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Relation of Echocardiographic Epicardial Fat Thickness and Myocardial Fat

https://doi.org/10.1016/j.amjcard.2010.01.368Get rights and content

Epicardial and myocardial fats increase with degree of visceral adiposity and possibly contribute to obesity-associated cardiac changes. Echocardiographic epicardial fat thickness is a new and independent marker of visceral adiposity. The aim of this study was to test whether echocardiographic epicardial fat is related to myocardial fat. Twenty consecutive Caucasian men (body mass index 30.5 ± 2 kg/m2, 42 ± 7 years of age) underwent transthoracic echocardiography for epicardial fat thickness, morphologic and diastolic parameter measurements, hydrogen-1 magnetic resonance spectroscopy for myocardial fat quantification, and magnetic resonance imaging for epicardial fat volume estimation. Hydrogen-1 magnetic resonance spectroscopic myocardial fat content, magnetic resonance imaging of epicardial fat volume, and echocardiographic epicardial fat thickness range varied from 0.5% to 31%, 4.5 to 43 ml, and 3 to 15 mm, respectively. Myocardial fat content showed a statistically significant correlation with echocardiographic epicardial fat thickness (r = 0.79, p <0.01), waist circumference (r = 0.64, p <0.01), low-density lipoprotein cholesterol (r = 0.54, p <0.01), plasma adiponectin levels (r = −0.49, p <0.01), and isovolumic relaxation time (r = 0.59, p <0.01). However, multivariate linear regression analysis showed epicardial fat thickness as the most significant independent correlate of myocardial fat (p <0.001). Although this study is purely correlative and no causative conclusions can be drawn, it can be postulated that increased echocardiographic epicardial fat accumulation could reflect myocardial fat in subjects with a wide range of adiposity.

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Methods

Twenty consecutive Caucasian men (mean body mass index 30.5 ± 2 kg/m2, range 25 to 36, mean age 42 ± 7 years) who were referred to our department for cardiometabolic risk assessment were recruited for transthoracic 2-dimensional guided M-mode echocardiography, hydrogen-1 (1H) magnetic resonance (MR) spectroscopy, cardiovascular MR imaging, and anthropometric and blood measurements. Patients with signs, symptoms, or clinical history of coronary artery disease, heart failure, diabetes mellitus,

Results

Subjects' clinical characteristics are presented in Table 1. Cardiac imaging parameters are presented in Table 2.1H-MR spectroscopic myocardial fat content, MR imaging of epicardial fat volume, and echocardiographic epicardial fat thickness were from 0.5% to 31%, 4.5 to 43 ml, and 3 to 15 mm, respectively. Intra- and interobserver reproducibilities of epicardial fat thickness were excellent (intraclass correlation coefficient 0.90 and 0.87, respectively). Correlation between epicardial fat

Discussion

The independent and strong relation of echocardiographic epicardial fat thickness and myocardial fat in subjects with a wide range of adiposity represents the main and novel finding of this study. Our study also suggests that epicardial fat thickness, as measured by standard cardiac ultrasound, may serve a predictor of myocardial fat content better than waist circumference and other more traditional biochemical risk factors.

Myocardial fat has been previously associated with increased visceral

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