Assessment Of Epicardial Adipose Tissue Research Articles

Open-bore MRI Scanner Assessment of Epicardial Adipose Tissue after Bariatric Surgery: A Pilot Study.

The recognition of epicardial adipose tissue (EAT) as a cardiac risk factor has increased the interest in strategies that target cardiac adipose tissue. The effect of bariatric and metabolic surgery (BMS)-induced weight loss on EAT volume was evaluated in this study. Fifteen bariatric patients, with (MS) or without (wMS) Metabolic Syndrome, underwent magnetic resonance imaging (MRI) using an open-bore scanner to assess EAT volume, visceral adipose tissue (VAT) thickness, and other cardiac morpho-functional parameters at baseline and 12 months after BMS. Nine patients underwent laparoscopic sleeve gastrectomy (LSG), and 6 patients underwent Roux-en-Y Gastric Bypass (RYGBP). EAT volume significantly decreased in all the patients 12 months post-BMS from 91.6 cm3 to 67.1 cm3; p = 0.0002 in diastole and from 89.4 cm3 to 68.2 cm3; p = 0.0002 in systole. No significant difference was found between the LSG and RYGBP group. Moreover, EAT volume was significantly reduced among wMS compared with MS. In particular, EAT volume in diastole was significantly reduced from 80.9 cm3 to 54.4 cm3; p = 0.0156 in wMS and from 98.3 cm3 to 79.5 cm3; p = 0.031 in MS. The reduction was also confirmed in systole from 81.2 cm3 to 54.1 cm3; p = 0.0156 in wMS and from 105.7 cm3 to 75.1 cm3; p = 0.031 in MS. Finally, a positive correlation was found between EAT loss, BMI (r = 0.52; p = 0.0443) and VAT (r = 0.66; p = 0.008) reduction after BMS. These findings suggest that EAT reduction may be a fundamental element for improving the cardio-metabolic prognosis of bariatric patients. Moreover, this is the first study performed with an open-bore MRI scanner to measure EAT volume.

Deep learning analysis of epicardial adipose tissue to predict cardiovascular risk in heavy smokers

BackgroundHeavy smokers are at increased risk for cardiovascular disease and may benefit from individualized risk quantification using routine lung cancer screening chest computed tomography. We investigated the prognostic value of deep learning-based automated epicardial adipose tissue quantification and compared it to established cardiovascular risk factors and coronary artery calcium.MethodsWe investigated the prognostic value of automated epicardial adipose tissue quantification in heavy smokers enrolled in the National Lung Screening Trial and followed for 12.3 (11.9–12.8) years. The epicardial adipose tissue was segmented and quantified on non-ECG-synchronized, non-contrast low-dose chest computed tomography scans using a validated deep-learning algorithm. Multivariable survival regression analyses were then utilized to determine the associations of epicardial adipose tissue volume and density with all-cause and cardiovascular mortality (myocardial infarction and stroke).ResultsHere we show in 24,090 adult heavy smokers (59% men; 61 ± 5 years) that epicardial adipose tissue volume and density are independently associated with all-cause (adjusted hazard ratios: 1.10 and 1.38; P < 0.001) and cardiovascular mortality (adjusted hazard ratios: 1.14 and 1.78; P < 0.001) beyond demographics, clinical risk factors, body habitus, level of education, and coronary artery calcium score.ConclusionsOur findings suggest that automated assessment of epicardial adipose tissue from low-dose lung cancer screening images offers prognostic value in heavy smokers, with potential implications for cardiovascular risk stratification in this high-risk population.

