title: Visceral adiposity and arterial stiffness: echocardiographic epicardial fat thickness reflects, better than waist circumference, carotid arterial stiffness in a large population of hypertensives.
abstract: OBJECTIVE
  Relationship between obesity and cardiovascular (CV) disease depends not only on the amount of body fat, but also on its distribution. For example, individuals with increased fat accumulation in the abdominal region have atherogenic lipid profiles and are at increased CV risk. The loss of elasticity in medium and large arteries is an early manifestation of atherosclerosis. The aim of this study was to evaluate whether echocardiographic epicardial adipose tissue, an index of cardiac adiposity, is related to carotid stiffness and carotid intima-media thickness (IMT), indexes of subclinical atherosclerosis, better than waist circumference in hypertensive patients.
  
  
  RESULTS
  We studied 459 patients with Grade I and II essential hypertension who were referred to our outpatient clinic over a period from May 2007 to March 2008. The population was first sorted by waist circumference and then by epicardial fat < or = 7 or >7 mm. We measured epicardial fat thickness, waist circumference, carotid artery stiffness, and carotid IMT in all patients. Patients divided according to waist circumference showed no statistical differences in carotid artery stiffness between the two groups. Subjects with epicardial fat >7 mm were older, had higher systolic, diastolic, and pulse pressure, increased left ventricular mass index, carotid IMT, diastolic parameters, and stiffness parameters compared with those with epicardial fat < or = 7 mm (P < 0.001). A positive correlation was found between epicardial fat and age, pulse pressure, stiffness parameters, carotid IMT, systolic blood pressure, and duration of hypertension, and a negative correlation was found with diastolic parameters. Age, carotid IMT, and stiffness parameters were independently related to epicardial fat.
  
  
  CONCLUSIONS
  Our findings indicate that epicardial fat reflects carotid artery stiffness in hypertension-induced organ damage.
authors.affiliation: Department of Cardiothoracic Sciences, Second University of Naples, Monaldi Hospital, Via L. Bianchi 1, Naples, Italy. natalefrancesco@hotmail.com
authors.forename: Francesco
authors.initials: F
authors.lastname: Natale
authors.forename: Michele A
authors.initials: MA
authors.lastname: Tedesco
authors.forename: Rosa
authors.initials: R
authors.lastname: Mocerino
authors.forename: Vincenzo
authors.initials: V
authors.lastname: de Simone
authors.forename: Giovanni M
authors.initials: GM
authors.lastname: Di Marco
authors.forename: Luigi
authors.initials: L
authors.lastname: Aronne
authors.forename: Maria
authors.initials: M
authors.lastname: Credendino
authors.forename: Carmine
authors.initials: C
authors.lastname: Siniscalchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Calabrò
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cotrufo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D004452:Echocardiography; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000000981:diagnostic imaging*; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000473:pathology; D012307:Risk Factors; D055105:Waist Circumference; D055815:Young Adult