We investigated the relationship between epicardial fat volume (EFV) measured by multislice computed tomography (MDCT) and long-term major adverse cardiac events (MACEs). Consecutive patients (n = 564) were enrolled in this retrospective study. Patients were divided into tertiles according to EFV. Patients were followed up for an average of 18 months. Patients in each tertile were similar in terms of gender and risk factors. Patients with greater EFV in the third group were more likely to be overweight (P = .001) and older (P = .001). High-density lipoprotein cholesterol levels were relatively lower in the third tertile (45 ± 9, 45 ± 11, and 43 ± 9 mg/dL, respectively; P = .018). The third group had a significantly higher rate of myocardial infarction (0.6%, 1.1%, and 3.7%, respectively; P = .043). The incidence of MACEs during the follow-up period was highest in the third group 15.9% (4.1%, 7.7%, and 15.9%, respectively; P = .001). Epicardial fat volume measured by MDCT was associated with increased long-term cardiovascular risk.
SacksHSFainJN. Human epicardial adipose tissue: a review. Am Heart J. 2007;153
(6):907–917.
2.
IacobellisGCorradiDSharmaAM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med. 2005;2
(10):536–543.
3.
HoEShimadaY. Formation of the epicardium studied with the scanning electron microscope. Dev Biol. 1978;66
(2):579–585.
4.
ChengK-HChuC-SLeeK-T. Adipocytokines and proinflammatory mediators from abdominal and epicardial adipose tissue in patients with coronary artery disease. Int J Obes. 2008;32
(2):268–274.
5.
MazurekTZhangLZalewskiA. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation. 2003;108
(20):2460–2466.
6.
BacaksızATasalASevgiliE. Epicardial fat thickness in patients with psoriasis vulgaris. Turk Kardiyol Dern Ars. 2014;42
(1):47–54.
7.
BakerARSilva NFdaQuinnDW. Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovasc Diabetol. 2006;5:1.
8.
IacobellisGWillensHJ. Echocardiographic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr. 2009;22
(12):1311–1319.
9.
YusufSHawkenSOunpuuS. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet. 2004;364
(9438):937–952.
10.
IacobellisGRibaudoMCAssaelF. Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab. 2003;88
(11):5163–5168.
11.
NataleFTedescoMAMocerinoR. Visceral adiposity and arterial stiffness: echocardiographic epicardial fat thickness reflects, better than waist circumference, carotid arterial stiffness in a large population of hypertensives. Eur J Echocardiogr J Work Group Echocardiogr Eur Soc Cardiol. 2009;10
(4):549–555.
12.
AhnS-GLimH-SJoeD-Y. Relationship of epicardial adipose tissue by echocardiography to coronary artery disease. Heart Br Card Soc. 2008;94
(3):e7.
13.
NabatiMSaffarNYazdaniJParsaeeMS. Relationship between epicardial fat measured by echocardiography and coronary atherosclerosis: a single-blind historical cohort study. Echocardiography. 2013;30
(5):505–511.
14.
den DekkerMATakashimaRvan den HeuvelER. Relationship between epicardial adipose tissue and subclinical coronary artery disease in patients with extra-cardiac arterial disease. Obesity (Silver Spring). 2014;22
(1):72–78.
15.
WangTLiuQLiuC. Correlation of echocardiographic epicardial fat thickness with severity of coronary artery disease in patients with acute myocardial infarction [published online March 19, 2014.]. Echocardiography. 2014. doi:10.1111/echo.12545.
FlüchterSHaghiDDinterD. Volumetric assessment of epicardial adipose tissue with cardiovascular magnetic resonance imaging. Obesity (Silver Spring). 2007;15
(4):870–878.
18.
GreifMBeckerAvon ZieglerF. Pericardial adipose tissue determined by dual source CT is a risk factor for coronary atherosclerosis. Arterioscler Thromb Vasc Biol. 2009;29
(5):781–786.
19.
HoKKPinskyJLKannelWBLevyD. The epidemiology of heart failure: the Framingham study. J Am Coll Cardiol. 1993;22(4 suppl A):6A–13A.
20.
IacobellisGLeonettiF. Epicardial adipose tissue and insulin resistance in obese subjects. J Clin Endocrinol Metab. 2005;90
(11):6300–6302.
21.
IacobellisGAssaelFRibaudoMC. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res. 2003;11
(2):304–310.
22.
IacobellisGLeonettiFSinghNSharma AM. Relationship of epicardial adipose tissue with atrial dimensions and diastolic function in morbidly obese subjects. Int J Cardiol. 2007;115
(2):272–273.
23.
ChaldakovGNStankulovISAloeL. Subepicardial adipose tissue in human coronary atherosclerosis: another neglected phenomenon. Atherosclerosis. 2001;154
(1):237–238.
24.
WuFZChouKJHuangYLWuMT. The relation of location-specific epicardial adipose tissue thickness and obstructive coronary artery disease: systemic review and meta-analysis of observational studies. BMC Cardiovasc Disord. 2014;14
(1):62.
25.
JeongJ-WJeongMHYunKH. Echocardiographic epicardial fat thickness and coronary artery disease. Circ J. 2007;71
(4):536–539.
26.
ParkJSChoiBJChoiSY. Echocardiographically measured epicardial fat predicts restenosis after coronary stenting. Scand Cardiovasc J. 2013;47
(5):297–302.
27.
AballayLREynardARDíaz MdelPNavarroAMuñozSE. Overweight and obesity: a review of their relationship to metabolic syndrome, cardiovascular disease, and cancer in South America. Nutr Rev. 2013;71
(3):168–179.
28.
ChangYSungEYunKE. Weight change as a predictor of incidence and remission of insulin resistance. PLoS One. 2013;8
(5):e63690.
29.
AlexopoulosNMelekBHArepalliCD. Effect of intensive versus moderate lipid-lowering therapy on epicardial adipose tissue in hyperlipidemic post-menopausal women: a substudy of the BELLES trial (Beyond Endorsed Lipid Lowering with EBT Scanning). J Am Coll Cardiol. 2013;61
(19):1956–1961.
