Epicardial adipose tissue and idiopathic deep venous thrombosis: an association study

Epicardial fat (EpiF) reflects abdominal visceral adiposity and visceral fat plays an important role in the development of an unfavorable metabolic and atherosclerosis risk profile. An increased cardiovascular risk has been evidenced in patients with deep venous thrombosis (DVT). Advancing age is characterized by alterations of body fat mass and function In this study we studied the association between EpiF, DVT, age, obesity and other atherosclerosis risk factors.

77 patients were recruited: 44 men and 33 women, 38 without DVT (65.9 ± 16.3 years, range 26-92 years) and 39 with DVT (65.4 ± 17.2 years, range 28-90 years). The study design was balanced for established atherosclerosis risk factors (gender, obesity, smoking habits, dyslipidemia, diabetes mellitus, arterial hypertension), for previous cardiovascular events, for use of statins and platelet anti-aggregating agents. Multivariate regression model and RECPAM regression tree were used to study the association between EpiF thickness and the other potential risk factors. Patients with DVT showed a thicker EpiF with respect to those without DVT (12 ± 2 mm vs. 9 ± 2 mm respectively, p < 0.001). Multivariate linear regression model showed that DVT, obesity and age were positively associated with EpiF thickness after adjusting for the established atherosclerosis risk factors. Furthermore, the RECPAM analysis was performed to evaluate interactions between DVT, age and obesity: four main distinct and homogeneous subgroups of patients in terms of EpiF thickness were identified. The most important variable in partitioning patients was represented, as expected, by DVT (p < 0.001) followed by age (p = 0.004), while obesity did not contribute to the model as well as the other atherosclerosis risk factors. Patients with DVT and older than 41 years of age had higher EpiF thickness in respect of patients with DVT and younger than 41 years of age. In patients without DVT the estimated cut-off age was 50 years, and older patients had thicker EpiF in respect of patients younger than 50 years of age.

DVT should be considered as strongly associated with EpiF thickness. Advancing age (with or without spontaneous DVT) is significantly associated with an increased EpiF thickness. The measurement of EpiF thickness, a valuable marker of cardio-metabolic risk, may represent a useful and reliable method to evaluate cardiovascular risk in patients with idiopathic deep phlebothrombosis.