Assessment of epicardial adipose tissue by echocardiography for risk stratification in young adults with abdominal obesity

Abstract

The negative role of epicardial adipose tissue (EAT) in the development of cardiovascular diseases makes it possible to use it as a new marker for assessing and predicting cardiovascular risk in obese individuals. Computed tomography (CT) remains the gold standard for determining adipose tissue distribution. However, this method is costly and time consuming. There is a need to search for less expensive and informative methods for visualizing visceral obesity, in particular, EAT. Aim. To study the link between EAT thickness, measured with echocardiography (EchoCG), and adipose tissue distribution, structural and functional parameters of the left ventricle (LV) in young people with abdominal obesity. Materials and methods. The study included 104 patients (62.5% women, 37.5% men) aged 1845 years, with abdominal obesity. In all subjects, height, body weight and waist circumference were measured and body mass index was calculated. EchoCG was performed to assess the LV structural and functional parameters and to determine EAT thickness. The volumes of subcutaneous, visceral, epicardial fat were determined by CT. Results. Correlation analysis revealed a significant link between EAT thickness, measured with EchoCG, both in systole and diastole, and EAT volume, measured with multispiral CT (EAT in systole r=0.85, p0.05, EAT in diastole r=0.68, p0.05). A correlation was revealed between EAT thickness and intra-abdominal fat (EAT in systole r=0.59, p0.05, EAT in diastole r=0.51, p0.05). Analysis showed that the greatest contribution to the risk for LV diastolic dysfunction is made by EAT volume. Using ROC analysis, it has been shown that EAT can be used to identify patients with LV diastolic dysfunction. Conclusion. EAT thickness measured with EchoCG in LV systole closely correlates with EAT and intra-abdominal adipose tissue volumes measured with multispiral CT. EAT thickness in systole more than 7.5 mm, in diastole 4.0 mm can serve as threshold values for assessing cardiovascular risk in obese individuals.

Keywords

• epicardial adipose tissue
• obesity
• metabolic syndrome
• abdominal obesity
• fat depots
• echocardiography
• diastolic dysfunction
• computed tomography