title: An increase in epicardial adipose tissue is strongly associated with carotid-intima media thickness and atherosclerotic plaque, but LDL only with the plaque.
abstract: OBJECTIVE
  Carotid intima-media thickness (CIMT) is reliable marker of subclinical atherosclerosis and cardiovascular events. Until today, there was no study that investigated whether epicardial adipose tissue (EAT), which is a surrogate for lipid depot in a special visceral tissue or circulating lipids, is more important for CIMT and atherosclerotic plaque.
  
  
  METHODS
  Our study, having cross-sectional and prospective observational design, included 252 patients who were admitted to our outpatient clinic. EAT identified as an echo-free space under the pericardial layer on 2-dimensional echocardiography, was measured perpendicularly in front of the right ventricular free wall at end-systole.
  
  
  RESULTS
  EAT significantly correlated with CIMT (r=0.623, p<0.001). CIMT was significantly increased with rising EAT thickness (0.72±0.15 mm, 0.85±0.16 mm, and 0.95±0.12 mm in patients with EAT <5 mm, 5-7, and >7 mm, p<0.001, respectively). Multiple linear regression analysis revealed that age (Beta: 0.406, p<0.001), male gender (Beta: 0.244, p<0.001), and EAT (Beta: 0.450, p<0.001) as independent correlates of CIMT. Otherwise, in logistic regression analysis, only EAT (OR, 1.386; 95% CI, 1.203-1.597, p<0.001) and LDL cholesterol (OR, 1.013; 95% CI, 1.002-1.013, p=0.02) were independent predictors for presence of carotid plaque.
  
  
  CONCLUSIONS
  Our study showed that EAT has a relationship with both CIMT and the presence of carotid plaque, but LDL is independently related to the plaque. This finding suggests that EAT thickness may be a risk factor and biomarker, playing an important role beginning from early stages of atherosclerosis, unlike LDL cholesterol, which appear to have a role in later stages of atherosclerosis.
authors: Department of Cardiology, Ankara Güven Hospital; Ankara-Turkey.
authors: Sinan Altan
authors: SA
authors: Kocaman
authors: Department of Cardiology, Ankara Güven Hospital; Ankara-Turkey.
authors: Oben
authors: O
authors: Baysan
authors: Department of Cardiology, Faculty of Medicine, Rize University; Rize-Turkey.
authors: Mustafa
authors: M
authors: Çetin
authors: Department of Cardiology, Ankara Güven Hospital; Ankara-Turkey.
authors: Tuğba
authors: T
authors: Kayhan Altuner
authors: Department of Cardiology, Ankara Güven Hospital; Ankara-Turkey.
authors: Ezgi
authors: E
authors: Polat Ocaklı
authors: Department of Cardiology, Faculty of Medicine, Rize University; Rize-Turkey.
authors: Murtaza Emre
authors: ME
authors: Durakoğlugil
authors: Department of Cardiology, Faculty of Medicine, Rize University; Rize-Turkey.
authors: Turan
authors: T
authors: Erdoğan
authors: Department of Cardiology, Ankara Güven Hospital; Ankara-Turkey.
authors: Mustafa Remzi
authors: MR
authors: Karaoğuz
mesh_terms: D000273:Adipose Tissue / Q000503:physiopathology*; D015415:Biomarkers; D059168:Carotid Intima-Media Thickness; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000503:physiopathology*; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL