Epicardial fat thickness and left ventricular mass in subjects with adrenal incidentaloma

Abstract

Emerging evidences indicate that patients diagnosed with adrenal incidentaloma may present with cardiovascular complications. Epicardial fat is known to play a role in left ventricle (LV) changes. Whether epicardial fat can be associated with LV mass (LVM) in patients with incidentaloma is unknown. We test the hypothesis that echocardiographic epicardial fat thickness is independently related to LVM in a well-studied group of subjects with adrenal incidentaloma. 46 consecutive patients (age 59 ± 9 years) with imaging diagnosis of adrenal incidentaloma and 30 healthy controls underwent echocardiogram for epicardial fat thickness and LVM measurement. Non-functional incidentaloma was confirmed in 40 subjects, whereas 6 patients were actually diagnosed with mild Cushing's syndrome. Epicardial fat thickness was significantly higher in patients with incidentaloma and mild Cushing's syndrome when compared to controls, (p < 0.01 for both). LVM(h2.7) was higher in subjects with adrenal incidentaloma than in controls and higher in subjects with mild Cushing's syndrome than in those with adrenal incidentaloma (p < 0.05 and p < 0.01). Multiple regression analysis showed that epicardial fat thickness was the best correlate (R (2) = 0.36, β 2.8, p < 0.01) of LVM in overall study patients. We showed for the first time that (1) epicardial fat thickness and LVM are higher in subjects with adrenal incidentaloma and (2) epicardial fat thickness independently correlates with LVM. Echocardiographic epicardial fat may serve as non-invasive marker of visceral fat and earlier cardiac abnormalities in patients with adrenal incidentaloma.

Adrenal gland volume, intra-abdominal and pericardial adipose tissue in major depressive disorder

“…Our finding of a correlation between adrenal gland volume, hypercortisolism and increased PAT may point to the role of HPAA activation promoting cardiovascular risks in depression. Interestingly, a recent study in patients with adrenal incidentalomas also found an association between adrenal gland volume with increased epicardial fat (Iacobellis et al, 2013). Incidentalomas are adrenal masses that are increasingly recognized with the widespread use of thoracic and abdominal imaging, and it has recently suggested that patients with adrenal incidentalomas may have an increased cardiovascular risk (Giordano et al, 2012).…”

“…In patients with adrenal incidentalomas, accumulation of IAT and epicardial adipose tissue has recently been reported (Debono et al, 2013;Iacobellis et al, 2013). Therefore we examined IAT, PAT and adrenal gland volume and aimed at testing the following hypotheses:…”

Metabolic comorbidities in Cushing's syndrome

“…Patients with adrenal adenomas and sCS have been found to have increased LV mass compared to healthy controls and subjects harbouring non-functioning adrenal adenomas (191). Significant structural and functional modifications of the heart and vasculature can also be detected in paediatric CS patients (192).…”

Left ventricular remodeling and epicardial fat volume in obese patients with severe obstructive sleep apnea treated by continuous positive airway pressure

“…We demonstrated here that an increase in EFV is significantly related to LV remodeling. Indeed, the relationship between epicardial fat and LV mass had been established previously in studies carried out in different populations [5][6][7][8], but our study is the first in population of obese patients with severe obstructive sleep apnea treated by a continuous positive airway pressure. Our data are consistent with previous studies supporting a negative role of epicardial fat deposit International Journal of Cardiology 179 (2015) 218-219 on cardiac function rather than a global effect of body volume obesity [9].…”