Diagnostic value of Multi Detector Computed Tomography in Assessment of Epicardial Adipose Tissue with Coronary Artery Disease

Diagnostic value of Multi Detector Computed Tomography in Assessment of Epicardial Adipose Tissue with Coronary Artery Disease

Epicardial adipose tissue assessment and current status of clinical application in children

心外膜脂肪组织（EAT）是位于心包脏层与心肌之间的脂肪组织。生理状态下，EAT具有参与代谢、提供热量以及机械保护的作用；病理状态下，EAT通过参与内皮功能、凝血和炎症相关的细胞因子分泌影响心血管功能。EAT可由影像学方法如经胸超声心动图、计算机断层扫描、心脏磁共振成像、正电子发射计算机断层显像进行定性和定量评价。EAT与儿童的肥胖、心血管疾病、遗传代谢疾病、炎症疾病、胰岛素抵抗及糖尿病的发生发展和远期预后有密切联系，可帮助儿童疾病的疗效评价、预后分析、危险分层、远期管理等，了解EAT与儿童相关疾病的联系具有重要的临床意义。该文就EAT的病理生理、评估方法和在儿童疾病的临床应用等方面作一综述，旨在为儿童EAT的量化及预测相关疾病的发生发展提供帮助。.

Echocardiographic assessment of epicardial adipose tissue: A marker of coronary artery disease

Recent studies have shown that epicardial adipose tissue (EAT) can be used as a cardiovascular risk evaluation tool. Coronary artery disease (CAD) assessment still to be a challenge with non-invasive explorations. Thus, we searched for a correlation between EAT and coronary artery disease. This is a prospective descriptive study that included 100 consecutive patients admitted to the cardiology department of the hospital of the internal security forces of Marsa and having consulted between November 2020 and April 2021 for symptoms that required coronary angiography. The mean age was 58 ± 12 years, with a masculine predominance (sex ratio = 6.14). Dyslipidemia and hypertension were the most common cardiovascular risk factors (86% and 57%, respectively). The median Gensini score was 8.5 [1–37] while the mean values of mean end-diastolic EAT (MEDE) and mean end-systolic EAT (MESE) were 3.3 ± 8 mm and 5.1 ± 1.3 mm, respectively. Thirty patients had a normal angiogram (Gensini score = 0, 30%), 29 patients had mild CAD (Gensini score = 1–19, 29%), and 41 patients had obstructive/severe CAD (Gensini score > 19, 41%). In univariate analysis, MEDE and MESE were significatively different between the tertiles of Gensini score (combined P < 0.001 for both). In bivariate analysis, there was a positive and moderate to strong significant correlation between EAT and Gensini score (MEDE: P < 0.001; r = 0.590, MESE: P < 0.001; r = 0.557). The analysis of receiver operating characteristic curve showed that a MEDE > 3.4 (sensibility = 80%, specificity = 72%) and a MESE > 5 (sensibility = 78%, specificity = 73%) can predict high Gensini score (OR = 11; 95% CI: 4.23–29; P < 0.001 and OR = 8; 95% CI: 3.21–20.4; P < 0.001, respectively). Echocardiographic measurement of the EAT is a useful non-invasive tool that can be used to predict obstructive CAD.

Assessment of epicardial adipose tissue on virtual non-contrast images derived from photon-counting detector coronary CTA datasets

ObjectivesTo assess epicardial adipose tissue (EAT) volume and attenuation of different virtual non-contrast (VNC) reconstructions derived from coronary CTA (CCTA) datasets of a photon-counting detector (PCD) CT-system to replace true non-contrast (TNC) series.MethodsConsecutive patients (n = 42) with clinically indicated CCTA and coronary TNC were included. Two VNC series were reconstructed, using a conventional (VNCConv) and a novel calcium-preserving (VNCPC) algorithm. EAT was segmented on TNC, VNCConv, VNCPC, and CCTA (CTA-30) series using thresholds of −190 to −30 HU and an additional segmentation on the CCTA series with an upper threshold of 0 HU (CTA0). EAT volumes and their histograms were assessed for each series. Linear regression was used to correlate EAT volumes and the Euclidian distance for histograms. The paired t-test and the Wilcoxon signed-rank test were used to assess differences for parametric and non-parametric data.ResultsEAT volumes from VNC and CCTA series showed significant differences compared to TNC (all p < .05), but excellent correlation (all R2 > 0.9). Measurements on the novel VNCPC series showed the best correlation (R2 = 0.99) and only minor absolute differences compared to TNC values. Mean volume differences were −12%, −3%, −13%, and +10% for VNCConv, VNCPC, CTA-30, and CTA0 compared to TNC. Distribution of CT values on VNCPC showed less difference to TNC than on VNCConv (mean attenuation difference +7% vs. +2%; Euclidean distance of histograms 0.029 vs. 0.016).ConclusionsVNCPC-reconstructions of PCD-CCTA datasets can be used to reliably assess EAT volume with a high accuracy and only minor differences in CT values compared to TNC. Substitution of TNC would significantly decrease patient’s radiation dose.Key points• Measurement of epicardial adipose tissue (EAT) volume and attenuation are feasible on virtual non-contrast (VNC) series with excellent correlation to true non-contrast series (all R2>0.9).• Differences in VNC algorithms have a significant impact on EAT volume and CT attenuation values.• A novel VNC algorithm (VNCPC) enables reliable assessment of EAT volume and attenuation with superior accuracy compared to measurements on conventional VNC- and CCTA-series.

