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Echocardiographic Epicardial Adipose Tissue Is Related to Anthropometric and Clinical Parameters of Metabolic Syndrome: A New Indicator of Cardiovascular Risk

Endocrinology, Department of Clinical Sciences, La Sapienza University, 00161 Rome, Italy; and Radiology Department, Ospedale G. Vannini, Istituto Figlie di S. Camillo (F.A.), 00100 Rome, Italy

Address all correspondence and requests for reprints to: Gianluca Iacobellis, M.D., Ph.D., Clinica Medica 2, Dipartimento di Scienze Cliniche, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy. E-mail: gianluca.iaco{at}tin.it.

Metabolic syndrome is related to multiple cardiovascular risk factors. Visceral adipose tissue (VAT) plays a key role in metabolic syndrome. Easy detection of VAT could be an important tool to increase knowledge of metabolic syndrome. The objective of this study was to study the relationship of echocardiographic epicardial adipose tissue to anthropometric and clinical parameters of metabolic syndrome. We selected 72 consecutive subjects, 46.5 ± 17.4 yr of age, with a body mass index between 22 and 47 kg/m². Each subject underwent transthoracic echocardiogram to measure epicardial fat thickness on right ventricle and magnetic resonance imaging to calculate visceral adipose tissue. Anthropometric, metabolic, and cardiac parameters were also evaluated. Echocardiographic epicardial adipose tissue showed a very good correlation with magnetic resonance imaging abdominal VAT and epicardial fat measurement (Bland-Altman plot and linear regression). Multiple regression analysis showed that waist circumference (r² = 0.428; P = 0.01), diastolic blood pressure (r² = 0. 387; P = 0.02), and fasting insulin (r² = 0.387; P = 0.03) were the strongest independent variables correlated with epicardial adipose tissue. Echocardiographic epicardial adipose tissue could be applied as an easy and reliable imaging indicator of VAT and cardiovascular risk.

Abbreviations: BMI, Body mass index; CI, confidence interval; CRP, C-reactive protein; CV, coefficient of variation; 2D, two-dimensional; LDL, low-density lipoprotein; LVM, left ventricular mass; MRI, magnetic resonance imaging; SAT, sc adipose tissue; TAT, total adipose tissue; VAT, visceral adipose tissue.

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