Epicardial Adipose Tissue Extent: Relationship With Age, Body Fat Distribution, and Coronaropathy

Abstract

Epicardial fat is a relatively neglected component of the heart and could be an important risk factor of cardiac disease. The objective of our study was to assess the relationship between epicardial adipose tissue (EAT) extent, fat distribution, and coronaropathy in a group of adult victims of accidental or suspicious sudden death. In 56 cadavers, we performed 34 measurements of EAT from five computerized photographs of the heart (anterior and posterior faces, and three ventricle transversal slices) and analyzed their relationship with anthropometric markers of adiposity (BMI, waist and leg circumference, thickness of abdominal and thigh subcutaneous adipose tissue (SAT)), with the presence and staging of coronary artery disease (CAD), and with markers of myocardial hypertrophy. Simple linear regressions showed that EAT measurements are highly intercorrelated (r from 0.4 to 0.6, P < 0.001), and correlate with age, waist circumference, and heart weight, and to a lesser extent, with BMI, abdominal SAT thickness, and leg SAT thickness. Multiple regression showed that age, waist circumference, and heart weight significantly and independently correlate with EAT (P < 0.0001). No other anthropometric measurement was found independently correlated with EAT. The EAT/myocardium ratios correlated positively with age and waist circumference. Anterior and posterior areas of EAT were found significantly increased in patients with CAD and correlated positively with CAD staging (P = 0.0034, r = 0.38). Anterior EAT surface was found positively associated with CAD (P = 0.01), independently of age and other adiposity measurements. Prospective studies are needed to assess the risk of occurrence/progression of CAD that relate to EAT excess.

Epicardial Fat Volume and Aortic Stiffness in Healthy Individuals: A Quantitative Cardiac Magnetic Resonance Study

“…We observed that aging was also associated with an increase in epicardial fat volume which may be due to a loss of lean body mass with an increase in fat mass and redistribution to the trunk and viscera which occurs with aging [20]. In contrast to the aortic PWV, the epicardial fat volume was significantly associated with BMI which is in concordance with previous studies [21,22]. We also observed a significant relationship between the epicardial fat volume and the aortic PWV.…”

Assessment of epicardial fat volume and myocardial triglyceride content in severely obese subjects: relationship to metabolic profile, cardiac function and visceral fat

“…In agreement with previous autopsy studies, or studies using Cardiac adiposity and heart function in obesity B Gaborit et al echography or computed tomography, EFV increases with age, BMI and waist circumference. 15,16,37,42 Surprisingly, EFV was not correlated with LV mass or EDV. Previous studies showed similar results.…”

“…25 EFV is an important fat depot and its abundance was clearly associated with the presence and severity of coronaropathy. 8,15,40 An inflammatory profile in patients with coronary disease was also enlightened, suggesting a pathophysiological link between EFV and the development or aggravation of coronaropathy. 5,8,9,41 This study provides a detailed characterization of the metabolic, inflammatory and cardiovascular parameters associated with EFV.…”

“…8,9 It has been shown that this ectopic fat is associated with the development of atherosclerotic coronary artery disease. [8][9][10][11][12][13][14][15][16] Its anatomic location, without any barrier to the adjacent myocardium, enables local paracrine interaction between EF and the myocardium, suggesting that EF could also have a functional and mechanical role in obesity-related dilated cardiomyopathy. 17,18 Myocardial lipid deposition (that is, lipid accumulation in the myocyte cytoplasm) is also a marker of ectopic fat accumulation.…”

Does Echocardiographic Epicardial Adipose Tissue Thickness become a Useful Biomarker?

“…Excessive EAT has been reported to be associated with known cardiovascular risk factors 1,2) . Moreover, several investigators have shown that quantity of EAT can be a marker for the presence and severity of coronary artery disease (CAD) [3][4][5][6] . Computed tomography and Magnetic resonance imaging provide volumetric measurement of EAT, whereas echocardiography determines only the thickness of regional EAT.…”