title: The Relationship Between Increased Epicardial Fat Thickness and Left Ventricular Hypertrophy and Carotid Intima-Media Thickness in Patients With Nonfunctional Adrenal Incidentaloma.
abstract: BACKGROUND
  Emerging evidences indicate that patients diagnosed with Adrenal Incidentaloma (AI) may present cardiovascular complications. Epicardial fat thickness (EFT) has recently been described as a new risk factor and an active player in metabolic syndrome and cardiovascular disease.
  
  
  OBJECTIVE
  We aimed to evaluate the relationship between EFT and left ventricular hypertrophy and carotid intima-media thickness, which are both strong predictors of cardiovascular morbity and mortality, in patients with nonfunctioning AI.
  
  
  METHODS
  We evaluated 51 patients (36 females and 15 males) diagnosed with AI and 35 (29 females, 6 males) age, gender and body mass index (BMI) matched healthy controls in terms of cardiovascular risk parameters. Epicardial fat was identified as the echo-free space between the outer wall of the myocardium and the visceral layer of the pericardium.
  
  
  RESULTS
  Epicardial fat thickness was significantly higher in patients with AI when compared to the control group (0.89 ± 0.32 cm vs. 0.74 ± 0.26 cm; P = 0.023). left ventricular (LV) mass index and median carotid intima-media thickness (CIMT) were also higher in subjects with AI than in controls (99.8 g/m2vs. 86.9 g/m2; P = 0.024 and 7.5 mm (5.5 - 11.5) vs. 6.5 mm (4.5 - 9.5); P = 0.017). There was a positive correlation between EFT, LV mass index, EFT and CIMT (r = 0.315, P = 0.004; r = 0.363, P < 0.001; respectively).
  
  
  CONCLUSIONS
  In this study we showed that EFT, measured by echocardiography is higher in subjects with AI when compared to healthy controls. epicardial fat thickness had the best independent correlation with AI in multiple logistic regression analysis. Incidentaloma is also associated with increased left ventricular mass index and CIMT. Adrenal incidentaloma patients may show early cardiac changes, such as increased left ventricular mass and increased CIMT.
authors.affiliation: Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey.
authors.forename: Nasiroglu Narin
authors.initials: NN
authors.lastname: Imga
authors.affiliation: Ankara Numune Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Ozgul
authors.initials: O
authors.lastname: Ucar Elalmis
authors.affiliation: Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey.
authors.forename: Mazhar
authors.initials: M
authors.lastname: Muslum Tuna
authors.affiliation: Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey.
authors.forename: Bercem
authors.initials: B
authors.lastname: Aycıcek Dogan
authors.affiliation: Ankara Numune Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Sahin
authors.affiliation: Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Berker
authors.affiliation: Ankara Numune Education and Research Hospital, Department of Endocrinology, Ankara, Turkey; Department of Endocrinology, Faculty of Medicine, Hitit University, Corum, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Guler
keywords: Adrenal Incidentaloma; Atherosclerosis; Epicardial Fat