McKenney-Drake, Mikaela L.Rodenbeck, Stacey D.Bruning, Rebecca S.Kole, AyeeshikYancey, Kyle W.Alloosh, MouhamadSacks, Harold S.Sturek, Michael2018-10-112018-10-112017-05McKenney-Drake, M. L., Rodenbeck, S. D., Bruning, R. S., Kole, A., Yancey, K. W., Alloosh, M., … Sturek, M. (2017). Epicardial Adipose Tissue Removal Potentiates Outward Remodeling and Arrests Coronary Atherogenesis. The Annals of Thoracic Surgery, 103(5), 1622–1630. http://doi.org/10.1016/j.athoracsur.2016.11.034https://hdl.handle.net/1805/17495BACKGROUND: Pericoronary epicardial adipose tissue (cEAT) serves as a metabolic and paracrine organ that contributes to inflammation and is associated with macrovascular coronary artery disease (CAD) development. Although there is a strong correlation in humans between cEAT volume and CAD severity, there remains a paucity of experimental data demonstrating a causal link of cEAT to CAD. The current study tested the hypothesis that surgical resection of cEAT attenuates inflammation and CAD progression. METHODS: Female Ossabaw miniature swine (n = 12) were fed an atherogenic diet for 8 months and randomly allocated into sham (n = 5) or adipectomy (n = 7) groups. Both groups underwent a thoracotomy, opening of the pericardial sac, and placement of radioopaque clips to mark the proximal left anterior descending artery. Adipectomy swine underwent removal of 1 to 1.5 cm2 of cEAT from the proximal artery. After sham or adipectomy, CAD severity was assessed with intravascular ultrasonography. Swine recovered for an additional 3 months on an atherogenic diet, and CAD was assessed immediately before euthanasia. Artery sections were processed for histologic and immunohistochemical analysis. RESULTS: Severity of CAD as assessed by percent stenosis was reduced in the adipectomy cohort compared with shams; however, plaque size remained unaltered, whereas larger plaque sizes developed in sham-operated swine. Adipectomy resulted in an expanded arterial diameter, similar to the Glagov phenomenon of positive outward remodeling. No differences in inflammatory marker expression were observed. CONCLUSIONS: These data indicate that cEAT resection did not alter inflammatory marker expression, but arrested CAD progression through increased positive outward remodeling and arrest of atherogenesis.en-USPublisher PolicyAtherosclerosisCoronary Artery DiseaseCoronary Artery ImagingInflammatory MediatorsObesityArticle