Echocardiographic epicardial fat thickness is associated with arterial stiffness

Epicardial adipose tissue represents visceral adiposity, the early detection of which could be helpful for assessing subclinical target organ damage. Although previous studies have reported a relationship between epicardial fat thickness (EFT) and carotid intima-media thickness, there have been no studies detailing the relationship between EFT and brachial-ankle pulse wave velocity (baPWV).

We consecutively enrolled 655 subjects (445 men, 55 ± 9 years) who underwent echocardiography and baPWV and had an ankle-brachial index greater than 0.95. The subjects were divided into four quartile groups depending on EFT. Subjects were also classified into two groups according to baPWV: group I (324 subjects), baPWV ≤ 1366 cm/s, and group II (331 subjects), baPWV>1366 cm/s.

The EFT in group II was significantly higher than in group I (4.2mm vs. 3.7 mm, p<0.001). There were significant differences in baPWV values among the EFT quartile groups (quartile I, 1327 ± 148.8 cm/s; quartile II, 1371 ± 215.0 cm/s; quartile III, 1434 ± 228.3 cm/s; quartile IV, 1507 ± 233.1 cm/s; p-value<0.001). In multivariate regression models, the highest quartile groups of EFT had higher odds ratios (ORs) for increased baPWV compared with that of the lowest quartile group (OR [95% confidence interval (CI)]: 2.19[1.21-3.95]), irrespective of confounding factors. Moreover, EFT was an independent determinant of baPWV (standard β=0.113, p=0.001).

This study demonstrates an independent relationship between EFT and arterial stiffness, suggesting that echocardiographic EFT measurement could be an easy-to-measure tool for early detection of subclinical target organ damage.