title: Association of epicardial fat with left ventricular diastolic function in subjects with metabolic syndrome: assessment using 2-dimensional echocardiography.
abstract: BACKGROUND
  Metabolic syndrome (MetS) is related with left ventricular diastolic dysfunction (LVDD) and poor cardiovascular outcome. Epicardial adipose tissue (EAT) thickness, measured by echocardiography, is increased in subjects with MetS. However, the association of EAT with LV diastolic function has not been evaluated in subjects with MetS.
  
  
  METHODS
  In this retrospective study, EAT thickness was measured in 1,486 consecutive asymptomatic patients with no known heart disease who had transthoracic echocardiography during a self-referred healthcare exam. Subjects with a history of ischemic heart disease, cardiomyopathy or significant valvular heart disease were excluded. LVDD was defined as E/e' ratio ≥ 15. Subjects were grouped into two groups, those with MetS and those without.
  
  
  RESULTS
  MetS was present in 346 subjects. There was no difference in LV systolic function between the two groups. However compared to patients without MetS, patients with MetS had larger left atrium (LA) size and higher E/e' ratio (38 ± 5 versus 35 ± 5 mm for LA and 10.0 ± 3.3 versus 8.7 ± 2.7 for E/e' ratio in subjects with versus without MetS both p < 0.001). LVDD was found in 27 (7.8%) subjects with MetS, compared to 30 (2.6%) subjects without MetS (p < 0.001). In subjects with MetS, EAT was significantly correlated with LVDD, even after adjusting for other cardiometabolic risk factors such as age, systolic blood pressure, BMI, blood glucose and LDL cholesterol (OR 1.845, 95% CI 1.153-2.951, p = 0.011).
  
  
  CONCLUSIONS
  Greater EAT is found in subjects with MetS. EAT is significantly associated with LVDD in subjects with MetS, even after adjusting for other risk factors.
authors.forename: Hyo Eun
authors.initials: HE
authors.lastname: Park
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, 39th FL, Gangnam Finance Center, 737 Yeoksam-dong Gangnam-gu 135-984, Seoul, Korea. sychoi9@gmail.com.
authors.forename: Su-Yeon
authors.initials: SY
authors.lastname: Choi
authors.forename: Minkyung
authors.initials: M
authors.lastname: Kim
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003971:Diastole; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010496:Pericardium / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D016277:Ventricular Function, Left