Importance of cardiac imaging assessment of epicardial adipose tissue after a first episode of myocardial infarction.

Over the past years, information about the crosstalk between the epicardial adipose tissue (EAT) and the cardiovascular system has emerged. Notably, in the context of acute myocardial infarction (AMI), EAT might have a potential role in the pathophysiology of ventricular structural changes and function, and the clinical evolution of patients. This study aims to assess the impact of EAT on morpho-functional changes in the left ventricle (LV) and the outcome of patients after an AMI. We studied prospectively admitted patients to our hospital with a first episode of AMI. All patients underwent percutaneous coronary intervention (PCI) during admission. Transthoracic echocardiography (TTE) was performed within 24-48 h after PCI, as well as blood samples to assess levels of galectin-3 (Gal-3). Cardiac magnetic resonance (CMR) was performed 5-7 days after PCI. Clinical follow-up was performed at 1 and 5 years after MI. Mean age of our cohort (n = 41) was 57.5 ± 10 years, and 38 (93%) were male. Nine patients had normal BMI, 15 had overweight (BMI 25-30), and 17 were obese (BMI > 30). Twenty three patients (56%) had ≥ 4 mm thickness of EAT measured with echo. In these patients, baseline left ventricular ejection fraction (LVEF) after AMI was significantly lower, as well as global longitudinal strain. EAT thickness ≥ 4 m patients presented larger infarct size, higher extracellular volume, and higher T1 times than patients with EAT < 4 mm. As for Gal-3, the median was 16.5 ng/mL [12.7-25.2]. At five-year follow-up 5 patients had major cardiac events, and all of them had EAT ≥ 4 mm. Patients with EAT >4 mm have worse LVEF and GLS, larger infarct size and longer T1 values after a MI, and higher levels of Gal-3. EAT >4 mm was an independent predictor of MACE at 5-year follow-up. EAT thickness is a feasible, noninvasive, low-cost parameter that might provide important information regarding the chronic inflammatory process in the myocardium after an infarction.

The Importance of the Assessment of Epicardial Adipose Tissue in Scientific Research.

Epicardial adipose tissue (EAT) exhibits morphological similarities with pericardial adipose tissue, however, it has different embryological origin and vascularization. EAT is a metabolically active organ and a major source of anti-inflammatory and proinflammatory adipokines, which have a significant impact on cardiac function and morphology. Moreover, it can regulate vascular tone by releasing various molecules. The relationship between EAT and cardiovascular disease and diseases of other organ systems is now considered a common discussion subject. The present clinical review article summarizes the epidemiological findings based on imaging techniques in studies conducted so far. In conclusion, evaluation of the epicardial adipose tissue constitutes a helpful scientific parameter, which can be assessed by means of different diagnostic imaging examinations.

Role of multislice computed tomography in assessment of epicardial adipose tissue in coronary artery diseases

Background This study aims to evaluate the relationship between epicardial fat volume and the severity of coronary artery disease (CAD) using multislice computed tomography (CT) coronary angiography. Patients and methods This was prospective study conducted in Misr Radiology Center, International Medical Center, and National Heart Institute and included 70 patients with clinical suspicious of CAD. They were aged from 35 to 73 years, with a mean age of 53.6±9.6 years. Results The study was performed on 70 patients with clinical suspicion of CAD. They were referred to undergo CT coronary angiography in the period from January 2018 to December 2019. They aged from 35 to 73 years, with a mean age of 53.6±9.6 years. Conclusion In our study, we found that epicardial fat volume is associated with presence and degree of CAD, although most multidetector CT fat depot measurements showed good association and correlation with grade of CAD.

