What is the clinical evidence from this study?

Study design: Cohort. Population: Coronary Artery Disease post-Coronary Artery Bypass Grafting (n=155). Intervention: Overweight (BMI ≥ 25 kg/m²) vs. Normal weight (BMI 18.5-24.9 kg/m²). Primary outcome: Combined adverse changes in NO levels and echocardiographic parameters (OR 1.917, 95% CI 1.204-3.052, p=0.006).

What does this research mean for the field?

Overweight in post-CABG patients independently predicts reduced nitric oxide levels and adverse echocardiographic changes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to assess how epicardial fat thickness and nitric oxide levels relate to echocardiographic measures in overweight patients post-CABG.

April 3, 2026Open Access

Association of Echocardiographic Parameters with Nitric Oxide Levels in Overweight Patients with Coronary Artery Disease after Coronary Artery Bypass Grafting

Key Result

Overweight in post-CABG patients independently predicted reduced nitric oxide levels and adverse echocardiographic changes (OR 1.917).

Key Points

The study aims to assess how epicardial fat thickness and nitric oxide levels relate to echocardiographic measures in overweight patients post-CABG.
Enrolled 155 post-CABG patients categorized by body mass index (BMI)
Assessed clinical, demographic, plasma nitric oxide levels, and echocardiographic parameters
Used regression analysis to identify predictors
Overweight patients showed significantly increased epicardial fat thickness
Plasma nitric oxide levels were significantly lower in overweight patients compared to normal-weight patients

Study Design

Type

Cohort (n=155)

Multicenter

Structured PICO

Does overweight status worsen echocardiographic parameters and nitric oxide levels in post-CABG patients during cardiac rehabilitation?

Population

Adults aged 35-65 years with single-vessel coronary artery disease post-CABG

Intervention

Overweight status (BMI 25-29.9 kg/m²) during cardiac rehabilitation

Comparator

Normal weight status (BMI 18.5-24.9 kg/m²) during cardiac rehabilitation

Outcome

Association between epicardial fat thickness (EFT), nitric oxide (NO) levels, and echocardiographic parameterssurrogate

In post-CABG patients, being overweight is associated with increased epicardial fat thickness, reduced nitric oxide levels, and impaired myocardial diastolic function, highlighting the need for targeted metabolic management during cardiac rehabilitation.

Main Result

Effect estimate: OR 1.917 (95% CI 1.204-3.052)

p-value: p=0.006

Limitations

Single-center study with a limited sample size
Observational design cannot establish causal relationships
Unmeasured confounders including physical activity levels, dietary patterns, and medication adherence
Limited follow-up duration precluding assessment of long-term clinical outcomes

Abstract

Introduction — Overweight and obesity are recognized as significant risk factors for adverse outcomes after coronary artery bypass grafting (CABG). One of the key mechanisms linking obesity to the progression of cardiovascular pathology is endothelial dysfunction, marked by reduced nitric oxide (NO) bioavailability. Objective — To evaluate the association between epicardial fat thickness (EFT), NO levels, and echocardiographic parameters in overweight patients during cardiac rehabilitation after CABG. Methods — We enrolled 155 post-CABG patients stratified by body mass index (BMI). Clinical and demographic characteristics, plasma NO levels, and echocardiographic parameters were assessed. Regression analysis was used to identify predictors. Results — Overweight patients exhibited a statistically significant increase in EFT and a decrease in plasma NO levels compared to normal-weight patients (p

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