THE IMMUNOHISTOCHEMISTRY AND MORPHOMETRY STUDY OF THE EPICARDIAL ADIPOSE TISSUE CHANGES IN CORONARY ARTERY DISEASE PATIENTS ON RIGHT ATRIAL APPENDAGES BIOPSIES.

Objective: Epicardial fat is a measurable and modifiable risk factor that can serve as a novel and additional tool for cardiovascular risk stratification. Alterations in epicardial adipose tissue (EAT) biology, including increased fat thickness, inflammation and angiogenesis, have been described in (CAD) patients. Here, we proposed to measure EAT thickness and characterize inflammatory infiltrate and angiogenesis in epicardial adipose tissue in coronary artery disease (CAD) patients with and without chronic heart failure (CHF). We attempted also to identify clinical factors that may predict the development of CAD/cardiac ischemia. Methods: The paper studies the association between the cardiovascular risk factors (CVRFs) and morphological EAT hallmarks (EAT thickness, inflammation and angiogenesis) in patients with CAD. EAT thickness was done by using morphometry based on usual histological stains. Inflammatory cell infiltration and angiogenesis was investigated by immunohistochemical staining, using antibodies against CD68 and CD34 markers, and morphometry was done in 5 random 200+ power fields of EAT on right atrial appendages (RAA) samples subsequently obtained during cardiac surgery. Results: All CAD patients showed CVRFs such as age >50 years, arterial hypertension, smoking, DM, obesity and hyperlipidemia. EAT thickness, macrophage infiltration and angiogenesis of the EAT in the CAD patients (patients) with CHF was greater than that in CAD patients without CHF. Conclusion: EAT thickness, inflammation and angiogenesis is related by age, HTA, HL, obesity and diabetes in patients with CAD and CHF, suggesting that these CV RFs factors may have a role in promoting cardiac ischemia. [ABSTRACT FROM AUTHOR]