Threshold values of high-risk echocardiographic epicardial fat thickness.
OBJECTIVE
Echocardiographic epicardial adipose tissue is a new index of cardiac and visceral adiposity with great potential as a diagnostic tool and therapeutic target. In this study, we sought to provide threshold values of echocardiographic epicardial fat thickness associated with metabolic and anthropometric risk factors.


METHODS
Epicardial fat thickness was measured in 246 consecutive white subjects (120 women, 126 men, median age 46 years (30-65), median BMI 32 kg/m(2) (22-52), median waist circumference 100.5 cm (85-140)), who underwent routine transthoracic echocardiogram for standard clinical indications. Metabolic syndrome (MetS), Insulin resistance, BMI, and waist circumference categories were identified and epicardial fat was calculated.


RESULTS
Among 246 subjects, 58% had MetS. These subjects showed median values of epicardial fat thickness of 9.5 and 7.5 mm (in men and women, respectively), significantly higher than those found in subjects without MetS (no MetS) (P < 0.001). Receiver operating characteristics (ROC) analysis showed that epicardial fat thickness of 9.5 and 7.5 mm maximize the sensitivity and specificity to predict MetS, in men and women, respectively. In separate analyses, median epicardial fat thickness values of 9.5 and 7.5 mm were cutoff points associated with high abdominal fat in men and women, respectively. When insulin sensitivity was considered separately, epicardial fat thickness of 9.5 mm was associated with insulin resistance.


CONCLUSIONS
Median values of 9.5 and 7.5 mm should be considered the threshold values for high-risk echocardiographic epicardial fat thickness in white men and women, respectively. Echocardiographic epicardial fat measurement may be of help for cardiometabolic risk stratification and therapeutic interventions targeting the fat.
Iacobellis
Gianluca
G
Department of Medicine, Cardiovascular Obesity Research and Management, McMaster University, Hamilton, Ontario, Canada. gianluca.iaco@tin.it
Willens
Howard J
HJ
Barbaro
Giuseppe
G
Sharma
Arya M
AM
D000328:Adult; D000368:Aged; D004452:Echocardiography / Q000379:methods* / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D008297:Male; D024821:Metabolic Syndrome / Q000000981:diagnostic imaging / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015588:Observer Variation; D010496:Pericardium / Q000000981:diagnostic imaging*; D012372:ROC Curve; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity