An increase in epicardial adipose tissue is strongly associated with carotid-intima media thickness and atherosclerotic plaque, but LDL only with the plaque

Abstract

Objective:Carotid intima-media thickness (CIMT) is reliable marker of subclinical atherosclerosis and cardiovascular events. Until today, there was no study that investigated whether epicardial adipose tissue (EAT), which is a surrogate for lipid depot in a special visceral tissue or circulating lipids, is more important for CIMT and atherosclerotic plaque.Methods:Our study, having cross-sectional and prospective observational design, included 252 patients who were admitted to our outpatient clinic. EAT identified as an echo-free space under the pericardial layer on 2-dimensional echocardiography, was measured perpendicularly in front of the right ventricular free wall at end-systole.Results:EAT significantly correlated with CIMT (r=0.623, p<0.001). CIMT was significantly increased with rising EAT thickness (0.72±0.15 mm, 0.85±0.16 mm, and 0.95±0.12 mm in patients with EAT <5 mm, 5–7, and >7 mm, p<0.001, respectively). Multiple linear regression analysis revealed that age (Beta: 0.406, p<0.001), male gender (Beta: 0.244, p<0.001), and EAT (Beta: 0.450, p<0.001) as independent correlates of CIMT. Otherwise, in logistic regression analysis, only EAT (OR, 1.386; 95% CI, 1.203–1.597, p<0.001) and LDL cholesterol (OR, 1.013; 95% CI, 1.002–1.013, p=0.02) were independent predictors for presence of carotid plaque.Conclusion:Our study showed that EAT has a relationship with both CIMT and the presence of carotid plaque, but LDL is independently related to the plaque. This finding suggests that EAT thickness may be a risk factor and biomarker, playing an important role beginning from early stages of atherosclerosis, unlike LDL cholesterol, which appear to have a role in later stages of atherosclerosis.

Thickness of carotid intima and epicardial fat in rosacea: a cross-sectional study

“… 4 - 6 , 13 - 15 Moreover, Hwang et al reported that EFT is related to the formation of non-calcified coronary plaque in asymptomatic individuals. 16 Similarly, it has been stated that EFT is associated with atherosclerotic plaque and CIMT by Kocaman et al 17 In our study, EFT and CIMT were also strongly correlated.…”

Morphometric measurements of systemic atherosclerosis and visceral fat: Evidence from an autopsy study

“…We did not find an association between PF and carotid or cerebral artery atherosclerosis. In contrast, previous studies have found an association between CIMT and epicardial fat [ 12 , 15 ], but data regarding cerebral arteries were not found in the literature.…”

“…We used morphometric measurements of atherosclerosis rather than using estimated atherosclerosis quantification [ 7 , 8 , 18 , 19 ]. Similarly, we used direct measurements to quantify the visceral fat instead of imaging methods [ 5 , 6 , 12 – 15 , 18 , 19 , 46 ]. Another strength was the larger sample size compared to previous autopsy studies that assessed a maximum of 116 individuals [ 7 , 8 , 18 – 20 ], allowing us to test the interaction between age and visceral fat.…”

“…PF consists of epicardial and paracardial fat, which is located between the visceral pericardium and the myocardium, and outside of the parietal pericardium, respectively [ 10 ]. The association between subclinical atherosclerosis as measured by carotid artery intima-media thickness (CIMT) and AVF [ 11 ] or epicardial fat [ 12 ] has also been described. Aortic atherosclerosis is associated with epicardial fat thickness, but PF was not evaluated [ 13 ].…”

RPS3A positively regulates the mitochondrial function of human periaortic adipose tissue and is associated with coronary artery diseases

“…Recent data in humans suggest that EAT and PAT may be “beige” in morphology, with features of both WAT and BAT 11 – 13 . Measurements of EAT and PAT volume have suggested that the thickness of pericardial adipose tissue, which comprises both EAT and PAT, may serve as a risk factor and biomarker to predict the early stages of atherosclerosis and coronary heart disease (CAD) 14 – 16 . Given the different depot-specific gene expression profiles in “brown” adipocytes, the purpose of this study was to provide a better understanding of the putative thermogenic function of human EAT and PAT using tissues obtained from patients undergoing open heart surgery with and without CAD.…”