Assessment of epicardial adipose tissue by echocardiography for risk stratification in young adults with abdominal obesity

The negative role of epicardial adipose tissue (EAT) in the development of cardiovascular diseases makes it possible to use it as a new marker for assessing and predicting cardiovascular risk in obese individuals. Computed tomography (CT) remains the gold standard for determining adipose tissue distribution. However, this method is costly and time consuming. There is a need to search for less expensive and informative methods for visualizing visceral obesity, in particular, EAT.&#x0D; Aim. To study the link between EAT thickness, measured with echocardiography (EchoCG), and adipose tissue distribution, structural and functional parameters of the left ventricle (LV) in young people with abdominal obesity.&#x0D; Materials and methods. The study included 104 patients (62.5% women, 37.5% men) aged 1845 years, with abdominal obesity. In all subjects, height, body weight and waist circumference were measured and body mass index was calculated. EchoCG was performed to assess the LV structural and functional parameters and to determine EAT thickness. The volumes of subcutaneous, visceral, epicardial fat were determined by CT.&#x0D; Results. Correlation analysis revealed a significant link between EAT thickness, measured with EchoCG, both in systole and diastole, and EAT volume, measured with multispiral CT (EAT in systole r=0.85, p0.05, EAT in diastole r=0.68, p0.05). A correlation was revealed between EAT thickness and intra-abdominal fat (EAT in systole r=0.59, p0.05, EAT in diastole r=0.51, p0.05). Analysis showed that the greatest contribution to the risk for LV diastolic dysfunction is made by EAT volume. Using ROC analysis, it has been shown that EAT can be used to identify patients with LV diastolic dysfunction.&#x0D; Conclusion. EAT thickness measured with EchoCG in LV systole closely correlates with EAT and intra-abdominal adipose tissue volumes measured with multispiral CT. EAT thickness in systole more than 7.5 mm, in diastole 4.0 mm can serve as threshold values for assessing cardiovascular risk in obese individuals.

Inter-Software and Inter-Scan Variability Amongst Post-Processing Software Platforms in Measurement of Epicardial Adipose Tissue

There is lack of standardisation of post-processing software platforms in the assessment of epicardial adipose tissue (EAT) on cardiac computed tomography (CT). This study assessed the inter-vendor agreement of EAT volume (EATv) and attenuation (EATa) on both contrast-enhanced (CE) and non-contrast CT (NCT) using freeware imaging software (OsiriX), EAT research-specific software (QFAT), and standard coronary CT reporting software (Vitrea).

Echocardiographic Assessment of Epicardial Adipose Tissue - A Marker of Visceral Adiposity

Visceral adipose tissue predicts an unfavorable cardiovascular and metabolic risk profile in humans. Existing methods to assess visceral adipose tissue have been limited. Thus, echocardiographic assessment of epicardial adipose tissue as a marker of visceral adiposity was suggested. The technique has been shown to be a very reliable method and an excellent measure of visceral adiposity. In this article, epicardial adipose tissue's localization on the heart, function, method of assessment and reliability as a marker of visceral adiposity is briefly reviewed. Areas of the technique requiring further study are identified.

Validation of the echocardiographic assessment of epicardial adipose tissue thickness at the Rindfleisch fold for the prediction of coronary artery disease

Background and AimEchocardiography is a promising technique for the assessment of epicardial adipose tissue (EAT). Increased EAT thickness is associated with different cardiac diseases, including; coronary artery disease (CAD). Since several different echocardiographic approaches have been proposed to measure EAT, the identification of a standardized method is needed. We propose the assessment of EAT maximal thickness at the Rindfleisch fold, the reproducibility of this measurement and its correlation with EAT thickness and volume assessed at cardiac magnetic resonance (CMR). Finally, we will test the predictive role of this measurement on the presence of significant CAD. Methods and ResultsIn 1061 patients undergoing echocardiography, EAT thickness was measured at the level of the Rindfleisch fold. In 70 patients, we tested the relationship between echo-EAT thickness and EAT thickness and volume assessed at CMR. In 499 patients with suspected CAD, undergoing coronary artery angiography, we tested the predictive value of EAT on the presence of significant CAD.Echo-EAT thickness measurements had an excellent reliability as indicated by the inter-observer (ICC:0.97; 95% C.I. 0.96 to 0.98) and intra-observer (ICC:0.99; 95% C.I. 0.98 to 0.99) reliability rates. Echo-EAT thickness significantly correlated with CMR-EAT thickness and volume (p < 0.001). An EAT thickness value >10 mm discriminated patients with significant CAD at coronary angiography (p < 0.001). At multivariable analysis, including demographic data and cardiovascular risk factors, EAT thickness was an independent predictor of significant CAD and showed an additive predictive value over common atherosclerotic risk factors. ConclusionsEchocardiographic assessment of EAT thickness at the level of the Rindfleisch fold represents a simple and trustworthy method. An increased EAT thickness shows an additive predictive value on CAD over common atherosclerotic risk factors, thus suggesting its potential clinical use for CAD risk stratification.

Assessment of epicardial adipose tissue in young obese children

ABSTRACTObjective: Epicardial adipose tissue thickness (EATT) is suggested to play a role in the development of cardiovascular disease. In adolescents it is correlated with BMI z-score, cardiovascular risk factors, and pro- and anti-inflammatory markers. EATT of overweight/obese children was compared with EATT of normal weight peers (cross-sectional design). We investigated the association between EATT, cardiovascular risk factors and pro- and anti-inflammatory markers and the effect of a one year, multidisciplinary, treatment program on EATT in overweight/obese children (longitudinal design).Methods: EATT was measured by echocardiography (25 obese, 8 overweight and 15 normal weight children; median age 5.1 years). In the overweight/obese children blood pressure, lipid profile, glucose, insulin, high sensitive CRP, and adiponectin concentrations were measured. In overweight/obese children participating in a multidisciplinary treatment program, measurements were repeated after 4 and 12 months.Results: EATT was significantly higher in the overweight (median 1.38mm) and obese (median 1.57mm) children compared to normal weight children (median 0.87mm). Among obese children EATT was significantly inversely associated with adiponectin (r = −0.485).Conclusions: EATT is increased in overweight/obese children and is inversely associated with adiponectin. Echocardiographic measurement of EATT is easy and might serve as a simple tool for cardio-metabolic risk stratification.

Original research. The Assessment of Epicardial Adipose Tissue in Acute Coronary Syndrome Patients. A Systematic Review

Abstract Background: This systematic review seeks to evaluate the role of epicardial adipose tissue (EAT), quantified either by thickness, assessed by transthoracic echocardiography, or by volume, assessed by cardiac computed tomography (CT), in the follow-up of patients with acute coronary syndromes (ACS). Method: One-hundred forty-four articles were screened, from which 56 were reviewed in full-text. From those, 47 studies were excluded for the following reasons: they did not meet the inclusion criteria; they were either reviews or meta-analyses; the study cohorts included only stable coronary artery disease patients; they did not state a clear and concise study design, endpoints, or follow-up. The final draft included nine studies for systematic evaluation. Results: Of the 2,306 patients included in the review, 170 underwent cardiac CT while the remaining 2,136 underwent transthoracic echocardiography for the measurement of EAT. The analysis found that the EAT thickness was significantly associated with major adverse cardiovascular events (MACE) rates during hospitalization (OR: -1.3, 95% CI: 1.05-1.62, p = 0.020) and at three years (HR: 1.524, 95% CI: 1.0-2.2, p = 0.038). The included studies found that EAT was correlated with the following clinical and angiographic risk scores for ACS: GRACE (r = 0.438, p &lt;0.001), TIMI risk score (r = 0.363, p = 0.001), SYNTAX score (r = 0.690, p &lt;0.0001; r = 0.610, p &lt;0.01), and Gensini score (r = 0.438, p = 0.001). There was an inverse correlation between ST-segment resolution of &lt;70% after revascularization and EAT (r = −0.414, p = 0.01), and the myocardial blush grade (r = −0.549, p &lt;0.001). The EF aggregation ranged between 2.65 mm and 4.7 mm within the included studies. Conclusions: EAT, evaluated either by echocardiography or cardiac CT, correlates with the severity of coronary lesions, with the clinical and angiographic risk scores for acute coronary syndromes, with indicators for coronary reperfusion, and with short- and long-term MACE rates. Further studies are required to fully elucidate the role of this extensively studied but still novel cardiovascular biomarker as part of a risk prediction tool.

