361e4bd.

5. Jiang L, Wang M, Zhang J, et al. Increased aortic calpain-1 activity mediates age associated angiotensin II signaling of vascular smooth muscle cells. PLoS ONE. 2008;3(5):e2231. doi:10.1371/journal.pone.0002231.

6. Liao D, Arnett DK, Tyroler HA, et al. Arterial Stiffness and the Development of Hypertension: The ARIC Study. Hypertension. 1999;34(2):201-6. doi:10.1161/01.hyp.34.2.201.

7. Vlachopoulos C, Aznaouridis К, Stefanadis С. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. JACC. 2010;55:1318-27. doi:10.1016/j.jacc.2009.10.061.

8. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018;39:3021-104. doi:10.1093/eurheartj/ehy339.

9. Endes S, Caviezel S, Schaffner E, et al. Associations of novel and traditional vascular biomarkers of arterial stiffness: results of the SAPALDIA 3 cohort study. PLOSone. 2016;11 (9):e0163844. doi:10.1371/journal.pone.0163844.

10. Milyagin VA, Milyagina IV, Purygina MA. Volumetric sphygmography method with VaSera VS-1500N: guidelines. Smolensk: SGMA; 2014. (In Russ.)

11. Orr J, Gentile C, Davy B, et al. Large artery stiffening with weight gain inhumans. Role of visceral fat accumulation. Hyper tension. 2008;51:1519-24. doi:10.1161/HYPERTENSIONAHA.108.112946.

12. Ferreira I, Snijder MB, Twisk JWR, et al. Central fat mass versus peripheral fat and lean mass: opposite (adverse versus favorable) associations with arterial stiffness? The Amsterdam Growth and health longitudinal study. J Clin Endocrinol Metab. 2004;89:2632-39. doi:10.1210/jc.2003-031619.

13. Xia N, Li H. The role of perivascular adipose tissue in obesityinduced vascular dysfunction. Br J Pharmacol. 2017;174(20): 3425-42. doi:10.1111/bph.13650.

14. Gil-Ortega M, Condezo-Hoyos L, García-Prieto CF, et al. Imbalance between pro and anti-oxidant mechanisms in perivascular adipose tissue aggravates long-term high-fat dietderived endothelial dysfunction. PLoS ONE. 2014;9(4):e95312. doi:10.1371/journal.pone.0095312.

15. Oda A, Taniguchi T, Yokoyama M. Leptin stimulates rat aortic smooth muscle cell proliferation and migration. Kobe J Med Sci. 2001;47:141-50.

16. Rittig K, Dolderer JH, BalletshoferB, et al. The secretion pattern of perivascular fat cells is different from that of subcutaneous and visceral fat cells. Diabetologia. 2012;55(5):1514-25. doi:10.1007/s00125-012-2481-9.

17. Diagnosis, treatment, prevention of obesity and associated diseases. National clinical guidelines. Russian Cardiology Society. Russian Scientific Medical Society of Therapists. Antihypertensive League. Association of Clinical Pharmacologists. 2017:3-164. (In Russ.) https://scardio.ru/content/Guidelines/project/Ozhirenie_klin_rek_proekt.pdf. (10 June 2021).

18. Mach F, Baigent C, Catapano A, et al. 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardio vascular risk. Eur Heart J. 2020;41(1):111-88. doi:10.1093/eurheartj/ehz455.

19. Celermajer DS, Sorensen KE, Gooch VM, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet. 1992;340:1111-15.

20. Muromtseva GA, Kontsevaya AV, Konstantinov VV, et al. The prevalence of non-infectious diseases risk factors in Russian population in 2012-2013 years. The results of ECVD-RF. Cardiovascular Therapy and Prevention. 2014;13(6):4-11. (In Russ.) doi:10.15829/1728-8800-2014-6-4-11.

21. Lehman SJ, Massaro JM, Schlett CL, et al. Peri-aortic fat, cardiovascular disease risk factors, and aortic calcification: the Framingham Heart Study. Atherosclerosis. 2010;210(2):656-61. doi:10.1016/j.atherosclerosis.2010.01.007.

22. Schroeter MR, Eschholz N, Herzberg S, et al. Leptin-dependent and leptin-independent paracrine effects of perivascular adipose tissue on neointima formation. Arterioscler Thromb Vasc Biol. 2013;33:980-7. doi:10.1161/ATVBAHA.113.301393.

23. Schnabel R, Larson MG, Dupuis J, et al. Relations of inflammatory biomarkers and common genetic variants with arterial stiffness and wave reflection. Hypertension. 2008;51(6):1651-7. doi:10.1161/HYPERTENSIONAHA.107.105668.

24. Lieb W, Larson MG, Benjamin EJ, et al. Multimarker approach to evaluate correlates of vascular stiffness: the Framingham Heart Study. Circulation. 2009;119(1):37-43. doi:10.1161/CIRCULATIONAHA.108.816108.

25. Korkmaz L, Cirakoglu OF, Ağaç MT, et al. Relation of epicardial adipose tissue with arterial compliance and stiffness in patients with hypertension. Angiology. 2014;65(8):691-5. doi:10.1177/0003319713502120.

26. Kocaman SA, Baysan O, Çetin M, et al. An increase in epicardial adipose tissue is strongly associated with carotid-intima media thickness and atherosclerotic plaque, but LDL only with the plaque. Anatol J Cardiol. 2017;17(1):56-63. doi:10.14744/AnatolJCardiol.2016.6885.

27. Cabrera-Rego JO, Navarro-Despaigne D, Staroushik-Morel L, et al. Association between endothelial dysfunction, epicardial fat and subclinical atherosclerosis during menopause. Clin Investig Arterioscler. 2018;30(1):21-7. doi:10.1016/j.arteri.2017.07.006.

28. Brakenhielm E, Veitonmaki N, Cao R, et al. Adiponectin induced antiangiogenesis and antitumor activity involve caspase mediated endothelial cell apoptosis. Proc Natl Acad Sci USA. 2004;101(8):2476-81. doi:10.1073/pnas.0308671100.

29. Tolstov SN, Salov IA, Rebrov AP. Endothelial Dysfunctions and their Correction in Women with Early Postmenopause. Rational Pharmacotherapy in Cardiology 2017;13(2):191-6. (In Russ.) doi:10.20996/1819-6446-2017-13-2-191-196.

30. Pavlovska I, Kunzova S, Jakubik J, et al. Associations between high triglycerides and arterial stiffness in a populationbased sample: Kardiovize Brno 2030 study. Lipids Health Dis. 2020;19(1):170. doi:10.1186/s12944-020-01345-0.