Increased echocardiographic epicardial fat thickness is related to impaired diurnal blood pressure profiles.
OBJECTIVE
Epicardial fat has been proposed as a new cardiometabolic risk factor. Although epicardial fat thickness (EFT) is associated with hypertension, the relationship between diurnal blood pressure profiles and EFT is still unknown. The purpose of this study is to investigate the association between the echocardiographic EFT and diurnal blood pressure profiles in hypertensive patients.


METHODS
After the ambulatory blood pressures of 123 patients were monitored, they were divided into three groups according to the clinical diagnoses: 41 patients (33.3%) were in the normotensive group, 40 patients (32.5%) were in the dipper hypertensive group and 42 patients (34.1%) were in the non-dipper hypertensive group. All participants underwent transthoracic echocardiography and ambulatory blood pressure monitoring to measure the EFT and blood pressure responses.


RESULTS
The mean EFT measurements of the dipper group were significantly higher than the normotensive group (6.5 ± 0.6 vs 5.8 ± 0.6; p < 0.0001). On the other hand, the mean EFTs of the non-dipper group were also significantly higher than the dipper group (7.4 ± 0.7 vs 6.5 ± 0.6, p < 0.0001). An EFT of ≥ 7 mm predicted the non-dipper profile in hypertensive patients with 74% sensitivity and 71% specificity (receiving operator characteristic area under the curve: 0.826, 95% CI 0.738-0.913; p < 0.0001). EFT was associated with both dipper (OR 8.9, 95% CI 3.03-26.3; p < 0.0001) and non-dipper blood pressure profiles (OR 12.3, 95% CI 1.75-86.31; p < 0.0001), and this relationship was also independent from all the risk factors.


CONCLUSIONS
Echocardiographic EFT assessment is independently associated with impaired diurnal blood pressure profiles in the hypertensive individuals. Thus, the echocardiographic assessment of the EFT may be helpful in cardiometabolic risk stratification and therapeutic interventions.
Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey. farukertas@hotmail.com
Faruk
F
Ertas
Hasan
H
Kaya
Halit
H
Acet
Habib
H
Cil
Abdurrahman
A
Akyüz
Yahya
Y
Islamoğlu
Ebru
E
Tekbaş
Zuhal
Z
Aritürk
Mesut
M
Aydin
Serdar
S
Soydinç
D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000473:pathology; D001794:Blood Pressure / Q000502:physiology*; D002940:Circadian Rhythm; D004452:Echocardiography / Q000379:methods; D015150:Echocardiography, Doppler; D005223:Fats; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D010496:Pericardium / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D012307:Risk Factors
D005223:Fats