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An increase in epicardial adipose tissue is strongly associated with carotid intima-media thickness and atherosclerotic plaque, but LDL only with the plaque [Anatol J Cardiol]
Anatol J Cardiol. 2017; 17(1): 56-63 | DOI: 10.14744/AnatolJCardiol.2016.6885  

An increase in epicardial adipose tissue is strongly associated with carotid intima-media thickness and atherosclerotic plaque, but LDL only with the plaque

Sinan Altan Kocaman1, Oben Baysan1, Mustafa Çetin2, Tuğba Kayhan Altuner1, Ezgi Polat Ocaklı1, Murtaza Emre Durakoğlugil2, Turan Erdoğan2, Mustafa Remzi Karaoğuz1
1Department of Cardiology, Ankara Güven Hospital; Ankara-Turkey
2Department of Cardiology, Faculty of Medicine, Rize University; Rize-Turkey

Objective: Carotid intima-media thickness (CIMT) is reliable marker of subclinical atherosclerosis and cardiovascular events. Until today, there was no study that investigated whether epicardial adipose tissue (EAT), which is a surrogate for lipid depot in a special visceral tissue or circulating lipids, is more important for CIMT and atherosclerotic plaque.
Methods: Our study, having cross-sectional and prospective observational design, included 252 patients who were admitted to our outpatient clinic. EAT identified as an echo-free space under the pericardial layer on 2-dimensional echocardiography, was measured perpendicularly in front of the right ventricular free wall at end-systole.
Results: EAT significantly correlated with CIMT (r=0.623, p<0.001). CIMT was significantly increased with rising EAT thickness (0.72±0.15 mm, 0.85±0.16 mm, and 0.95±0.12 mm in patients with EAT <5 mm, 5–7, and >7 mm, p<0.001, respectively). Multiple linear regression analysis revealed that age (Beta: 0.406, p<0.001), male gender (Beta: 0.244, p<0.001), and EAT (Beta: 0.450, p<0.001) as independent correlates of CIMT. Otherwise, in logistic regression analysis, only EAT (OR, 1.386; 95% CI, 1.203–1.597, p<0.001) and LDL cholesterol (OR, 1.013; 95% CI, 1.002–1.013, p=0.02) were independent predictors for presence of carotid plaque.
Conclusion: Our study showed that EAT has a relationship with both CIMT and the presence of carotid plaque, but LDL is independently related to the plaque. This finding suggests that EAT thickness may be a risk factor and biomarker, playing an important role beginning from early stages of atherosclerosis, unlike LDL cholesterol, which appear to have a role in later stages of atherosclerosis. (Anatol J Cardiol 2017; 17: 56-63)

Keywords: epicardial adipose tissue, carotid intima-media thickness, LDL cholesterol, atherosclerotic plaque, subclinical atherosclerosis


Sinan Altan Kocaman, Oben Baysan, Mustafa Çetin, Tuğba Kayhan Altuner, Ezgi Polat Ocaklı, Murtaza Emre Durakoğlugil, Turan Erdoğan, Mustafa Remzi Karaoğuz. An increase in epicardial adipose tissue is strongly associated with carotid intima-media thickness and atherosclerotic plaque, but LDL only with the plaque. Anatol J Cardiol. 2017; 17(1): 56-63

Corresponding Author: Sinan Altan Kocaman, Türkiye


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