Unraveling the role of resistin, retinol-binding protein 4 and adiponectin produced by epicardial adipose tissue in cardiac structure and function: evidence of a paracrine effect

Preoperative assessments included echocardiography, coronary angiography, and blood analysis. mRNA expression of resistin, RBP4, and adiponectin was measured in thoracic subcutaneous adipose tissue and two regional epicardial adipose tissue samples, one adjacent to the left anterior descending artery and one adjacent to the right coronary artery. LV ejection fraction correlated negatively with adiponectin mRNA expression near the left anterior descending artery (rho = -0.390, p = 0.025). The E/A ratio, an index of diastolic function, correlated negatively with both resistin (rho = -0.529, p = 0.024) and RBP4 (rho = -0.458, p = 0.049) mRNA expression near the left anterior descending artery. No differences in epicardial adipokine mRNA expression were observed between individuals with and without coronary artery disease in the corresponding coronary artery. Limitations include the cross-sectional design precluding causal inference, a proportion of participants evaluated after recent myocardial infarction, wide distributions of mRNA expression, use of non-parametric tests with lower statistical power, and an imbalanced ratio of CAD to non-CAD participants.