Recent studies have shown that different visceral fat depots can make a special contribution in development of endocrine and cardiovascular diseases. Epicardial adipose tissue (EAT) is a unique visceral fat depot, closely anatomically and physiologically related to the myocardium. This visceral fat depot has a transcriptome and secret that are very different from fat depots of other localizations. In healthy individuals, the EAT performs a buffer and cardioprotective function, but with the development of pathology, the EAT begins to secrete pro-inflammatory factors, and the synthesis of anti-inflammatory cytokines decreases. This fact is confirmed by numerous studies. A promising area of modern cardiology is the study of the prognostic value of epicardial fat in assessing the risk of cardiovascular disasters and survival of patients with various comorbid conditions. It has been proven, that people even with a normal body mass index have a risk of cardiovascular diseases and complications. People with normal body weight and the presence of visceral obesity have the cardiovascular risk in 2.75 higher, and the risk of death from all causes in 2.08 higher than in people with normal body weight without visceral obesity. Thus, only the use of anthropometric examination methods in practice may be insufficient for the diagnosis of visceral obesity. The most affordable, reproducible, cost-effective method of visualization of epicardial fat in clinic is echocardiography doppler methods. This review is devoted to the possibilities of using ultrasound diagnostics in the assessment of epicardial fat, as well as the possibility of improving the stratification of cardiovascular and metabolic risks based on an additional analysis of the epicardial fat thickness.

Aim. To identify predictors of the severe course of a new coronavirus infection. Materials and methods. A retrospective analysis of 120 clinical case histories of patients hospitalized in hospitals in Tyumen with a confirmed diagnosis of COVID-19 within one year (01.08.202001.08.2021) was carried out. The patients were divided into two groups: 1st with a favorable outcome (n=96), 2nd with an unfavorable (fatal) outcome (n=24). For a more complete analysis, scales for assessing the clinical condition of patients (SHOCK-COVID), severity assessment (NEWS2) were used. Information processing was carried out in the IBM.SPSS.Statistics-19 program (USA). Results. As a result of the study, the median age for the 1st group was significantly lower (58 years) than for patients of the 2nd group (69 years; p=0.029). A certain set of laboratory parameters for group 2 patients deviate significantly from the reference values (C-reactive protein CRP 7.6 [4.7; 15.2] mg/dl, D-dimer 1.89 [1.36; 5.3] mcg/ml, ferritin 605 [446.7; 792] ng/ml). When analyzed in groups, taking into account the main markers of the severity of the disease, using the V.Yu. Mareev CCAS-COVID (Clinical Condition Assessment Scale) scale, for the 1st group, the sum of the set of parameters was 6 [2; 7] points, which corresponds to the average severity of coronavirus infection, for the 2nd group 13 [9; 16] points severe course. For patients of the 2nd group, a significant increase in the indicators of an unfavorable prognosis was revealed in comparison with the 1st group. Conclusion. Thus, in this study, the level of CRP, ferritin, D-dimer, the percentage of lung tissue damage according to computed tomography results, SaO2 were significantly associated with an unfavorable prognosis.

Epicardial adipose tissue (EAT) is a visceral depot of the heart fat, which has high plasticity and directly contact with the myocardium and coronary arteries. Epicardial fat is a unique paracrine organ closely anatomically and physiologically related to the myocardium. Recent studies have repeatedly confirmed the role of epicardial fat in the progression of the cardiovascular diseases. The accumulation of EAT, measured by using new non-invasive imaging techniques, is prospectively associated with the onset and progression of coronary heart disease (CHD) and atrial fibrillation. This review focuses on modern in vivo methods for assessing epicardial fat.