Substantial Changes in Epicardial Fat Thickness After Weight Loss in Severely Obese Subjects

Abstract

We sought to evaluate the effect of weight loss on echocardiographic epicardial fat thickness, as index of visceral adiposity, and whether epicardial fat change after the weight loss can be proportionally different from overall body weight changes and related to cardiac parameters changes in severely obese subjects. This was an interventional study in 20 severely obese subjects (12 women, 8 men, BMI 45 ± 5 kg/m 2 , 35 ± 10 years) who underwent 6-month very low calorie diet weight loss program. Baseline and after 6-month weight loss anthropometrics, echocardiographic epicardial fat thickness, left ventricular mass (LVM), and diastolic function parameters were assessed. Subjects lost 20% of original body weight, BMI reduced by 19% of original BMI, waist circumference decreased by 23% of initial waist circumference. Epicardial fat thickness decreased from 12.3 ± 1.8 to 8.3 ± 1 mm P < 0.001 after the 6-month very low calorie diet, as −32% of baseline epicardial fat thickness. LVM and diastolic function changes were better correlated with epicardial fat changes. We showed that significant weight loss can be associated with significant reduction in the epicardial fat thickness, marker of visceral adiposity in severely obese subjects. Epicardial fat decrease, therefore visceral fat decrease, can be proportionally higher than overall adiposity decrease. Epicardial fat changes are significantly associated with obesity-related cardiac morphological and functional changes during weight loss. Measurement of echocardiographic epicardial fat thickness may provide an additional tool in understanding the metabolic risk associated with variation in fat distribution.

Adipokines and cardiovascular disease: A comprehensive review

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Epicardial Fat in the Maintenance of Cardiovascular Health

“…Weight loss by caloric restriction, 37 exercise, 38 or bariatric surgery 39 in obese patients leads to significant reductions (9%-32%) in epicardial fat thickness. Pharmaceutical treatments associated with thinner epicardial fat target either lipid metabolism or glucose homeostasis.…”

Role of Epicardial Adipose Tissue in Atrial Fibrillation

“…Weight loss has been Epicardial Adipose Tissue in AF Patients shown to lead to marked reductions in pericardial fat and may limit the potentially adverse effects of pericardial fat deposits, including changes in cardiac morphology and function. 13 The effects of some pharmacological therapy on EAT have been evaluated. A recent study showed that treatment with pioglitazone in type 2 diabetic patients with CAD was associated with a reduction in inflammation-related gene expression in EAT.…”