title: Epicardial fat thickness in patients with rheumatoid arthritis.
abstract: BACKGROUND
  Epidemiologic data indicates that rheumatoid arthritis is an independent risk factor for cardiovascular disease. Epicardial adipose tissue is a novel cardio-metabolic risk factor. Our aim was to evaluate epicardial fat thickness (EFT) using echocardiography in patients with rheumatoid arthritis compared to healthy control subjects. Secondly, we investigated relationship between epicardial fat thickness and clinical and echocardiographic parameters in patients with rheumatoid arthritis.
  
  
  METHODS
  The study population included 76 consecutive patients with rheumatoid arthritis (64 female; mean age, 53 ±11 years, median disease duration, 7.8 years) and 50 healthy subjects as controls (39 female; mean age, 52 ± 6 years). All patients underwent echocardiography to assess left ventricular diastolic dysfunction, left ventricular hypertrophy and EFT. All values were compared between groups.
  
  
  RESULTS
  EFT was higher in rheumatoid arthritis patients than in healthy controls (0.66±0.20 vs. 0.54±0.18; p= 0.003). Thickness of Intra Ventricular Septum (IVS) (1.1±0.06 and 9.8±0.08; p=0.001) and posterior wall (PW) (0.98±0.05 and 0.93±0.08; p=0.015) was higher in patients with rheumatoid arthritis compared to healthy controls. Early diastolic myocardiac peak velocity or late diastolic mitral peak velocity (E/A) ratio was lower in rheumatoid arthritis patients compared to healthy patients (1.1 ±0.8 and 1.24±0.1 p=0.001) as well as, E/e' was higher in Rheumatoid arthritis (RA) patients than healthy patients. (E/e':8.7±1.6 and 8.0±1.4 p=0.020). In patients with rheumatoid arthritis, EFT was positively correlated with hypertension and duration of disease and E/e' (r: 0.10, p: 0.010, r: 0.306, p: 0.004 and r: 0.465 p: 0.007 respectively) and EFT was negatively correlated with E/A (r: -.262 p:0.022).
  
  
  CONCLUSIONS
  To our knowledge, this is the first report about epicardial adipose tissue in rheumatoid arthritis patients. Epicardial fat thickness as an indicator of cardiovascular involvement was higher in rheumatoid arthritis patients.
authors.affiliation: Department of Cardiology, Bozok University School of Medicine Yozgat, Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Fatma
authors.affiliation: Department of Cardiology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey.
authors.forename: Koc
authors.initials: K
authors.lastname: Bunyamin
authors.affiliation: Department of Physical Medicine and Rehabilitation, Abant Izzet Baysal University School of Medicine, Bolu, Turkey.
authors.forename: Sarikaya
authors.initials: S
authors.lastname: Savas
authors.affiliation: Department of Physical Medicine and Rehabilitation, Bozok University School of Medicine Yozgat, Turkey.
authors.forename: Ucar
authors.initials: U
authors.lastname: Mehmet
authors.affiliation: Department of Cardiology, Bozok University School of Medicine Yozgat, Turkey.
authors.forename: Yazıcı
authors.initials: Y
authors.lastname: Selma
authors.affiliation: Department of Cardiology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey.
authors.forename: Boyraz
authors.initials: B
authors.lastname: Ismail
authors.affiliation: Department of Cardiology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey.
authors.forename: Caglar
authors.initials: C
authors.lastname: Sabri
authors.affiliation: Department of Pathology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey.
authors.forename: Ozyalvacli
authors.initials: O
authors.lastname: Gulzade
authors.affiliation: Department of Cardiology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey.
authors.forename: Donmez
authors.initials: D
authors.lastname: Ibrahim
authors.affiliation: Department of Cardiology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey.
authors.forename: Yazici
authors.initials: Y
authors.lastname: Mehmet
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000473:pathology; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000473:pathology; D016022:Case-Control Studies; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D050152:Intra-Abdominal Fat / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000473:pathology; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*
keywords: Rheumatoid arthritis; cardiac involvement; epicardial fat thickness