Tag Archives: M.D.

Heart fat link to cardiac disease

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A study has found more evidence supporting the role of fat around the heart in promoting atherosclerosis.

New results from the Multi-Ethnic Study of Atherosclerosis (MESA) has showed that pericardial fat is more strongly related to coronary artery plaque than either body mass index (BMI) or waist circumference.

When plaque forms in the arteries, it deposits in an irregular manner, causing thickening of the artery wall on one side, but not the other. The ratio of the thick side to the thin side is referred to as plaque eccentricity and is a strong indicator of heart disease.

While previous studies have looked at the relationship of pericardial fat to atherosclerosis in patients with severe coronary disease, this is the first study to determine the association of pericardial fat on coronary artery plaque burden in asymptomatic individuals.

“The individuals in this study had no symptoms and were otherwise healthy,” said senior author David A. Bluemke, M.D., Ph.D., director of Radiology and Imaging Sciences at the National Institutes of Health (NIH) Clinical Care.

The heart

The heart

“They did not have significant coronary artery narrowing. Yet, despite this, they had coronary plaque that could be detected by MRI,” added Bluemke.

For the study, 183 individuals without clinical cardiovascular disease were recruited from the Baltimore and Chicago field centers of MESA, a study funded by the NIH.

“Pericardial fat is located behind the sternum, around the heart, and we cannot see it except with CT or MRI,” said Bluemke.

“In some people, extra fat forms preferentially in this area. We do not know why. However, extra fat around the heart is generally associated with being overweight or obese,” added Bluemke.


The results showed that pericardial fat volume correlated significantly with the degree of plaque eccentricity in both men and women. After adjustment for BMI, waist circumference, traditional risk factors, C-reactive protein level and coronary calcium content, the relationship between pericardial fat and plaque eccentricity remained significant in men, but not in women.

“The findings indicate yet another reason that obesity is bad for us,” said Bluemke.

“It is particularly bad when the fat forms around the heart, since the heart fat appears to further promote coronary artery plaque,” added Bluemke.

The study has been published online in the journal Radiology.

New simple test for prostate cancer

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A urine test could soon help doctors detect prostate cancer early and better evaluate a patient”s treatment options, according to a new study involving an Indian-origin scientist.

Prostate cancer screening is currently based on a blood test to detect prostate-specific antigen (PSA). But that test often produces false results and leads to unnecessary biopsies.

The new test developed by the University of Michigan Comprehensive Cancer Center and the Michigan Center for Translational Pathology appears to be better at detecting prostate cancer, and could help some men delay or avoid a needle biopsy while pointing out men at highest risk for clinically significant prostate cancer.

The test looks for a genetic anomaly that occurs in about half of all prostate cancers, an instance of two genes changing places and fusing together.

This gene fusion, TMPRSS2:ERG, is believed to cause prostate cancer.

Prostate cancer cells

Prostate cancer cells

Studies in prostate tissues show that the gene fusion almost always indicates cancer. But because the gene fusion is present only half the time, the researchers also included another marker, PCA3. The combination was more predictive of cancer than either marker alone.

“Testing for TMPRSS2:ERG and PCA3 significantly improves the ability to predict whether a man has prostate cancer,” said lead author Scott Tomlins, M.D., Ph.D., a pathology resident at the U-M Health System.

“We think this is going to be a tool to help men with elevated PSA decide if they need a biopsy or if they can delay having a biopsy and follow their PSA and urine TMPRSS2:ERG and PCA3,” he added.

The researchers looked at urine samples from 1,312 men at three academic medical centers and seven community-based hospitals. The men all had elevated PSA levels and had gone on to receive either a biopsy or prostatectomy, surgery to remove their prostates.


The researchers evaluated the urine samples for TMPRSS2:ERG and PCA3 and stratified patients into low, intermediate and high scores, indicating their risk of cancer. They then compared this to biopsy results.

Biopsies indicated cancer in 21 percent of men from the low-score group, 43 percent in the intermediate group and 69 percent in the high group.

Further, the urine test scores correlated with how aggressive the cancer was.

“Many more men have elevated PSA than actually have cancer but it can be difficult to determine this without biopsy. This test will help in this regard. The hope is that this test could be an intermediate step before getting a biopsy,” said senior study author Arul Chinnaiyan, M.D., Ph.D., director of the Michigan Center for Translational Pathology and S.P. Hicks Professor of Pathology at the U-M Medical School.