The Relationship of epicardial adipose tissue to metabolic syndrome and cardiovascular risk factors

Baik, Seung Hee; Ahn, Sung Gyun; Choi, Jung Hyun; Koh, Bo Ram; Yoo, Jun Hwan; Kang, Soo Jin; Choi, Byoung Joo; Choi, So Yeon; Yoon, Myeong Ho; Tahk, Seung Jea; Shin, Joon Han

Abstract

BACKGROUND: Increased adiposity is widely accepted as the main expression of obesity and an important risk factor for the development of cardiovascular and metabolic syndrome. The significance of epicardial adipose tissue (EAT), frequently observed during a transthoracic echocardiographic examination, is not well recognized. The purpose of this study was to investigate the relationship of EAT to metabolic syndrome and cardiovascular risk factors.
METHODS
We collected clinical, biochemical, and anthropometric information from 289 consecutive and prospective patients (147 men; 59+/-11 years) who visited our hospital for a complaint of chest pain. EAT thickness was measured by transthoracic echocardiography on the free wall of the right ventricle in the parasternal long axis and short axis views at the base level during end-diastole.
RESULTS
EAT thickness was significantly increased in 185 (64%) patients with metabolic syndrome as compared with patients without metabolic syndrome (4.3+/-2.5 mm vs. 3.6+/-2.8 mm, p=0.005). By a simple linear regression analysis, EAT was correlated to age (r=0.484, p<0.001), waist circumference (r=0.177, p=0.01), the level of HDL cholesterol (r=-0.182, p=0.001) and log CRP (r=0.268, p=0.012). Multivariate analysis showed that age and log CRP were the independent variables that correlated to EAT thickness.
CONCLUSIONS
These results suggest that echocardiographic EAT should be considered as a new useful imaging indicator of visceral adipose tissue related to metabolic syndrome and cardiovascular disease.