Table 3.
Studies of therapeutic measures to decrease the epicardial fat volume.
| Author (reference) | Methodology | Conclusions |
|---|---|---|
| Park et al. [157] | Retrospective study in 145 patients who underwent PCI and coronary angiography scheduled for 6 to 8 months later; they underwent two-dimensional TTE in two stages; 82 patients received atorvastatin (20 mg) and 63 patients received simvastatin/ezetimibe (10/10 mg) | The use of statins, particularly atorvastatin, is associated with a reduction in the volume of EAT in patients with CAD; EAT change was 0.47 ± 0.65 mm in the atorvastatin group versus 0.12 ± 0.52 mm in the simvastatin/ezetimibe group; p = 0.001; multivariate analysis: atorvastatin group: OR: 0.509; 95% CI: 0.162–0.855; p = 0.005 |
|
| ||
| Sacks et al. [158] | Study in 55 patients (12 controls) with CAD, MS, or DM who underwent open heart surgery for fat sample acquisition; genetic analysis was performed by RT-PCR; 7 diabetic patients received pioglitazone 25 mg for 24 months (average) | The use of pioglitazone in patients with coronary artery disease and type 2 DM was associated with a decrease in the genetic expression of proinflammatory and anti-inflammatory cytokines in EAT |
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| ||
| Lima-Martínez et al. [159] | Intervention pilot study for 24 weeks in 26 type 2 diabetic patients with HbA1c ≥ 7% on metformin monotherapy; those who met the inclusion criteria received metformin 1000 mg/10 mg sitagliptin and underwent two-dimensional TTE | The addition of sitagliptin to metformin therapy produces a rapid decline in the volume of EAT, thus serving as a noninvasive method (measured by ultrasound) of change in visceral fat during pharmacological interventions (before: 9.98 ± 2.63; after: 8.10 ± 2.11 mm; p = 0.001) |
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| ||
| Elisha et al. [160] | Randomized pilot study intervention for 6 months in 56 patients (36 treated with insulin detemir and 20 with insulin glargine) who underwent two-dimensional TTE | The use of insulin detemir yielded a reduction in the volume of EAT and less fat gain in comparison with the use of insulin glargine (detemir, −1.7 ± 0.52 mm, versus glargine, −1.1 ± 1.6 mm; p < 0.05) |
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| ||
| Kim et al. [161] | Study in 24 obese patients who underwent a 12-week supervised exercise training program (60–70% of the maximal heart rate, 60 min/day, 3 days/wk) besides two-dimensionally guided M-mode TTE | The aerobic training significantly reduced the thickness of the EAT, which was also associated with a decrease in visceral adipose tissue (8.11 ± 1.64 versus 7.39 ± 1.54 mm before and after exercise training, resp.; p < 0.001) |
CAD: coronary artery disease, DM: diabetes mellitus, EAT: epicardial adipose tissue, Hb: hemoglobin, MS: metabolic syndrome, PCI: percutaneous intervention, RT-PCR: reverse transcription polymerase chain reaction, and TTE: transthoracic echocardiogram.