title: Epicardial fat reflects arterial stiffness: assessment using 256-slice multidetector coronary computed tomography and cardio-ankle vascular index.
abstract: OBJECTIVE
  The cardio-ankle vascular index (CAVI) reflects overall arterial stiffness from the aorta to the ankle, independent of blood pressure. We aimed to investigate the association of fat burden assessed by visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and epicardial adipose tissue (EAT) with CAVI in an asymptomatic population.
  
  
  METHODS
  A total of 260 asymptomatic Korean individuals who had CAVI, abdominal computed tomography (CT) and coronary CT were evaluated retrospectively. The VAT, SAT, EAT and SAT to VAT ratio (SVR) were measured and assessed for correlation with CAVI.
  
  
  RESULTS
  Different fat compartments showed different correlations with arterial stiffness as assessed by CAVI. The amount of fat measured by VAT (r= 0.129, p= 0.037), EAT (r=0.193, p= 0.002) and SVR (r=-0.168, p= 0.007) showed a significant correlation with CAVI, whereas the amount of total abdominal fat and SAT did not (p= 0.261 and p= 0.434 respectively). From step-wise multivariate regression analysis including age, pulse pressure, fasting blood sugar level, VAT, SVR and EAT, EAT (p= 0.036) and age (p<0.001) showed significant associations with CAVI. When quartiles of CAVI were assessed, EAT showed serial increment, whereas SVR showed a stepwise decrease from the first quartile to fourth quartile of CAVI (p=0.041).
  
  
  CONCLUSIONS
  VAT, EAT and SVR, which reflect metabolic risk, have shown significant correlations with arterial stiffness measured by CAVI. EAT showed an independent association with arterial stiffness after adjusting for covariables by multivariable correlation analysis. Among the different parameters reflecting fat burden, EAT showed the strongest correlation with CAVI.
authors.affiliation: Department of Internal Medicine, Health System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hyo Eun
authors.initials: HE
authors.lastname: Park
authors.forename: Su-Yeon
authors.initials: SY
authors.lastname: Choi
authors.forename: Hua Sun
authors.initials: HS
authors.lastname: Kim
authors.forename: Min Kyung
authors.initials: MK
authors.lastname: Kim
authors.forename: Sang-Heon
authors.initials: SH
authors.lastname: Cho
authors.forename: Byung-Hee
authors.initials: BH
authors.lastname: Oh
mesh_terms: D000842:Ankle / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D055109:Ankle Brachial Index; D003331:Coronary Vessels / Q000033:anatomy & histology / Q000473:pathology*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D059289:Vascular Stiffness