Assessment of epicardial adipose tissue and carotid/femoral intima media thickness in insulin resistance

BackgroundMetabolic syndrome is a combination of multiple cardiovascular (CV) risk factors including insulin resistance (IR). Carotid, femoral intima media thickness (IMT), and epicardial fat thickness (EFT) are considered as novel cardiometabolic risk factors. We aimed to test the hypothesis that carotid, femoral IMT, and EFT are increased in patients with IR. MethodsWe enrolled consecutively and prospectively 113 patients with IR. Then we collected data from an age- and sex-matched control group of 112 individuals without IR. Homeostasis model assessment (HOMA) index value >2.5 was accepted as IR. Patients with diabetes mellitus, CV diseases, systolic heart failure, chronic liver or renal diseases were excluded. On B-mode duplex ultrasound the mean IMT at the far wall of both left and right common carotid/femoral arteries were measured manually. EFT was measured on the free wall of the right ventricle at end-diastole from the parasternal long-axis views by standard transthoracic 2D echocardiography. ResultsBoth carotid IMT and EFT were significantly higher in patients with IR compared to controls (0.80±0.21mm vs 0.60±0.21mm; p<0.001 and 7.34±1.96mm vs 5.22±1.75mm; p<0.001, respectively). However, there were no significant differences in femoral IMT between the groups (0.74±0.20 vs 0.69±0.17; p=0.062). In multivariate linear regression analysis age (β=0.223, p=0.010), 2-h blood glucose (β=0.198, p=0.021), and IR (β=0.369, p<0.001) were independent predictors of EFT. On the other hand age (β=0.363, p<0.001) and IR (β=0.321, p<0.001) were independent predictors of carotid IMT. ConclusionsPatients with IR have increased carotid IMT and EFT, but not femoral IMT. This apparent incoherence may be due to the involvement of carotid arteries prior to femoral arteries in patients with IR.

Relation between Non-Alcoholic Fatty Liver Disease and Epicardial Fat in Metabolic Syndrome

Background:Non-alcoholic fatty liver disease (NAFLD) is becoming recognized as a component of the metabolic syndrome and insulin resistance. There has been recent interest in the association between epicardial fat and atherosclerotic disease with increased risk of cardiovascular mortality and morbidity. Aim of the work: In this study we investigated the relationship between the metabolic syndrome with liver involvement and epicardial fat. Patients and methods: 85 patients who had the criteria of metabolic syndrome are subjected to thorough clinical evaluation. Abdominal circumference, body mass indexand waist/hip ratio were recorded for all patients. Laboratory investigations including urine, complete blood picture, fasting and postprandial blood glucose, uric acid, blood urea and creatinine,C-reactive protein (CRP) , lipid profile, liver enzymes and bilirubin were done to all patients. Ultrasonography was used to grade fatty liver and measure the thickness of epicardial fat. Results: Patients with high ALT levels have significantly higher (p<0.01) AST, fasting blood glucose (FBG), uric acid, triglyceride (TG) level, more epicardial fat and waist circumference (p<0.05) compared to those with normal levels. Patients with high grade of fatty liver have significantly higher total cholesterol, TG, FBG, AST, ALT, uric acid levels, more epicardial fat and waist circumference (p<0.01) compared to those with mild and moderate. ALT, FBG and TG are significantly higher in patients with detectable epicardial fat than those without (p<0.01). There were significant direct correlations between epicardial fat thickness with FBG (r= 0.324; p<0.01), TG (r= 0.217; p<0.05), AST (r= 0.493; p<0.01), ALT (r= 0.561; p<0.01), and grade of fatty liver (r= 0.479; p<0.01). Also there were significant direct correlations between FBG with waist circumference (r= 0.422; p = 0.01), TG level (r = 0.370; p<0.01), HDL-C (r = 0.284; p<0.05) and grade of fatty liver (r = 0.533; p = 0.01). There were significant direct correlations between grade of fatty liver with waist circumference (r= 0.264; p<0.05), TG (r= 0.407; p<0.01), uric acid (r= 0.288; p<0.05), and AST levels (r= 0.642 p<0.01). CRP was found correlated only with liver enzymes (r = 0.481;p<0.05). Simple logistic regression analysis revealed that epicardial fat thickness (mm) showed a trend in patients with NAFLD and metabolic syndrome. Conclusion: Echocardiographic assessment of epicardial adipose tissue, abdominal ultrasound assessment of NAFLD and transaminase level might serve as a reliable marker of visceral adiposity and more severe degree of metabolic syndrome.

