Adipokines in Coronary Microvascular Dysfunction a Systematic Review Matteo Spezia Alberto Bonato Giulia De Fortunato and Arianna Bossi Introduction Obesity is one of the most diffuse and increasing conditions of our age it is also a wellknown ID: 919938
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Slide1
The
role
of Obesity and Adipokines in Coronary Microvascular Dysfunction: a Systematic Review
Matteo Spezia, Alberto Bonato, Giulia De Fortunato and Arianna Bossi
Slide2Introduction
Obesity
is one of the most diffuse and increasing conditions of our age, it is also a well-known risk factor for cardiovascular diseases Obesity is associated with a low chronic state of inflammation and dysregulation of adipokines secretion that could be linked to
coronary microvascular dysfunction (CMD)
CMD is defined as a reduced coronary reserve flow in absence of obstructive coronary artery disease (CAD)
Slide3Introduction
A substantial proportion of patients with angina symptoms undergoing invasive diagnostic coronary angiography does
not present obstructive coronary artery disease These patients might have an underlying, and often undetectable, microvascular dysfunction The role of obesity in the development of CMD
still remains poorly understood.
Slide4Objective
To aim of the present study is to investigate the crucial role of obesity and its molecular alterations in the pathogenesis, progression and severity of CMD development
Slide5Methods
A systematic review
was performed by searching PubMed, Embase and Cochrane Library database Studies of any level of evidence published in peer reviewed journals were includedPRISMA guidelines were applied and risk of bias was assessed, as well as the
methodological quality After this assessment, we excluded all the articles with serious risk of bias and/or low quality
Slide6Methods
8 articles
on human and animal literature, assessed as medium or high quality, were includedWe examined the data of 593 patients
Slide7Results
Overall,
CFR was shown to be significantly reduced
in patients with obesityThe same trend was found evaluating
pharmacological induced stress MBF, which was reduced in patients with obesity, without obstructive coronary artery disease.
Nevertheless,
MBF at rest did not show a significant difference
in patients with obesity from our analysis.
Slide8Results
The level of adipokines, in particular of
IL-6, TNF-alpha, adiponectin and
leptin resulted increased in patients with abnormal CFR.
Increase in leptin and
CRP
, along with reduction in adiponectin plasma levels in obese individuals, correlated with a significant decrease of stress-induced MBF.
Slide9Limitations
Heterogeneity
of the studies and of the reported dataDifferent methods were used to assess the cardiac functionMost of the included studies were retrospective and cross-sectional but no randomized controlled clinical trial was found
The study is based only on
observational evidence that did not show causation but only association
Slide10Conclusions
Obesity is associated with a significant
higher risk of developing coronary microvascular disfunction, which is reflected by diminished CFR and stress MBF. Systemic inflammation and adipokines imbalance related to obesity has been closely linked to a blunt coronary flow.
Further evidence is required to clear out the role of Obesity from a molecular point of view on the coronary endothelium
Slide11Grazie!
For
any question or comment, you can email me at:matteo.spezia@studenti.unipd.it