Epicardial adipose tissue and coronary artery disease: an article review

Article type Review article Adipose tissue surrounding the heart may contribute in the progression of coronary atherosclerosis due to its proximity to the coronary arteries. In addition, epicardial adipose tissue has paracrine and endocrine functions. It can secrete numerous bioactive molecules. Most previous studies examined the relation between coronary artery disease and epicardial adipose tissue have used echocardiography and have reported controversial results, probably due to differences in measurement techniques and study populations. This study aimed to give a brief review on the value of echocardiographic assessment of epicardial adipose tissue in the prediction of coronary artery disease severity. Epicardial adipose tissue, easily and non-invasively evaluated by transthoracic echocardiography, can be considered as an adjunctive marker to classical risk factors despite all the limitations. Moreover, it might be recommended as a useful quantitative screening examination for the prediction of the presence and the severity of coronary artery disease and the extent of atherosclerosis.

Echocardiographic assessment of epicardial adipose tissue in obese children and its relation to clinical parameters of metabolic syndrome

The aim of the study was to evaluate cardiac function and epicardial adipose tissue (EAT) of obese children with echocardiography and to study the relationship of EAT to other echocardiogrpahic findings and to clinical parameters of metabolic syndrome(MS) in children. This study included 74 obese children and adolescents form the patients attending the obesity clinic of National Research Centre. Metabolic syndrome was determined according to International Obesity Task Force (IOTF) 2007 criteria. Forty leanchildren were included in the study as a control group. All children were subjected to: clinical assessment including standing height, body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Echocardiography examination with measurement of EAT thickness and Biochemical parameters (fasting glucose, insulin, HOMA index, total cholesterol, triglyceride, HDL-C and LDL-C). BMI, SDS BMI, WC, HC and HOMA index were significantly higher in obese compared to lean children P = 0.001. Left atrial (LA) diameter, septal, posterior wall thickness, relative wall thickness and left ventricular mass (LVM) were increased in obese compared to non obese group while LV systolic and diastolic functions did not differ in obese versus lean children P > 0.05. The patients had significantly thicker EAT compared to control P = 0.01. There was a significant correlation between EAT thickness in comparison to BMI, WC, HC, LA diameter, LVM, HOMA, Triglyceride and LDL-C No significant difference in EAT thickness between obese patients with or without metabolic syndrome. Assessment of EAT thickness in routine echocardiographic examinations might be a feasible and reliable method for the evaluation of obesity and its related cardiovascular risks during childhood. There is no significant association between EAT thickness and metabolic syndrome in obese children.

Weight loss in obesity reduces epicardial fat thickness; so what?

the physiological roles of human epicardial adipose tissue (EAT) are not well defined because this strategically located white adipose tissue (WAT) depot is difficult to access and study, and most of the information about it comes from humans with severe cardiac diseases undergoing open heart